Diabetes and apnea

[JumpStart]

Metformin (glucophage) did not help with that at all and I got really discouraged.

While I have been on insulin for decades, mettormin seems to be making a comeback for me (and for others, I am told). I started using it when first diagnosed, and went to insulin about 1 1/2 yrs later, since metformin was ineffective in controlling my sugar. They re-started me on it about a year ago (since it combats insulin resistance, the enemy of insulin users) and it has lowered my insulin usage by 10-15% while still keeping my a1c at the same level. Since insulin is a great (some say the greatest) fat building hormone, the less I take, the happier I am. And I expect them to increase the metformin quantity in another couple of months, if things work out as planned, and concurrently again reduce insulin. Keeping my fingers crossed!

[JumpStart]

My doctor has me testing once a day at random times. Like SS my morning levels are always high. Since I've retired and started working out on a regular basis, my A1c has dropped from 7.8 to 7 and my weight from 275 to 260. Of course the 'threat' of insulin was a great motivator.

I am absolutely dumbfounded that with an a1c over 7 that you were not taking insulin. The longterm damage from an elevated glucose level is well documented, and 7.8 would indicate an average daily elevated glucose level in excess of 175 ml/dL. Wow. Keep working hard on reducing it - you are still far above average, and medically considered diabetic, as your doctor no doubt told you. Are you also checking regularly with a retinologist? Not just an opthomologist. Early diagnosis and laser work can be a sight saver. I know - I have a stubborn adult son with sight now in only one eye. The other eye "sees" light and dark, and *some* shapes/outlines.

[greatunclebill]

thanks for all the very informative replies. my wife has a bunch of reading to do when she gets home from work.

[Schnauzers 5]

About two years ago my former doctor had me tested A1c and fasting was 112. I refused Metformin and changed my diet. I was never over 6.8 ( never hit 7) and went down to 5.8. The highest home test has been one AM at 120. I have new test strips and if I wait until I have fasted nine hours or more my glucose is 91, 94, 96, today was nine hrs fasting and I was 83. My weight has\not changed much and I eat anything I want but I dont eat beef and rarely any animal protein like beef, chicken etc. I eat some dairy. I am happy about this but wonder if it is accurate. I drink too much grape juice and now cherry too. I find that if I have only slept five or six hours and then test, my glucose is higher but never bad. 101. Before with old strips I tested as high as 116 but also may have only fasted six to eight hrs. Could my old test strips I had a long time and did not use often be old and inaccurate? A few months ago I had my eyes tested by a specialist and my only problem is cataracts developing. Do you think I am totally not pre or Diabetic? I dropped my former woman doctor who had only been a doc for three yrs and labeled me Diabetic. I always argued with her that I am not diabetic. I want to keep it that way. I also ate chocolate ice cream evenings with no trouble or rise in glucose.

[PaulaO2]

The life of test strips vary. Mine say no more than 3 months after opening.

[greatunclebill]

here is an article my wife found:

One of the most common question I hear from my clients is, "Why is my glucose high in the morning when I haven't eaten for hours?"

Maybe you can identify with this situation: You went to bed last night at 10:30 p.m. and your blood glucose was 126 mg/dL. When you woke up this morning at 6:00 a.m., it was 148 mg/dL.

What happened?

It's Probably Not Something You Ate
First, I want you to know that these circumstances aren't likely to be due to the dinner meal you ate the night before, or even to the ice cream you ate before going to bed. We know this is so because the rise in glucose caused by food is generally over within 2 to 5 hours after a meal, with this time range depending on the types of foods consumed. That is, a meal higher in fat will take longer to digest than if you ate only carbohydrates.

Other than illness and stress, possible reasons for these morning highs are

•insufficient insulin
•the dawn phenomenon
•the Somogyi effect
Insufficient Insulin
If you take insulin, you might not be taking enough to cover your morning blood glucose levels. Try testing your blood glucose levels before bed and then again at around 2 a.m. If your blood glucose levels are high at 2 a.m., you might need more insulin. But be sure to talk with your doctor before making any of your own insulin adjustments.

The Dawn Phenomenon
This is defined as an early-morning rise in blood glucose levels due to the secretion of certain hormones--cortisol and growth hormone--that cause the body to release stored glucose. To determine if you are experiencing the dawn phenomenon, test your blood glucose level before bed and again at around 2 a.m. If your glucose is normal at 2 a.m. but high in the morning, you could be experiencing the dawn phenomenon. Ask your doctor about this.

The Somogyi Effect
This phenomenon is referred to as rebound hyperglycemia and is usually seen in people who take insulin. What happens is that blood glucose levels go too low late at night, which causes hormones to overcompensate by producing glucose. To determine if you are experiencing the Somogyi effect, try testing before you go to bed and again at 2 a.m. If your blood glucose levels are too low at 2 a.m. (less than 70 mg/dL is considered low), you might be experiencing the Somogyi effect. Again, let your doctor know.

If you are experiencing morning highs, talk with your doctor or diabetes educator. Continuous glucose monitoring might be a good way to determine what is causing your morning hyperglycemia.

[JumpStart]

GUB, is your wife on insulin? What was the date of the report you referred to?

While a number of insulins on the market have a "peak" of around 2-4 hours, with their useful curve looking somewhat like half of a sine wave, some newer ones are effective within 15-20 minutes. The relatively new insulin glargine (Lantus) is a long-acting, man-made version of human insulin. It is injectable, and provides a stable basal rate for a 24 hour period, thus avoiding the ups and downs previously experienced by diabetics using other versions of the shorter acting insulins alone. There is now another extended release insulin (whose name escapes me), different but also highly effective, besides insulin glargine. With these extended release medications (one or the other), and an appropriate bolus of a shorter acting (shorter time frame from injection to loss of effectiveness) insulin with meals, much or all of what that report described is avoided.

As to the "dawn phenomenon", that can also be dealt with by avoiding carbohydrates at bedtime, or by adjusting the insulin dosage, both just regular or the extended release version described earlier. I believe you can also avoid this with different medications, including metformin.

[Schnauzers 5]

The life of test strips vary. Mine say no more than 3 months after opening.

They were more than three months old and had me around 116 a lot and never 90s. I miss typed I meant 93, not 83. I sleep late on Sundays sometimes, like today and it was just 96. Probably 11 or 12 hrs ago was last food. I guess for now I must be ok. I never have high numbers. Since I only get 50 and some always error, I try not to use more than one a day or less. I don't have enough test strips to try 2 hrs after a meal too. I must say, what with grape juice, potatoes, and chocolate ice cream, you would think morning test would test high. If I become type 2, I would be the first known one in our family. That former doctor kept saying I was Diabetic yet no medical proof. Had I taken Metformin I wonder how sick it could have made me. She is a 35yr old overweight herself awful doctor. She also wanted me to have unnecessary test and remove my gal bladder when it was just a nut stuck in my common bile duct. It passed and I have been fine since.

[greatunclebill]

GUB, is your wife on insulin? What was the date of the report you referred to?

While a number of insulins on the market have a "peak" of around 2-4 hours, with their useful curve looking somewhat like half of a sine wave, some newer ones are effective within 15-20 minutes. The relatively new insulin glargine (Lantus) is a long-acting, man-made version of human insulin. It is injectable, and provides a stable basal rate for a 24 hour period, thus avoiding the ups and downs previously experienced by diabetics using other versions of the shorter acting insulins alone. There is now another extended release insulin (whose name escapes me), different but also highly effective, besides insulin glargine. With these extended release medications (one or the other), and an appropriate bolus of a shorter acting (shorter time frame from injection to loss of effectiveness) insulin with meals, much or all of what that report described is avoided.

As to the "dawn phenomenon", that can also be dealt with by avoiding carbohydrates at bedtime, or by adjusting the insulin dosage, both just regular or the extended release version described earlier. I believe you can also avoid this with different medications, including metformin.

the only part i claim as mine was where i wrote "here is an article my wife found:"

everything else posted was the article she found, posted as just general for what it's worth information. my wife is not on insulin and those are not her numbers. her diabetes is controlled with metformin. sorry for any confusion.

[JumpStart]

....my wife is not on insulin and those are not her numbers. her diabetes is controlled with metformin.

That is a blessing!

... sorry for any confusion.

No problem - I apparently just missed the boat! :grin: Not the first time.