Morning highs???

sheila32 · 04-06-2005, 02:03 PM

With the use of metformin/glucophage i have my blood sugar under control for most of the day except in the morning. I have not been on Met for a full month yet so i am thinking mayb it will take a little more time to bring that morning number down. Does anyone else have a high reading in the morning??? Mine is usually from 140 - 170.

stillhavehope · 04-06-2005, 03:17 PM

Sheila ~ Mine was usu in that range 130-160 til my endo upped my avandia from 4mg to 8 mg. Now it is almost always under 120 (90-110) unless I have been very bad the night before!! Do you eat a snack before bedtime? Sometimes you have to make adjustments to that. I am also taking 2000 met (1000 with breakfast & 1000 with dinner). I just needed that extra boost to get the am under control. My last A1c was 5.3 (101 avg). I have also been low carbing and that has helped tremendously.

Good Luck,
Sherry

sheila32 · 04-07-2005, 02:29 PM

I've been low carbing and all my other numbers are fine. It's just the morning one that is giving me a hard time. I take my metformin at 12 hour intervals so i do have something small at night. Maybe the meds will take longer to bring the morning mumbers down or maybe i will need to add another med. Im hoping not.

nobimbo · 04-07-2005, 08:21 PM

High fasting blood sugars are very common, and this is known as the Dawn Phenomenon. What helped mine was to take my Met ER differently than the way it was prescribed (I take 3 in the evening, one in the morning, instead of two in the morning, two at night). Some people find they can reduce theirs by eating a small snack before bed (protein + carbs). Others find a small glass of wine in the evening helps. When I have tried eating very low carb, my morning bs's were actually higher, and I have seen others say the same thing. This is probably because the glycogen stores are depleted more quickly, so the liver makes more sugar (gluconeogenesis) to make up the slack. Here is some more info about the Dawn Phenomenon:

DAWN PHENOMENON

Everyone, diabetic or not, exhibits some Dawn Phenomenon. It is a natural part of our bodies' circadian rhythms. Some have said it is the way our ancestors had the strength to rise and slay a wooly behemoth for breakfast.

Since most of us fast while sleeping, with teenagers a possible exception, our bodies use stored energy during sleep. If you have read our Nutrition Section, you know that the body uses all three macro-nutrients (carbohydrates, proteins, and fats) to store energy.

The most easily used is the storage medium of carbohydrates, called glycogen. Glycogen is made from glucose, and is stored in the liver and muscles. Since it is basically nothing more than a complex matrix of glucose, it is easy for the body to store and use, something the body does all day long. The technical term for the act of creating and storing glycogen is glycogenesis. When the body calls for the conversion of glycogen back to glucose it is called glycogenolysis.

Another macro-nutrient that is available to be converted to glucose is protein. Most of us think of our protein as being stored in muscle, but the body has protective mechanisms to make muscle wasting its last choice. One of the most useful and readily available sources of protein storage is in blood components, i.e., albumin (plasma). The body uses a process performed in the liver to convert amino acids, the building blocks of proteins, into glucose. The name for this process is gluconeogenesis, literally "the creation of new glucose".

So, what does all this have to do with a high fasting BG? Overnight, usually between 4am and 11am, your body releases some hormones. These are Growth Hormone (GH) from the anterior pituitary gland, cortisol from the adrenal cortex, glucagon from your pancreatic alpha-cells, and epinephrine (adrenalin). These hormones cause an increase in insulin resistance, raising your BG. In addition, these hormones trigger glycogenolysis and gluconeogenesis, adding stored or new glucose to your bloodstream. Dawn Phenomenon, and its associated increase in insulin resistance, is the reason most diabetics are far more sensitive to carbs in the morning.

Dealing with Dawn Phenomenon

There are many ways of defeating Dawn Phenomenon. You will have to experiment with the following suggestions to see what works for you.

Try eating no food after dinner. This works for people whose Dawn Phenomenon isn't very strong. Basically, it lowers their baseline BG, so that when DP does hit them, the increase keeps them below a certain level, usually 120 (6.7).
Try eating a small snack of fat and protein before bed. Most find that a tablespoon of peanut butter, or some cheese and deli meat are effective. The theory here is that the slow-digesting fat and protein holds their BG high enough overnight to avoid Somogyi Effect (see below).
Eventually, you will learn how the two disparate approaches above work for you. Hopefully, you will set personal targets to guide you, eg., if my BG is below XXX (insert your target here), I need a snack. If my BG is over XXX, I don't need a snack.
Lastly, the prescription medication Metformin HCl (Glucophage) is often very effective in limiting Dawn Phenomenon for Type-2s and insulin resistant Type-1s. Of course, Type-1s can adjust their basal (slow) insulin regimen to account for Dawn Phenomenon.
Lastly, EAT BREAKFAST. The resulting increase in blood glucose from food will often turn off the continued rise. If you don't, some diabetics will continue to rise until 10-11 am.

Linda

stillhavehope · 04-08-2005, 12:04 PM

Nobimbo~ Wow, thanks for all of that great info. I didn't know there was an actual name for it. I am definitely considering seeing if I change the way I take my met will make any difference. Do you notice the difference right away or does it take a few days to see if the change is working????

Thanks,
Sherry

nobimbo · 04-08-2005, 06:27 PM

Quote:

Originally Posted by stillhavehope

Nobimbo~ Wow, thanks for all of that great info. I didn't know there was an actual name for it. I am definitely considering seeing if I change the way I take my met will make any difference. Do you notice the difference right away or does it take a few days to see if the change is working????

Thanks,
Sherry

Sherry, it took at least a couple of weeks for a noticable change. Around the same time (about a year ago), I also added cinnamon capsules to my regime. My fasting blood sugars had been creeping back up close to 120; they are now 95-105. My last HBA1c was 4.9 (non-diabetic range)!

Linda

stillhavehope · 04-11-2005, 05:50 PM

Linda ~ Cinnamon capsules~ I have been reading that it can help lower your bs #'s. How long have you been on them? Is it something you can get otc at walmart? What dose & regimen do you follow with that? That A1C ROCKS !!!!!!! My last was 5.6 or 5.3 ~ I forget exactly.

Thanks again for even more info. I am always trying to stay on top of the research. I like to hear from actual people that it helped them personally than just reading about random people in research trials or studies.

Sherry

nobimbo · 04-11-2005, 07:58 PM

Quote:

Originally Posted by stillhavehope

Linda ~ Cinnamon capsules~ I have been reading that it can help lower your bs #'s. How long have you been on them? Is it something you can get otc at walmart? What dose & regimen do you follow with that?

The first few months I took one 500 mg capsule of whole cinnamon with breakfast and 1 with dinner. I ordered them online and can't remember the site I got them from, sorry (there are many more sites that carry them now than when I first started on them, so you can just google it). I then switched to a cinnamon extract capsule (200 mg); I take one with breakfast and dinner, sometimes two at a time. I tried to find out the equivalence between the extract and the whole cinnamon (called manufacturers, posted questions on boards), but never could find the answer. The extract is more potent, so I guess the 250 mg is at least equivalent to the 500 mg of whole cinnamon. The brand I'm using right now is Planetary Formulas, and I get it at iherb.com. It is also available at GNC, but is much more expensive there. I hear Walmart does carry cinnamon capsules now. After the research came out about a year ago, the cinnamon capsules became more available. I find it helpful because I want to make sure I take the same amount each day for consistency. One thing to know: it can take a few weeks until there is a noticable difference in IR and blood sugar. The researchers think it works in similar ways as Metformin, which also takes a while to kick in to reverse insulin resistance. Another good thing to know: cinnamon can thin the blood, so it may cause heavier AF. I don't take it during my period because I already am dealing with very heavy bleeding due to a uterine fibroid.

The researchers say they aren't sure about any toxicity issues with large amounts of cinnamon over a long period of time. One of the head researchers patented a special cinnamon extract (called Cinn-U-Lin) that supposedly has only the water soluble parts of cinnamon (it's the oil-soluble parts that are potentially toxic); it is way more expensive than the regular cinnamon caps. Some diabetics make a cinnamon tea, where the oil soluble sludge goes to the bottom and is discarded. I am much too lazy to go through all of that! I don't think the amount of cinnamon I am taking each day will lead to any problems, so I'm sticking with my regimine.

Linda

jennb76 · 04-20-2005, 08:41 PM

Thank you for mentioning this....It's been on my mind, and I couldn't figure out why if I was good the previous day, I wake up to numbers varying from 155 to 170, when after breakfast it's lower (under 140)...I'll have to do some experimenting to see if I can get it down.

stillhavehope · 04-21-2005, 12:21 PM

I found the 500mg at Walmart. It is $4.96 for 100 capsules so I am going to get some next time I go grocery shopping.