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Medical Forum / Diseases and Disorders / Diabetes / August 2007Higher BG in a.m. WHY?
Now here's where I'd like to know opinions and theories. Science is also welcome. Factual science is even better. Why is my husband's (Andrew)BG higher in the morning after eating breakfast? His everyday breakfast includes coffee, w/ heavy cream, stevia, veggies such as zuccini, mushrooms, bell pepper, 4 egg white, 2 tablespoons blue cheese, 2 tablespoons slivered almonds (basic almonds/no roasting or anything else), and 4 stawberries. Please note 50 situps and 50 (man) pushups are done before eating. He's not overweight. I'm not sure if I need to supply any further info. about him here. Thanks for any input. :) > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] > need to supply any further info. about him here. Thanks for any > input. :) Coffee/caffeine with my breakfast makes me need more insulin to balance the carbs (I use a pump). There is also a possibility that the exercise is causing the liver to release glucose, causing a rise in blood sugars. He's type 2 no meds. > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] > need to supply any further info. about him here. Thanks for any > input. :) > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] > need to supply any further info. about him here. Thanks for any > input. :) The body is the most insulin resistant in the morning. >Now here's where I'd like to know opinions and theories. Science is >also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] >need to supply any further info. about him here. Thanks for any >input. :) What are the BG numbers and timing? Pre and post. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraltraveloz.blogspot.com/ latest: Mossman Gorge in the Daintree Rainforest http://loraldiabetes.blogspot.com/ latest: Self-Testing and Type 2 Management Before eating, first wake up--100-112 average After eating--120-180 at one hour after finishing eating. > On Sat, 11 Aug 2007 20:37:38 -0700, SugarQueen > [quoted text clipped - 18 lines] > latest: Mossman Gorge in the Daintree Rainforesthttp://loraldiabetes.blogspot.com/ > latest: Self-Testing and Type 2 Management > Before eating, first wake up--100-112 average > After eating--120-180 at one hour after finishing eating. Ok, so he does start with some dawn phenomenon. I would be testing after the exercise to see if it went higher than the fasting. If so then the exercise would be better done later in the day. Is he trying anything to get the fasting bg down? Bed time snack etc. >> Before eating, first wake up--100-112 average >> After eating--120-180 at one hour after finishing eating. [quoted text clipped - 3 lines] >would be better done later in the day. Is he trying anything to get the >fasting bg down? Bed time snack etc. I agree. Start the exercise about an hour after eating or do it later in the day. Before that it may be exacerbating the liver dump. The meal doesn't look like too much carbs. I would have problems with the strawberries - but others don't so YMMV for those. 120-180? Is there anything different about that menu or exercise timing for the 180? Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraltraveloz.blogspot.com/ latest: Mossman Gorge in the Daintree Rainforest http://loraldiabetes.blogspot.com/ latest: Self-Testing and Type 2 Management > On Sun, 12 Aug 2007 14:58:48 +1000, "Ozgirl" > [quoted text clipped - 25 lines] > latest: Mossman Gorge in the Daintree Rainforesthttp://loraldiabetes.blogspot.com/ > latest: Self-Testing and Type 2 Management Um. No. Other than during the week with the 180 I was doing some training for work which required me to be away from home for a week in a hotel. There was some stress, definitely, and my daily activities were much less physical than during my normal work week. So, yeah, I guess you could chalk it up to a change in output (physical work done) and a lack of change in input (the food I eat). I think, in general that my liver is a little overactive in the mornings because I dread waking up and starting my workday. It is probably trying to kick me out of bed. I cut out the strawberries one of the days when I was gone and it that day my numbers were down by 40 pts (from 180 to 140). I can average around 140 with strawberries with my normal routine, but I think the lack of physical activity and the added stress of being on a business trip just made the whole thing push my BGs over the top. In response to the bad numbers I did start jogging at the end of the day during my trip. By the end of the trip my BGs were 127 after the same meal as before (without the strawberries). I'm thinking I'm just carb intolerant in the morning, as others have mentioned. My wife was curious, as am I, with the actual mechanism that causes the insulin resistance/carb intolerance in the mornings verses other times during the day. I will have to experiment with the exercise after breakfast, although the timing will be all backwards from what I'm used to. Oh, well, in the name of Science.. Thanks for all the help, guys.. Andrew T2 since 9/06 D&E, (Beer), ChickenSalads, Red Wine and Nookie last A1c5.5 , next one coming out this week.... > I will have to experiment with the >exercise after breakfast, although the timing will be all backwards >from what I'm used to. Oh, well, in the name of Science.. Thanks for >all the help, guys.. Took me around 2 years, and a few months of metformin by that time, before I could do any exercise beyond a short stroll before about 11am. It would guarantee a liver dump. I'm assuming I had a fatty liver, which diet, exercise and metformin sorted out. Now I can do a karate workout at 9:30 without a twitch - but for a long time, I could only exercise energetically in the evenings. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25 hood...@yahoo.com wrote: > > >> Before eating, first wake up--100-112 average > > >> After eating--120-180 at one hour after finishing eating. [quoted text clipped - 21 lines] > guess you could chalk it up to a change in output (physical work done) > and a lack of change in input (the food I eat). Without weighing meals, there may have been an inadvertant increase in the amount eaten even if there is not a change in "the food I eat." Moreover, cortisol levels are at their highest in the AM which increases liver production of glucose (gluconeogesis). Be hungry... be healthy... be blessed: http://TheWellnessFoundation.com Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist.... > The meal doesn't look like too much carbs. I would have > problems with the strawberries - but others don't so YMMV > for those. I can't eat berries or melon at breakfast, but am fine with them at lunch or dinner. > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] > need to supply any further info. about him here. Thanks for any > input. :) It is quite common in type 2 to be much more resistant to insulin in the morning, and therefore get higher blood glucose levels in the morning. KC If you exercise before breaking the fast then you don't switch off the liver function (preparing you for the morning). I do exercise before breakfast, 40 minute, jog/walk but I have a glass of tomato juice first. When is he measuring the pre-breakfast bg (fasting bg)? If he is already waking high, before brekky, then he needs to sort out the fasting bg and break the fast before exercising. If he is waking normal and you are seeing the rise after breakfast, try measuring the second time after exercise but before brekky. See if there was a substantial rise form the exercise on empty. If that reading is normal then perhaps even the few carbs at breakfast are still too many. > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] > need to supply any further info. about him here. Thanks for any > input. :) | Now here's where I'd like to know opinions and theories. Science is | also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] | need to supply any further info. about him here. Thanks for any | input. :) be very careful about responses you've received. a few are a bit off course. being a T1, i've seen my glucose do some really funky things. also testing at 1hr isn't really doing much good since most times, digestion hasn't even peaked. testing at 2hrs is much more telling and at 90mins or so to try to catch a peak. (just helps to adjust food intake is all) anyhow, you claim he exercises prior to eating, this is why he's higher after, because you have more then likely a liver dump because of the exercise (body thinking it's outta fuel) and then eating on top of the dump. have him switch it around exercise after he's eaten and then test glucose at 90min and 2hr, if it's a higher fat meal, test again at 3 and 4hrs also. fat delays can be quite nasty sometimes. also, as to someone's comment about your hubby having dawn phenomenon, by the numbers you posted, it's very very doubtful.. and just remember, none of us are doctors, though, some here, get their rocks off trying to play one. :P technically having dawn phen is having a glucose reading 50mg higher when you wake then when you went to bed. (taken from my dr's PDR in her office... bored one day so did some reading while waiting) take care rk, t1 since 5/00 glutten for punishment on asd since 7/00 > | Now here's where I'd like to know opinions and theories. Science is > | also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 12 lines] > times, digestion hasn't even peaked. testing at 2hrs is much more > telling and at 90mins or so to try to catch a peak. I am not sure this is true. In the diabetic pregnancy program they had us all test at 1 hour after beginning to eat, and we were told that was when the peak was. Other pregnant diabetics on the internet that I chatted with had endocrinologists who had them test at 1 or 2 hours. My diabetic pregnancy program had us stay below 120 at 1 hour. The people with endocrinologist care had them stay under 140 if they were testing at 1 hour after eating and had them stay under 120 if they were testing at 2 hours after eating. The lower expected number at 2 hours tells me that they exect the peak at 1 hour not at 2 hours. (just helps to > adjust food intake is all) anyhow, you claim he exercises prior to > eating, this is why he's higher after, because you have more then [quoted text clipped - 9 lines] > you wake then when you went to bed. (taken from my dr's PDR > in her office... bored one day so did some reading while waiting) I definitely have that then. Without 44 units of NPH at night, I would be over 100 mg/dl higher than when I went to bed. KC >> be very careful about responses you've received. a few are a bit >> off course. being a T1, i've seen my glucose do some really funky [quoted text clipped - 5 lines] >all test at 1 hour after beginning to eat, and we were told that was when >the peak was. Easy to check when yours is - just test a lot... mine is around 40 mins now; it was about 70 mins at dx. I'm taking that to mean that I'm regaining something of a Phase 1 response. Reisa's a T1 - they're a different beast... Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25 Ok, folks...thanks for all you're advice. The consensus was "exercise after eating, not immediately after waking up" and so I did just that. I woke up, tested: FBS 97. Ate my normal breakfast (weighed the veggies 9 oz). that was 2 mushrooms, a bit of zucchini, some red onion and some broccoli plus 4 egg whites, 6 whole almonds, and a tbs of butter. BGs at 1 hour 129. Then I did my quickie exercise of 50 pushups and 50 situps. BG afterward 119. Now, this was possible because it is my day off, I'm not sure how the timing will work on days when I get up at 5am and have to leave out the door by 6:30. I already don't get as much sleep as I should during the week. 6 hours is the most i usually can get, with 5 being more likely. I work 4 10 hour days with a 1 hour commute each way. Exercise after work is not really feasible, as I am exhausted by then. So if I get up at 4:30 instead of 5, I may be able to fit in all the exercise I need in the morning (shhheeesh). I will definitely need a new bedtime to do that. Just not enough hours in the day to manage all the things that are priorities. My wife has been very helpful in helping with meals and household responsibilities so that I don't get too stressed during the week. And on the weekends I sleep in as long as it takes to "deep cycle" my batteries. Gotta do what ya gotta do, I guess. But this little experiment has been helpful in getting to the bottom of my higher morning numbers and ways to offset it. News flash, I just reached my ideal weight today (165). Before my DX I was at my highest weight ever (215). Advice from this forum helped alot to keep me on the right track and fine tune my DM management. Thanks again, everyone! Andrew, T2 (42 yr old) D&E, low-carb "Zonish" food, red wine, nookie and Science last A1c 5.5, anxiously awaiting the next one > Exercise after work is not >really feasible, as I am exhausted by then. Nah - try it and see - exercise GIVES you energy, not takes it away. Starting is the biggest hurdle; then it's self-perpetuating. Stick some music with a good beat on an MP3 player, and you're away. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25 > > Exercise after work is not > >really feasible, as I am exhausted by then. [quoted text clipped - 7 lines] > D&E, 100ug thyroxine > Last A1c 5.6% BMI 25 Ok, I'll try it. I was the "just do it" guy last week and here I am whining about "I'm tooo tired after work--wahhh". In fairness, I am on my feet 10 hours a day and by 7:30 when I get home my dogs don't wanna go for a walk. I do think I'd benefit most from the exercise in the AM, since those are the numbers I am chasing. I saw the results firsthand--higher numbers when I'd exercise on an empty stomach, lower when I'd eat first. It's just a matter of timing to get it to work. I'm not really adding anything except a small wait after eating before exercising. I'd really like to go for that bike ride before work, get myself pumped up for the day, etc. I could eat slightly less, and snack earlier in my workday so I am not too full to exercise without waiting too long and being late for work. (But Boss, my Diabetes made me late...) It's all about adapting and not getting stuck in one particular mode, if that mode isn't working...Thanks for the kick in the butt! Andrew > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] > need to supply any further info. about him here. Thanks for any > input. :) I would try the exercise after eating. 50 sits up and 50 push ups everyday is fantastic. if you can get him to include some cardio or build up to doing cardio that would also help. has he reached his goals or is he still adding sit ups and pushups? I dont know how old he is but sounds like he is doing great. Tom > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's [quoted text clipped - 6 lines] > need to supply any further info. about him here. Thanks for any > input. :) He's already experiencing dawn phenomenon. Then his body needs even more glucose for the exercise, so it goes into even greater sugar production mode. When the food arrives, it isn't turning off the DP, so the extra sugar only makes the problem worse. Have him eat first, wait 30 mins., then exercise. I'll bet his numbers go down. Jim Jim is probably right on. It's Liver dump. d...@webtv.net wrote: > Jim is probably right on. > > It's Liver dump. No such thing. Glucose, the monosaccharide, is not stored by any organ to be dumped much less by the liver. Instead, there is the synthesis of and breakdown of glycogen (aka body starch). The latter is a controlled process (glycogenolysis) to produce glucose rather than uncontrolled dumping of glucose. The BG elevation is happening because of insulin resistance combined with higher cortisol levels in the AM. Moreover, for those who have been low-carbing so that there is essentially no glycogen stores, the process of glucose production by the liver is gluconeogenesis and happens by the breakdown of muscle to produce the amino acids that are utilized. Be hungry... be healthy... be blessed: http://TheWellnessFoundation.com/PressRelease Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist > Now here's where I'd like to know opinions and theories. Science is > also welcome. Factual science is even better. Why is my husband's > (Andrew)BG higher in the morning after eating breakfast? Here's a great study in an A/V format that looks at "normal" subjects with continous glucose monitoring for a few weeks. Interestingly, even normal folks have a hard time with a high carb breakfast as opposed to high carb at other meals. Christiansen, Prof. J. S., On the occasion of the Annual Meeting of the EASD, Copenhagen, 13-Sep-06 What is Normal Glucose? - Continuous Glucose Monitoring Data from Healthy Subjects www.diabetes-symposium.org/index.php?menu=view&chart=4&id=322 Also have a look at http://www.phlaunt.com/diabetes/17561156.php for more info on this topic. Regards Randy > Here's a great study in an A/V format that looks at "normal" subjects > with continous glucose monitoring for a few weeks. [quoted text clipped - 6 lines] > Healthy Subjects > www.diabetes-symposium.org/index.php?menu=view&chart=4&id=322 I just ran across that the other day, and yes, it surprised me that nondiabetics seem to have DP too!  Signaturehttp://www.ornery-geeks.org/consulting/ > > Here's a great study in an A/V format that looks at "normal" subjects > > with continous glucose monitoring for a few weeks. [quoted text clipped - 9 lines] > I just ran across that the other day, and yes, it surprised me that > nondiabetics seem to have DP too! Many (most) nondiabetics have insulin resistance (IR/MetS) because of having bad "inside" fat (visceral adipose tissue or VAT). It is only when we are hungry from eating less, down to the optimal amount, that our bodies get rid of the VAT to cure the IR/MetS and possibly also cure type-2 diabetes: http://HeartMDPhD.com/HolySpirit/Healing This completely free Approach comes with free cardiologist support via usenet plus an unprecedented million-dollar guarantee: http://TruthRUS.org/Guarantee Be hungry... be healthy... be blessed: http://TheWellnessFoundation.com/PressRelease Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist >> Here's a great study in an A/V format that looks at "normal" subjects >> with continous glucose monitoring for a few weeks. [quoted text clipped - 9 lines] > I just ran across that the other day, and yes, it surprised me that > nondiabetics seem to have DP too! Diurnal cortisol rhythm. Cortisol peaks between 6-8 a.m. and hits its nadir at midnight. Cortisol raises bg. Susan >> Here's a great study in an A/V format that looks at "normal" subjects >> with continous glucose monitoring for a few weeks. [quoted text clipped - 6 lines] >> Healthy Subjects >> www.diabetes-symposium.org/index.php?menu=view&chart=4&id=322 > I just ran across that the other day, and yes, it surprised me that > nondiabetics seem to have DP too! There are large numbers of diabetics in the general population who haven't yet been diagnosed, and an even larger number of non-diabetics are people with damaged and degenerating BG control who are simply not diabetic *yet*. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >>> Christiansen, Prof. J. S., On the occasion of the Annual Meeting of >>> the EASD, Copenhagen, 13-Sep-06 >>> What is Normal Glucose? - Continuous Glucose Monitoring Data from >>> Healthy Subjects >>> www.diabetes-symposium.org/index.php?menu=view&chart=4&id=322 > There are large numbers of diabetics in the general population who > haven't yet been diagnosed, and an even larger number of non-diabetics > are people with damaged and degenerating BG control who are simply not > diabetic *yet*. Yeah, but... did you LOOK at it? They didn't just report averages, they showed graphs of individual's readings. I don't rememebr exactly, but the nondiabetics were mostly young people with A1c's in the 4.5-5.5 range or so. Sure, the high end of that range may be prediabetic, but some of them looked darned normal to me. But they *all* had larger spikes after breakfast than lunch and dinner. Signaturehttp://www.ornery-geeks.org/consulting/ > >>> Christiansen, Prof. J. S., On the occasion of the Annual Meeting of > >>> the EASD, Copenhagen, 13-Sep-06 [quoted text clipped - 15 lines] > > But they *all* had larger spikes after breakfast than lunch and dinner. It is likely that all the subjects had bad "inside" fat (visceral adipose tissue or VAT) from overeating (eating until stomachs are stretched thereby killing hunger via GLP-1). Be hungry... be healthy... be blessed: http://TheWellnessFoundation.com/PressRelease Prayerfully in Jesus' awesome love, Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist "It is likely that all the subjects had bad "inside" fat (visceral adipose tissue or VAT) from overeating (eating until stomachs are stretched thereby killing hunger via GLP-1)." Thank you for the compliment, imitation is said to be the highest form and now you repeat my point about glp-1. But sadly you got it wrong, the right hormone for the wrong reason. It becomes crystal clear when one does not keep up with the literature in this area. The two pound diet,aka 2 pd etc., is trash science. God bless. >> Now here's where I'd like to know opinions and theories. Science is >> also welcome. Factual science is even better. Why is my husband's >> (Andrew)BG higher in the morning after eating breakfast? > Here's a great study in an A/V format that looks at "normal" subjects > with continous glucose monitoring for a few weeks. > Interestingly, even normal folks have a hard time with a high carb > breakfast as opposed to high carb at other meals. > Christiansen, Prof. J. S., On the occasion of the Annual Meeting of > the EASD, Copenhagen, 13-Sep-06 > What is Normal Glucose? - Continuous Glucose Monitoring Data from > Healthy Subjects > www.diabetes-symposium.org/index.php?menu=view&chart=4&id=322 Not all the "normal" subjects had a hard time with high carb breakfasts. One questions the wisdom of describing people's BG metabolism as "normal" when what they mean is "have not been diagnosed with diabetes" :-) > Also have a look at http://www.phlaunt.com/diabetes/17561156.php for > more info on this topic. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] |
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