Diabetes and apnea

[greatunclebill]

a couple years ago my wife was diagnosed with type 2 diabetes at age 58. the doctor didn't feel she needed a home tester as she was controlled pretty good with medication. her last fasting lab test was 125. her A1C was 5.8 but recently jumped to 6.2. our new doctor said she could have a home tester if she wanted it so she bought one. the numbers are all over the chart depending when she eats, what she eats and how long it's been. she starts work at 12:30 pm, has lunch at 2:30 pm and maybe a break at 5 pm if they are not busy. there is no food or drink permitted in the work area so she normally doesn't eat til 10, 11 or 12 when she gets home. then to bed around 1 or 2 am and gets up at 7, 8 or 9 am. what is the best time for her to test, given her schedule and her average lab scores or does she even need to test?

[Dreamcatcher]

My Mrs doesnt bother testing as she knows when she is low or high by the way she feels. She has several testers as over here in the uk you can get them free and to buy are only a few dollors ($5) I would imagine that doing the test 3 times a day at the same time would give her the best results but Im sure there are other sufferers on here that could give you better advise

[PaulaO2]

The ideal time to test is 2hrs after eating. And, if really erratic and trying to track trends, right before a meal.

Fats slow down digestion so peanut butter sammiches would be good. Or almonds or just peanuts.

Avoid fast sugars such as white bread and of course sodas.

Have her pick a few things she doesn't mind eating repeatedly then start testing. Test before the meal then 2hrs later. If that meal keeps the glucose down, then that's a good one! If it doesn't, change one thing and try again with the next meal.

For me, it is sweet tea. Sky rockets. And potatoes. No clue why the potatoes but in nearly any form, zoom it goes.

I also strongly, urgently, suggest seeing a Registered Dietician. The one I saw was a HUGE help. Not a nutritionist, but a registered dietician.

[JumpStart]

My Mrs doesnt bother testing as she knows when she is low or high by the way she feels. She has several testers as over here in the uk you can get them free and to buy are only a few dollors ($5) I would imagine that doing the test 3 times a day at the same time would give her the best results but Im sure there are other sufferers on here that could give you better advise

While I don't know your wife's diabetic condition, I think she is fooling herself. Many long-time diabetics can recognize the symptoms of low blood sugar, generally, but not always, in time to avert reaching a very serious low, or even a coma. I generally do so around 40-50 mg/dL. I have also missed the symptoms with significantly bad results. Every such low damages organs and kills brain cells. It is a recognized fact, however, that high glucose readings are impossible to accurately determine. I have been a tpe 2 diabetic for over 29 years, and can assure you - and her - that while the dangers of hypoglycemia (low blood glucose) are more immediate in effect, those of hyperglycemia (high blood glucose) are just as serious, and have a long lasting and serious deliterious effect on everything from brain cells to kidneys, and a long list of other organs as well. Testing is fast, easy, cheap and only moderately intrusive, and it can save your life or avoid my greater fear, leaving me helpless and dependent.

As to when to test, in addition to PaulaO2's advice, first thing in the morning, before eating or drinking anything, is an important time to test, per my endocronologist. It is the ONLY test I NEVER fail to take. It permits you to determine how your night went, so, if necessary, you can alter your pre-bedtime activities such as snacks, drinks, etc..

[Les]

The AC1 test is only an average of blood sugars over 2 to 3 months, it was all confusing to me when i first found out i was diabetic, but it is not that hard to keep your sugars down.
The glucose meter is a must, it is what you eat and how much, i eat most foods but the amount depends on the reading 2 hours after the first bite of food in a meal, their is plenty of info on the net about foods low, average and high GI foods.
I try to keep my sugars down to 8 or under 2 hours after the first bite of food, i think the US is differant, so it would be around 144 in their values.

Potatoes, rice, pasta, white bread, lemonade, fruit juices, make my sugars go high, it is really all about eating to what the meter says.

[JumpStart]

The AC1 test is only an average of blood sugars over 2 to 3 months, it was all confusing to me when i first found out i was diabetic, but it is not that hard to keep your sugars down.

Red blood cells have a lifespan of 3 1/2 to 4 months (100-120 days), and it is from these cells that the data for the a1c is derived. I have several docs who advise me, and one taught an MCE class on the subject, that the average time of an a1c is therefore about equal to that lifespan, although 3 months is apparently a commonly used, if slightly erroneous, time frame.

A fasting a1c of 6 or less is generally considered non-diabetic, while anything over is classified as diabetic.

Any diabetic who can maintain an a1c of 7 or less is doing well - and 6.5 or below, quite well. At those rates, retina issues and loss of vision, a great fear for diabetics, will be very long in coming, if at all. And while daily meter readings are useful in determining spot checks, and enabling a person to determine if a particular food or activity is acceptable, it is the a1c which is the standard by which the medical community determines your overall compliance and performance.

[SuperSleeper]

I've found that if I test immediately upon awakening in the morning, I get an abnormally high skew of blood sugar levels. Testing at that time of day doesn't seem to provide accurate results for some reason, or at least not results that are more representative of what my averages are going to be throughout the day.

From WebMD:

Dawn phenomenon. The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows. Between 3:00 a.m. and 8:00 a.m., your body starts to increase the amounts of counter-regulatory hormones (growth hormone, cortisol, and catecholamines). These hormones work against insulin's action to drop blood sugars. The increased release of these hormones, at a time when bedtime insulin is wearing out, results in an increase in blood sugars. These combined events cause your body's blood sugar levels to rise in the morning.

[PaulaO2]

When they first finally slapped me with the diabetes diagnosis, my fasting blood glucose was 185. However, my A1c was just 4.7. Using a meter, I proved their theory that I was one of those who hit more lows than highs.

Metformin (glucophage) did not help with that at all and I got really discouraged. No matter what I ate or did, my blood glucose went sky high then dropped like a rock. I hit 70 and below just as often as I hit over 200. My doc has me on Actos right now and it is working like a charm. It stays within a very safe and normal range although certain foods, like the brownie I just had at my fave pizza joint, will make it rise.

Interestingly, with Actos, my A1c now is between 5.7 and 6.2.

There is rumblings that Actos will be taken off the market (it already is in a lot of European countries) and I'm starting to panic.

I don't think my diabetes has anything to do with my SA though. It is definitely a family thing. I thought it very funny that my younger bro got it first. He got his revenge though (or karma did it for him). I was diagnosed two years later on his birthday.

[JumpStart]

I've found that if I test immediately upon awakening in the morning, I get an abnormally high skew of blood sugar levels. Testing at that time of day doesn't seem to provide accurate results for some reason, or at least not results that are more representative of what my averages are going to be throughout the day.

From WebMD:

Dawn phenomenon. The dawn phenomenon is the end result of a combination of natural body changes that occur during the sleep cycle and can be explained as follows. Between 3:00 a.m. and 8:00 a.m., your body starts to increase the amounts of counter-regulatory hormones (growth hormone, cortisol, and catecholamines). These hormones work against insulin's action to drop blood sugars. The increased release of these hormones, at a time when bedtime insulin is wearing out, results in an increase in blood sugars. These combined events cause your body's blood sugar levels to rise in the morning.

Perhaps "bedtime insulin" is also wearing out as a useful determination, since it does not seem to include the 24 hour insulins, such as Lantus. I don't know, not an MD, but it wouldn't be accurate for me. And I would question specific hours which fail to take into consideration the schedule for the individual involved. My *morning* test is frequently after 8 am. I take Lantus once a day to provide an appropriate basal level, with additions of Humalog at meals and as otherwise needed [e.g., - such as after strenous exercise (streneous for me, anyway :grin:]. I have found that when my morning tests are continuously within my "normal" range, my 4-month a1c is also in a good range. And the reverse is true as well.

[PollCat]

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.

My doctor gave me three testers shortly before I retired so I could have one at home, one in the office, and another in my car. When I registered one of the testers, the company sent me a fourth one. Most companies will give you a free tester since they know you'll have to buy the strips from them. In the case of the FreeStyle Lite tester, the company gives you a discount card to help you with your co-pay. Thus reducing my out-of-pocket costs to $15 for one hundred strips (list price somewhere in the $75 to $95 range).