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Old 10-11-2008, 05:30 AM   #1
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teecee001 HB User
High Blood Sugars

I am trying to help a friend who has Diabetus 2. He has been on 1000 mg metformin twice daily for a year, his blood sugars were to high his last visit. Running between 130 and 180. His A1C was 7.6. The dr has now added Amaryl and he is on 2 mg in the morning and 3 mg in the evening. His blood sugar 2 hrs after supper meal is like 130 which dr says is fine but by 6am its running 160 to 180 and dr wants it like 110. What is going on??? He is watching his carbs. But whats a portion??? How many carbs a day??? He eats whole grains but something is not right. Can anyone help? I am hoping to get back to this web site to see answers.
thanks

 
Old 10-11-2008, 08:54 AM   #2
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Re: High Blood Sugars

A "portion" is 15 grams of carbohydrate, or 60 calories. A small apple. 1 piece of bread. Wheat bread or pumpernickel has the lowest carbs of any of the "standard" breads.

He should try limiting himself to 10 "portions" of carbohydrates per day. This would make up about 40 percent of a 1500 calorie diet.

I am guessing, but I think his sugar level is going low while he sleeps. This causes his liver to output glucose, which results in the fasting high sugar levels. He could try eating 1 portion of his carbohydrate just before bed, or a piece of fruit, small apple, orange, etc.....so that perhaps he wouldn't get
the morning "spike".

You didn't mention if he is overweight, or what his exercise is like. But these are two MAJOR factors in his metabolism. If he is overweight and sedentary, it may require heavy medication like what you are describing to bring his HbA1c into the control regime.

Adding a 20-30 minute brisk walk every day might just be the ticket.

Last edited by tfkeel; 10-11-2008 at 08:58 AM.

 
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Old 10-11-2008, 09:41 AM   #3
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Re: High Blood Sugars

Quote:
Originally Posted by tfkeel View Post
A "portion" is 15 grams of carbohydrate, or 60 calories. A small apple. 1 piece of bread. Wheat bread or pumpernickel has the lowest carbs of any of the "standard" breads.

He should try limiting himself to 10 "portions" of carbohydrates per day. This would make up about 40 percent of a 1500 calorie diet.

I am guessing, but I think his sugar level is going low while he sleeps. This causes his liver to output glucose, which results in the fasting high sugar levels. He could try eating 1 portion of his carbohydrate just before bed, or a piece of fruit, small apple, orange, etc.....so that perhaps he wouldn't get
the morning "spike".

You didn't mention if he is overweight, or what his exercise is like. But these are two MAJOR factors in his metabolism. If he is overweight and sedentary, it may require heavy medication like what you are describing to bring his HbA1c into the control regime.

Adding a 20-30 minute brisk walk every day might just be the ticket.
Thank you so much. He is maybe 15 pounds over weight from what Dr says. His life style for most days is quite sedentary for the moment he has had 5 procedures to his legs in 16 months and one more to go to unclog arteries. They are hoping this is the last. He can walk but not brisk so maybe after this one he will be able to. thank you again and he will i know try a carb before bed.

 
Old 10-11-2008, 04:26 PM   #4
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itotito HB User
Re: High Blood Sugars

Quote:
Originally Posted by teecee001 View Post
know try a carb before bed.
He Could try a few things before bed.

Try some carbs as tfkeel suggested.
He can also try peanut butter that will slowly keep his glucose level stable for a few hours.
He can try Apple cider Vinegar tablets with cheese since this was shown to reduce morning levels, especially for people with high morning levels.
He can try a glass or two of red wine at night
He can try some excercise at night.

Different things help different people. I'm guessing he isn't bouncing off a low, but the best way to be sure would be to measure his levels at 2 or 3 am.

As tfkeel said, excercise helps alot. If he can't walk, swimming may be an option

Last edited by itotito; 10-11-2008 at 06:41 PM.

 
Old 10-12-2008, 01:14 PM   #5
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SamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB User
Re: High Blood Sugars

I tend to agree with TFKeel...it sounds as if he's probably having nighttime lows, and as Itotito pointed out, the only way to be certain is to test his bg's at about 2-3 AM. If he's low then, that means the morning highs are definitely rebound highs, and the way to eliminate them is to eat a small snack before bedtime containing a small amount of carbohydrates along with some protein.

Ruth

 
Old 10-14-2008, 07:53 AM   #6
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Question Re: High Blood Sugars

Thank all of you for your replys but nothing seems to be working. Am i right to think that the amaryl my friend takes is more or less fast acting, as in peaks in 2 to 3 hrs. If so and his bs is say 150 at night then he takes 3mg of Amaryl in the eveing before bed his sugar goes down, then spikes in the morning. Is Amaryl the only drug?? Seems this is causing the problem. Since he was put on it his morning ones havent went down at all. HE is trying very hard to count carbs and doing good i think. He has tried the evening carb to keep it from the morning spike it hasnt worked either. Any suggestions will help. We have made an appty with his dr. Any ideas on meds or is this man just going to have to use insulin? Hes really getting nuts about this and feels defeated.

 
Old 10-14-2008, 08:29 AM   #7
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itotito HB User
Re: High Blood Sugars

Quote:
Originally Posted by teecee001 View Post
Thank all of you for your replys but nothing seems to be working. Am i right to think that the amaryl my friend takes is more or less fast acting, as in peaks in 2 to 3 hrs. If so and his bs is say 150 at night then he takes 3mg of Amaryl in the eveing before bed his sugar goes down, then spikes in the morning. Is Amaryl the only drug?? Seems this is causing the problem. Since he was put on it his morning ones havent went down at all. HE is trying very hard to count carbs and doing good i think. He has tried the evening carb to keep it from the morning spike it hasnt worked either. Any suggestions will help. We have made an appty with his dr. Any ideas on meds or is this man just going to have to use insulin? Hes really getting nuts about this and feels defeated.
Did the Amaryl make his morning levels better, worst or no difference ? I was under the impression they were bad before the Amaryl.

I also did a quick search on Amaryl and it says to take this medication by mouth usually once daily, with breakfast or the first main meal of the day. Is that what his Dr told him ?

Last edited by itotito; 10-14-2008 at 08:34 AM.

 
Old 10-14-2008, 10:29 AM   #8
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Re: High Blood Sugars

His bs have never been over 200. When he went to the dr they were like 140 to 180 in the morning. He was then only on metformin. Then the dr added the amaryl, first 2mg,in morning with metformin, then added 2 mg and so on in the eveing also. SO now its 1000 metformin and 2 mg amaryl in the AM and 1000 metorfin and 3mg amaryl in PM. Actually bs havent changed much at all. EXCEPT when he takes the amaryl in the morning if he doesnt eat enough carbs his bs has dropped in 70's and sometimes in 40's. I was just told by an uncle who is diabetic as long as his doesnt go over 200 he doesnt worry about anything. And this man is 80 and been diabetic like 20 yrs and has no complications from it. SO is 170 or 180 that big a deal?

 
Old 10-14-2008, 12:08 PM   #9
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itotito HB User
Re: High Blood Sugars

Quote:
Originally Posted by teecee001 View Post
His bs have never been over 200. When he went to the dr they were like 140 to 180 in the morning. He was then only on metformin. Then the dr added the amaryl, first 2mg,in morning with metformin, then added 2 mg and so on in the eveing also. SO now its 1000 metformin and 2 mg amaryl in the AM and 1000 metorfin and 3mg amaryl in PM. Actually bs havent changed much at all. EXCEPT when he takes the amaryl in the morning if he doesnt eat enough carbs his bs has dropped in 70's and sometimes in 40's. I was just told by an uncle who is diabetic as long as his doesnt go over 200 he doesnt worry about anything. And this man is 80 and been diabetic like 20 yrs and has no complications from it. SO is 170 or 180 that big a deal?
If he is taking Amaryl at night, maybe it is causing him to go low and bounce up. This was suggested by a few people previously. I thought his bad numbers were before the Amaryl. I think he really owes it to himself to test at 2 or 3 AM to see if that's it. If not, he has dawn phenomenen going on. If he is 170 or 180 for several hours this is not a good thing. I know it's a pain to test during the night, but he needs to know

 
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