How can blood sugar go up without eating? - Page 3

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How can blood sugar go up without eating? - Page 3


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Old 11-29-2013, 08:07   #21
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Hi Everyone... I just found this forum this evening. A couple of years ago I did really good at getting my bG under control (my a1c was down to 5.1). Over the last year though I have slipped alot.

A couple of weeks ago I started measuring my bG again. I noticed that when I go to bed my bG is down around 100. After waking up though I noticed it has been between 115 to about 120. A couple hours after eating breakfast it was back down to about 100 which made no sense to me. The idea of my body thinking it is starving and my liver dumping glucose into my blood stream makes a lot of sense. I thought I had a pretty good handle on understanding diabetes.... but I can tell this site and all you folks are going to teach me a lot! Thanks!
I don't personally like this language "my body thinks I'm starving and ...". WAY too dramatic and not accurate. What's happening here is that it is NORMAL for the liver to secrete some glucose starting just BEFORE you wake up. That's not the problem, it's normal and no one is "starving". In a normal person this might take them up 10 points or something like that in preparation for getting up and the day ahead.

The problem with T2s is not this glucose secretion by the liver, it's what happens next. In the normal person, there is an immediate reaction by the pancreas which secretes some insulin. This would be the case for most T2s, too except perhaps very late-stage T2s with pancreas's like a T1 (finished).

The trouble is "hepatic insulin resistance". After years of abuse from excessive glucose and more importantly fructose and fat droplets in the liver (which were caused by the fructose), the liver - like skeletal muscle and fat tissue - loses its ability to "hear" the command of insulin to STOP (it's command to both muscle and fat is "Let me IN"). The insulin is there, the liver is just not responding correctly. It heard the first hormones just fine - the ones which ordered it to dump away, but fails to respond to the subsequent insulin.

No "starvation" involved anywhere in this story!

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Old 12-16-2013, 15:10   #22
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And that's what Marsha refers to - we wake up with a decent reading, but if we don't eat something, our blood sugar level rises anyhow.

It isn't only what we eat that raises blood sugar . . . if we haven't eaten for several hours, our body signals our liver that we haven't been fed so we must be starving. The liver obliges by converting its stores of glycogen into glucose and dumping it into our bloodstream to save us from dying of starvation. This works great for ordinary people, but we diabetics are glucose challenged, and when we get a dump, our pancreas often doesn't respond with the proper amount of insulin, so what we get is high blood sugar. So it's good to eat a bite or two right away, even if it's only a handful of nuts or a piece of cheese. Anything to let our liver know we aren't starving and we don't need its assistance!
I was just wondering, say you are not feeling hungry at lunch or dinner and don't eat, or you have a big pause between your lunch and dinner, could this cause liver dump and raise your bsl? Should we always eat just a tiny bit of food every four hours even if not hungry? Or does this only happen when we are actually feeling hungry and don't eat anything? Does this still happen if you were to have a drink or some kind instead and just sip it very very slowly? (say when ill).


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Old 12-16-2013, 15:50   #23
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Also I find this to be true for me also to the OP. As one suggested, the rise could be happening earlier, something I will have to test. Usually my bsl continues to rise for a couple of hours after. Like today my waking bsl was a nice 4.8 mmol/L and then it went up to 7 mmol/L despite that I ate some salad sticks with full fat cream cheese just after waking up.

Is there any way I can stop this from happening? It doesn't seem that eating stops my liver. At the moment I am just doing 11km of slow cycling, which I *think* may be helping it to stop or go back down again, but on days where I don't have enough time to do this, what other options do I have?

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Old 12-16-2013, 17:03   #24
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Also I find this to be true for me also to the OP. As one suggested, the rise could be happening earlier, something I will have to test. Usually my bsl continues to rise for a couple of hours after. Like today my waking bsl was a nice 4.8 mmol/L and then it went up to 7 mmol/L despite that I ate some salad sticks with full fat cream cheese just after waking up. Is there any way I can stop this from happening? It doesn't seem that eating stops my liver. At the moment I am just doing 11km of slow cycling, which I *think* may be helping it to stop or go back down again, but on days where I don't have enough time to do this, what other options do I have?
You are a T1D. What are your insulin doses throughout the day, both basal and meal doses?

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Old 12-16-2013, 17:16   #25
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You are a T1D. What are your insulin doses throughout the day, both basal and meal doses?

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I'm on the pump, and at the moment I'm on around 60g carbs a day and just seeing how my control goes with that for a couple of weeks. Basal is 24.5 units (still trying to figure this out, but my levels are much more stable than what they were before, and before they were pretty shocking). Bolus varies day by day but is generally around 6-11 units (taking into account I'm still trying to work out my basal rates and have had to correct a few highs).

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Old 12-16-2013, 19:55   #26
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If you are looking to halt DP, eating something when you wake will not halt it completely, it may help a bit but you will need to take a small bolus to halt it. Remember, being T1 your pancreas will not supply any insulin when DP kicks in. So you need to supply it. When I was experimenting on how much insulin I would need to halt DP, I woke up, took my basal and then waited to see how much my BG would rise. I would wake up near 80 and an hour later I would be near 150. So when I wake up now, as long as my sugar is not below 80, I take a half unit of rapid insulin. If my sugar is below 80, I wait until it gets above 85ish, then take a small amount of insulin. The only way to get this perfect is to eat the same amount of carbs and protein every night. I believe the amount of carbs and protein eaten the night before will determine how severe your DP will be the next morning. Also if you deplete your liver stores, your DP will be much less. Also if you read Dr. Bernstein's Diabetes Solution, he explains all of this, along with other invaluable information that will help you understand how to successfully manage all aspects of diabetes. Although I do not follow his advice 100%, I do follow it probably 95%. I feel you can't be happy doing the same exact thing, eating the same exact macro nutrients, day after day. As humans, we need a bit of flexibility. But at least the book taught me what to expect and how to treat diabetes.

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Old 12-17-2013, 07:55   #27
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If you are looking to halt DP, eating something when you wake will not halt it completely, it may help a bit but you will need to take a small bolus to halt it. Remember, being T1 your pancreas will not supply any insulin when DP kicks in. So you need to supply it. When I was experimenting on how much insulin I would need to halt DP, I woke up, took my basal and then waited to see how much my BG would rise. I would wake up near 80 and an hour later I would be near 150. So when I wake up now, as long as my sugar is not below 80, I take a half unit of rapid insulin. If my sugar is below 80, I wait until it gets above 85ish, then take a small amount of insulin. The only way to get this perfect is to eat the same amount of carbs and protein every night. I believe the amount of carbs and protein eaten the night before will determine how severe your DP will be the next morning. Also if you deplete your liver stores, your DP will be much less. Also if you read Dr. Bernstein's Diabetes Solution, he explains all of this, along with other invaluable information that will help you understand how to successfully manage all aspects of diabetes. Although I do not follow his advice 100%, I do follow it probably 95%. I feel you can't be happy doing the same exact thing, eating the same exact macro nutrients, day after day. As humans, we need a bit of flexibility. But at least the book taught me what to expect and how to treat diabetes.

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I agree, some amount of flexibility is necessary for some to be happy and with different lifestyles.

I have thought about what you have said...I suppose then that it is a matter of seeing what happens and what works best for me. I'm wondering if I do some low intensity cardio most mornings, whether this will help to deal with this problem. I have to exercise every day anyway, so I wonder if this would help deal with any spikes.

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Old 12-17-2013, 13:17   #28
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I agree, some amount of flexibility is necessary for some to be happy and with different lifestyles. I have thought about what you have said...I suppose then that it is a matter of seeing what happens and what works best for me. I'm wondering if I do some low intensity cardio most mornings, whether this will help to deal with this problem. I have to exercise every day anyway, so I wonder if this would help deal with any spikes.
My BGs go up when I exercise, so for me that would not be an option. I take a small bolus of insulin prior to exercise. For some people exercise will lower their sugars. Try it out and see. Keep in mind, after exercise, you are way more insulin sensitive. So after exercise, depending on his vigorous, you could need less insulin for many hours. Again, the only way to know is giving it a try. Just keep these things in mind so you can avoid going too low later in the day.

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Old 12-17-2013, 13:26   #29
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My BGs go up when I exercise, so for me that would not be an option. I take a small bolus of insulin prior to exercise. For some people exercise will lower their sugars. Try it out and see. Keep in mind, after exercise, you are way more insulin sensitive. So after exercise, depending on his vigorous, you could need less insulin for many hours. Again, the only way to know is giving it a try. Just keep these things in mind so you can avoid going too low later in the day.

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I have actually experimented and found that if I go at a slower pace of cardio (aerobic), my bsl does not rise, in fact it goes lower usually (unless you have a pump and can change the basal rate to slightly lower temporarily). Previous to this I was doing high intensity (anaerobic) and that would cause my blood sugar to rise. I still do the same amount of kms, I just take a bit longer to do it now. I actually have another recent post related to this subject. Some believe prolonged high intensity cardio is actually not as healthy as we thought...
And if time will allow, it's probably actually better to do a slower paced cardio for diabetics (at least I have found this to be true). It's to do with the liver releasing glucose into the blood as well as various stress hormones like cortisol which can elevate your bsl for hours after exercise.


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