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elevted Fasting blood glucose levels in the morning than post lunch levels
doctor,
I am diabetic since two years. I always take proper precautions regarding diet, exercise. I take glycomet(Metformin 250 mg twice a day after breakfast and after dinner. For some period the fasting levels are within the normal range less than 110. But since about 4 to 5 months i have been observing that the fasting glucose levels are higher than the post lunch levels.
. My blood sugar lab test levels for some period is as under
5/8/11 8/9/11 1/12/11 14/6/12 18/6/12 26/8/12 29/12/12
Fasting 123 114 111 122 112 105 114
127 118 117 161 147 113 126
24/1/13
122
131
HBA1 c: 6.4 6.9 6.6 6.9
1.I would like to seek your expert advise. 2. I also wish to know is it somgyi effect or Dawn effect as stated in the web? 3. What is your suggestion regarding the enhancement of glycomet or combination of drugs?
My medical history is I had IHD 37 yrs back no complications/mild Hypertension (Under control)Diabetes (since 2010) Hyperthyroidsm(2011). I am a vegetarian and walks for 4 km every day (6 days a week) and im 70 years old male.
I will be eagerly awaiting your expert advise.
I am diabetic since two years. I always take proper precautions regarding diet, exercise. I take glycomet(Metformin 250 mg twice a day after breakfast and after dinner. For some period the fasting levels are within the normal range less than 110. But since about 4 to 5 months i have been observing that the fasting glucose levels are higher than the post lunch levels.
. My blood sugar lab test levels for some period is as under
5/8/11 8/9/11 1/12/11 14/6/12 18/6/12 26/8/12 29/12/12
Fasting 123 114 111 122 112 105 114
127 118 117 161 147 113 126
24/1/13
122
131
HBA1 c: 6.4 6.9 6.6 6.9
1.I would like to seek your expert advise. 2. I also wish to know is it somgyi effect or Dawn effect as stated in the web? 3. What is your suggestion regarding the enhancement of glycomet or combination of drugs?
My medical history is I had IHD 37 yrs back no complications/mild Hypertension (Under control)Diabetes (since 2010) Hyperthyroidsm(2011). I am a vegetarian and walks for 4 km every day (6 days a week) and im 70 years old male.
I will be eagerly awaiting your expert advise.
Best Answer
Dear Doctor, I am sorry for that. I generally go for 4 km walk in the morning. after return i take a cup of coffee and at 9 am i take 3 idlis. AT 1 pm i take small quantities of rice, dhal, rasam and butter milk. At 4 pm i take a cup of ocffee.Again at 8 pm I take 2 chapathis or pulkas with little veg curry and a glass of butter milk.Between lunch and dinner i dont take any thing. I am totally a vegetarian. in the evening also i do not confine to the house . ill be going around.
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as you are vegetarian and most vegetarian foods are carbs, it can be difficult to control blood sugar just by reducing carbs.
Your HBA1c is increasing and your fasting blood sugar is well above normal. From your HBA1C I think your sugars are also high the rest of the day. Normal HBA1C should be 4.3 - 4.6 (non diabetic) and for persons with diabetes should be as close to normal as possible and ideally < 6.0.
Ideally fasting blood sugar is < 95 (ideally 80s).
2 hours after eating blood sugar should be ideally < 120.
You can test fasting, then 2 hours after every meal (or fasting then before lunch and before dinner) - maybe try this on alterntiave days - to see how high your sugars are and if they are staying high. You could also test 2 hours after eating (try eating differnety meals) to see which foods do and don't make your sugars high. Then avoid those foods which raise your blood sugars.
My advice is to reduce any fast acting carbs - this would mean replacing things like rice , breads, fruits, with vegetable (except corn and potato) and slower acting carbs such as lentils. Avoid sugar in all added forms. Try to eat more protein and fats (so that you have enough calories for your energy). Exercise after every meal (ie. walking) may also help reduce blood sugars.
Please also talk to your Dr about your meds. Your glucomet is only at 500 a day? Am I correct? There is room to increase this dose further. If this does not get your blood sugars down a low dose of insulin may be an option. To keep you healthy and avoid complciations, it is very important to normalise blood sugar. Your HBA1C is nearly 7 and indicates that you do need to take more efforts (both lifestyle and meds) to reduce it.
Hope this can be helpful.