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Medical Forum / Diseases and Disorders / Diabetes / October 2006

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High Glucose in the AM

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Macenheimer - 25 Oct 2006 14:53 GMT
What would cause early morning elevation of glucose levels but normal levels
througout the day? Doc was concerned that my "fasting" glucose levels were
borderline. Because it was always convenient, I had always had labs in the AM.
Because of a scheduling problem at the office, my last blood test wasn't
drawn until closer to noon. That test was <90. I went out and purchased a $80
tester and have been testng at various times of the day and find that my
levels are well within the normal level as long as I test after 10-11AM.
However, pretty much any test taken between the time I wake up (around 8am)
and 10am, the levels are usually towards the high end.

This week = average level 2 hours after eating = 87

I have not had a recent GTT but have had them in the past and they were
normal.
Susan - 25 Oct 2006 14:57 GMT
> What would cause early morning elevation of glucose levels but normal levels
> througout the day? Doc was concerned that my "fasting" glucose levels were
[quoted text clipped - 10 lines]
> I have not had a recent GTT but have had them in the past and they were
> normal.

Have you tested closer to 45-60 minutes after meals?

Your higher morning numbers may be a result of a dawn phenomenon or high
morning cortisol levels (pushes up blood glucose).

If your post meal numbers are higher than you'd want at one hour, but as
low as you say at two hours, you may have lost some first phase insulin
response, but still have a robust second phase, giving you low two hour
readings.

In any case, while you don't mention how high your a.m. readings are,
the fact that your numbers are better the rest of the day suggests that
you can take steps to avoid progression of any IGT you may have toward
diabetes.

Susan
oldal4865 - 25 Oct 2006 19:47 GMT
>What would cause early morning elevation of glucose levels but normal levels
>througout the day? Doc was concerned that my "fasting" glucose levels were
[quoted text clipped - 10 lines]
>I have not had a recent GTT but have had them in the past and they were
>normal.

    A few comments:

1.  Great average bG.

    Note that many of us test most often at our expected "worst" times,
i.e.  about 2 hours after a meal.    There is some debate over using
2-hour-after-eating vs. fasting-in-the-morning blood sugars to evaluate
diabetes.    The U.S. docs favor "fasting in the morning",  European docs
favor "after eating"

2.  Morning is the overall worst time for sugar control for most diabetics.
Our circadian rhythms cause our bodies to release hormones which "order" our
livers to release glucose into our blood.    If your beta cells are in top
notch shape,   they can handle the extra glucose.   If they're not in top
notch shape,  we see morning spikes.   It's called the "Dawn Effect" and
often the "Morning Effect"

Mine is fierce.   Starts around 4 a.m. and lasts till about 10:30 a.m.

3.  Morning spikes are a symptom of oncoming diabetes.    Their presence
suggests that your beta cells are not in top notch shape and that is a sign
of the damage to beta cells which is the proximate cause of diabetes.

4.  Sorry about the $80 meter.   Three suggestions:

          a.  Keep your eyes and ears alerted to free meter deals.   It may
be a 90% rebate offer on a meter on the pharmacy shelf,  or a function at
which a salesman passes out free meters.     You want at least one spare.

In March and November,  many hospitals offer Diabetes Expos.  The Expos
offer free medical tests applicable to diabetes,   free medical lectures,
and booths with the latest in diabetes support equipment.     You can often
talk a meter vendor out of a free meter!

         b.  IMO,  Wal-Mart sets the bench mark for cheap but acceptable
meters.   Their house brand  (Relion) goes for $8 and the strips are about
the cheapest around at ~0.44 - 0.50 apiece.   I have two;  I find them
acceptable though lacking in the fancy bells and whistles of the premium
brands.

        c.  If you need more strips for your current meter,  investigate
Hocks mail order.   I have dealt with them and been happy with their service
and prices.

       http://www.hocks.com/

Regards
 Old Al
Loretta Eisenberg - 25 Oct 2006 22:29 GMT
90 is an absolute good bg.  I dont undersgtand the problem.  From what
you wrote I assume it was under 90.  Has your doctor diagnosed you with
diabetes.  From what you wrote, it doesnt seem to me that you are.  You
could have gotten a meter for free by calling the company as long as you
purchase the strips.

The money is in the strips not the meter.

Until you have something to worry about, worrying about what might be is
a waste of energy and hard on the nerves.

Been that and done that for forty years.

Loretta

--
In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.
Alan S - 25 Oct 2006 23:25 GMT
>What would cause early morning elevation of glucose levels but normal levels
>througout the day? Doc was concerned that my "fasting" glucose levels were
[quoted text clipped - 10 lines]
>I have not had a recent GTT but have had them in the past and they were
>normal.

Two articles to read that may clarify things for you:

Dawn Effect:
http://www.diabetic-talk.org/dp.htm
Structured Testing:
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

Before you over-react, what are the numbers that your doc is
calling "borderline"?

Incidentally, most of my 2hr numbers are in the same range
as yours - but they weren't back when I was diagnosed.

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraltravel.blogspot.com/
latest: Museum Musings
 
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