Just a quick question...

My morning fasting numbers have gone from 90 - 108 over the last 6 months and just wondering if there is anything I can do to help with this. I know its probably DP but I'm wondering if there is anything I can do that would reduce this? Is it better to have a small snack before bed or no snack?

I'm a thin type 2 or 1.5, exercise 5 times a week and already on low carb diet. I take 2x500mg of met each day but I'm not sure they do anything as my a1c has averaged 5.9 - 6.1 over the last couple of years with and without the met...

Thanks for any advice...

Paul

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If you can get your doctor to prescribe insulin, they tend to start people on basal first. Agree that bolus for meals would be beneficial & you'd only need small doses. What are your typical readings after meals? Postprandial spikes are ones to control.

I think your "true" fasting is what it is when you wake up, not 2.5 hours later racing to the lab. Not a biggie for normal people, but makes a difference to us.

Post meal numbers for me always depends on the meal and exercise afterwards. If I had one piece of bread at lunch (I haven't for about a year now) I would rise to about 12.0 at one hour and then back to about 7.5 at 2 hours. I always walk after dinner for 75-80 mins and this helps my spike so I introduce a few more carbs. I'll usually be around 6.5 after my walk. Sometimes when I cant walk I'm 10.0-12.0, at 1 hour, with the same meal.

Maybe I should just learn to be ok with my current schedule/treatment until numbers start to get higher and then push for the pen...

Thanks, Paul

Hi Paul
My Endo thinks I have MODY and we sound quite a bit alike, my fasting numbers run from 80 to 95. I had no response to Metformin, was doing quite well with a low-carb diet (A1C of 5.9) but I kept losing weight. I asked to be put on insulin and have had wonderful results, I can now eat up to 30 carbs in a meal. I'm not on a basel insulin at all just novolog for meals.

Hi Lisa,

Hi Lisa,

30 carbs per meal would be excellent... I know if I had 30 carbs for lunch I would probably be around 12-15 an hour later :(

I lost quite a bit of weight when first dx because I wasn't sure what to eat and I overreacted. I went down to 142 lbs and at 6-1 that's way too skinny. I still have a hard time putting the weight on (currently 155 lbs) and wish I could introduce a few more carbs at meals.

Maybe its time I started looking for a better Dr (current Dr treats me as a typical type 2 and tells me to watch carbs and exercise... Duh). The problem here in Ontario you need to be refereed to see an Endo and my Dr tells me she has "it" under control...

Thanks, Paul

I would add a vote for finding a new doc. I'm a T1/LADA and I'm currently using only bolus insulin. My fasting BG is fine and even without insulin, my BG will usually come down to an okay level by three hours post-meal even without insulin. However, using insulin gives me way more flexibility re food choices and allows my BG to be <130 most of the time by the two hour post-meal mark. If you're not actually a T2, delaying insulin is probably not helping anything.

Wow. What I want to know, with your morning numbers so tight, is what you're doing right so I can copy you :-).

When I'm having dawn phenomena my morning numbers can rise a couple hundred in just the hour after waking up. (e.g. wake up at 6 with a bg of 90, check again an hour later and I'm at 390). What helps me quash this, is to take my insulin and eat breakfast first thing when I wake up.

yeah...really, that's DP...at least as we know it!

I wish my numbers were that low in the first thing in the morning. My first test is usually between 5:30 am and 7:30 am depending on my work shift. I seem to be between 135 and 166 as a fasting reading. if I test 2 hours after eating it may be around 280 to 325 and after 5 hours just before eating lunnch between noon and 2 pm it drops to 95 to 105. Same kind of readings for just before dinner about 7 pm.
Taking Metformin 500 mg for the blood sugar twice a day after morning test and right after the evening test.

From what you're saying I'd reckon you would do really great with a low dose of insulin. Then you won't just have reasonable numbers (with a lot of hard work), but you will have excellent numbers with moderate (and consistent) work.

If you can find a doctor who will prescribe you insulin might be just the trick. If you can keep your pancrease functioning as well as possible you may go many many years on very low doses (and without having to increase doses much at all).

I guess you'd need to find a doctor of the Bernstein school of thought. HE likes to start people on insulin early to keep things working and complication free...

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