[Angie]

Hello, Forum members:

I'm glad to have found this site, and the compassionate and dedicated folks on it.

The skinny on me: male, 53 years old, 6 feet, 245 pounds, coronary artery stent placed (Lower Anterior Descending artery) in April 2009 (after catheterization showed a 75 percent blockage--no symptoms). Cholesterol 123, triglycerides 186, BP approx. 120/80.

Diagnosed "officially" as diabetic around five years ago. Currently on Janumet (50/1000 mg. 2x day). Latest A1C was 6.85. Fasting BG anywhere from 120-150; post-prandial 120-170; usually less than 140. Exercise usually brings the numbers down quickly. I try to walk at lunchtime (2 1/2 miles) at least 3X a week, and get to health club when I can. Recently diagnosed with Peripheral Diabetic Neuropathy due to burning in both big toes, and was put on a prescription vitamin--Metanx--by my internist, whom I trust and find to be an excellent diagnostician. In 10 days' time, my feet feel significantly better, aiding greatly in my walking. Can't say if Metanx is at least partly responsible or not; just glad the situation has improved!

My questions to the forum:

Has anyone had experience with Metanx? If so, was it helpful to you?

Also, what can be done about the "Dawn Effect," or "Dawn Phenomenon?" I hadn't heard about it until my doctor told me how it frustrates a lot of diabetics from keeping their fasting BG under control. Until I learned of this overnight hormone release accompanied by excess sugar manufactured by the liver, I never could understand why my after-meal readings were often lower than my fasting ones.

Thanks in advance for any feedback on the above. Glad to (virtually) make everyone's acquaintance!

-Andy

 

[Shanny]

Welcome aboard, Andy! Always good to make new friends. Good to hear about Metanx too, AND . . . especially good to hear you have a knowledgeable doc you can trust! Those are worth their weight in GOLD!

The dawn phenomenon surely does bedevil a lot of us, to some degree. While mine doesn't usually fall outside of my target range, it's still sometimes my highest reading of the day. So if I test well at bedtime, I might then have a snack to keep things on course through the night. Sometimes it works and sometimes it doesn't - depending on how well or how long I sleep.

 

[breezeonby]

Hello, Forum members:

I'm glad to have found this site, and the compassionate and dedicated folks on it.

The skinny on me: male, 53 years old, 6 feet, 245 pounds, coronary artery stent placed (Lower Anterior Descending artery) in April 2009 (after catheterization showed a 75 percent blockage--no symptoms). Cholesterol 123, triglycerides 186, BP approx. 120/80.

Diagnosed "officially" as diabetic around five years ago. Currently on Janumet (50/1000 mg. 2x day). Latest A1C was 6.85. Fasting BG anywhere from 120-150; post-prandial 120-170; usually less than 140. Exercise usually brings the numbers down quickly. I try to walk at lunchtime (2 1/2 miles) at least 3X a week, and get to health club when I can. Recently diagnosed with Peripheral Diabetic Neuropathy due to burning in both big toes, and was put on a prescription vitamin--Metanx--by my internist, whom I trust and find to be an excellent diagnostician. In 10 days' time, my feet feel significantly better, aiding greatly in my walking. Can't say if Metanx is at least partly responsible or not; just glad the situation has improved!

My questions to the forum:

Has anyone had experience with Metanx? If so, was it helpful to you?

Also, what can be done about the "Dawn Effect," or "Dawn Phenomenon?" I hadn't heard about it until my doctor told me how it frustrates a lot of diabetics from keeping their fasting BG under control. Until I learned of this overnight hormone release accompanied by excess sugar manufactured by the liver, I never could understand why my after-meal readings were often lower than my fasting ones.

Thanks in advance for any feedback on the above. Glad to (virtually) make everyone's acquaintance!

-Andy

My podiatrist told me about Metanx and the fact that it is a combination of B-6, B-12 & folic acid. He told me that most insurance companies will not pay for it because it is considered vitamins. He told me to take a B-complex vitamin and folic acid, the cost would be considerably less. My neuropathy didn't improve by adding these. I wish it would have, there are less side effects.

The dawn phenomenon is a problem for many. I don't have much of a problem with it since I started back on Lantus taken in the evening. The fasting blood sugar is such an important aspect of overall blood glucose control. Welcome to the forum!

 

[onaughmae]

Hi there and welcome to the forum! I have not had any experience with Metanx, but I do take a multivitamin with folic acid everyday. I only have a very small degree of neuropathy and that is concentrated in my right big toe. Its doesnt hurt anymore, just occasionally feels "asleep". Both of my feet had become quite painful a few months ago, but once my blood sugar got more under control the symptoms backed way off.

The Dawn Phenomenon is really kicking my butt pretty bad. My liver insists on "helping me out" every morning whether I need it or not. I tried changing my Lantus from morning to night, then even splitting the dose every 12 hours. I tried going to bed on the low side of BG, and going to bed on the high side....I tried a small snack before bed...nothing working for me. You just have to try different things and see what works for your body. What I would do if I was you is to check your blood sugar at intervals during your sleep cycle to see if you are dropoping low or not. I know its a pain to get up and do it...but the info will be good to have. There are actually two things that can be happening. There is the dawn phenonenon and there is something called the Somogyi effect. They both result in high AM blood sugars but have different causes.

The Somogyi effect occurs when you have a low in the night and your body tries to correct it, resulting in hyperglycemia. Try checking your BG around 2-3am to see if you are going low. The best way to fix this, is to avoid going low in the first place. Have a little snack with some sort of protein in it that will hold your BG up a bit (like a piece of whole wheat toast with peanut butter). Go to bed with a little higher of BG than maybe you usually do.

Dawn phenomenon is a little different. It occurs becasue the body naturally realeases hormones in the early morning to sort of "jump start the body" for the day. These hormones cause a rise a blood glucose. Of course for the diabetic that doesnt have enough insulin (or ability to use it properly), this causes high AM blood sugars. What I have been told to try and fix this is to maybe exercise later in the evening, or have a lower carb higher protein dinner. Neither of thiose things have had much effect for me but I keep trying what I can. The only thing that "fixes" mine is to get up....eat breakfast (I know that seems wrong when its high already) and take my insulin to cover it. That usually brings it down fairly quickly. I am just starting on a pump so we are hoping that maybe that will fix mine

Sorry for the long reply, but hope it helped some. Good luck!

 

[Angie]

Thanks for the welcome!

Hi, Shanny-

Thanks much for your "welcome" message; it is appreciated! You are absolutely right--a caring, resourceful physician is such a plus in what I'm learning is a fundamental change in the way I live my life. Thanks, also, for the observations re. the "Dawn Phenomenon."

I think that "fundamental" aspect is the gist of my joining the Forum and seeking advice (and I guess some empathy, too!). I've accepted that diabetes is part of my life and needs to be addressed, very seriously, for the rest of my life. Maybe I have an "advantage," however convoluted it may seem, in that my late wife died from complications of multiple sclerosis, a degenerative illness, as you probably know, for which relatively little can be done. I've seen profound and devastating effects of illness overwhelm the human body (but in her case, NOT her spirit!), so I feel lucky by comparison, in that I have a large degree of control in my own hands, in managing my diabetes.

I look forward to reading about folks' experiences and hope to be able to contribute some useful observations of my own.

Thanks for the work you do to keep this most valuable resource up and running!

-Andy

Welcome aboard, Andy! Always good to make new friends. Good to hear about Metanx too, AND . . . especially good to hear you have a knowledgeable doc you can trust! Those are worth their weight in GOLD!

The dawn phenomenon surely does bedevil a lot of us, to some degree. While mine doesn't usually fall outside of my target range, it's still sometimes my highest reading of the day. So if I test well at bedtime, I might then have a snack to keep things on course through the night. Sometimes it works and sometimes it doesn't - depending on how well or how long I sleep.

 

[Angie]

Thanks for the welcome!

Hi, breezeonby-

Thanks much for the welcome! Yes, like you, I found my insurance didn't cover Metanx, either--it runs $35 for a month's supply for me. The product states results could be achieved anywhere from one week to four months, so we'll see if there is permanent improvement. Today I notice some tingling in the underside of my big toes, plus some general foot soreness. Hard to tell if that soreness is just "tired feet" or something more. Plus, when you have a herniated disk and related compressed nerve pain, it can be hard to ferret out the diabetes-related symptoms. Sorry you didn't have a better outcome with the vitamins.

Thanks also for the information on fasting BG levels. I don't know much about Lantus--my drug experience has been limited to Januvia (not very effective for me), and Janumet. I'll read up on it!

-Andy

My podiatrist told me about Metanx and the fact that it is a combination of B-6, B-12 & folic acid. He told me that most insurance companies will not pay for it because it is considered vitamins. He told me to take a B-complex vitamin and folic acid, the cost would be considerably less. My neuropathy didn't improve by adding these. I wish it would have, there are less side effects.

The dawn phenomenon is a problem for many. I don't have much of a problem with it since I started back on Lantus taken in the evening. The fasting blood sugar is such an important aspect of overall blood glucose control. Welcome to the forum!

 

[breezeonby]

Good day Andy! If you start having shooting or stabbing pain in your feet, you may be experiencing more serious neuropathy. If so, there are at least 2 medications that can help. Gabapentin and Lyrica. I have only taken Gabapentin and I take 300MG in the morning and 1200MG at night. The medication makes me nauseated, so I keep my AM dose low. My night time dose is high because I sleep through the side effects. This dose really helps and I am sleeping through the night. Before taking Gabapentin, I would wake up with shooting pain in my feet. Not something you want to wake up to. Enjoy your day!

 

[Angie]

Thanks for your welcome message!

Hi, Pam-

Thanks so much for your very helpful reply to my initial post, and sorry it has taken me this long to respond. Busy weekend, but things are settling down--just in time for work Monday!

I'm glad the foot pain for you subsided, and that your neuropathy appears to be limited. I'll wait to see how the Metanx plays out over the next few months. How long have you been taking the vitamins?

Your advice on checking BG during the night to get a better handle on how the Dawn Phenomenon impacts me in particular sounds good. It really is something--last night (the entire day, if fact), I was fairly "bad" in my eating habits (not typical for me anymore)--even had Bourbon Chicken with pork fried rice last night (yikes!), so what does my BG read this morning? Why, 115--one of my best recent fasting readings. Go figure...sometimes there doesn't seem much rhyme or reason to how we test, does there?

I notice that you are on Neurontin; I presume for nerve pain. My late wife had a particularly severe case of Multiple Sclerosis (the complications eventually took her life), so I am well aware of this medication. I sincerely hope you can jettison this drug one day (along with all the others)!

Thanks again for sharing your experiences and offering some very useful advice. Please feel free to drop me a line anytime.

Best of luck to you, too!

-Andy


QUOTE=onaughmae;10388]Hi there and welcome to the forum! I have not had any experience with Metanx, but I do take a multivitamin with folic acid everyday. I only have a very small degree of neuropathy and that is concentrated in my right big toe. Its doesnt hurt anymore, just occasionally feels "asleep". Both of my feet had become quite painful a few months ago, but once my blood sugar got more under control the symptoms backed way off.

The Dawn Phenomenon is really kicking my butt pretty bad. My liver insists on "helping me out" every morning whether I need it or not. I tried changing my Lantus from morning to night, then even splitting the dose every 12 hours. I tried going to bed on the low side of BG, and going to bed on the high side....I tried a small snack before bed...nothing working for me. You just have to try different things and see what works for your body. What I would do if I was you is to check your blood sugar at intervals during your sleep cycle to see if you are dropoping low or not. I know its a pain to get up and do it...but the info will be good to have. There are actually two things that can be happening. There is the dawn phenonenon and there is something called the Somogyi effect. They both result in high AM blood sugars but have different causes.

The Somogyi effect occurs when you have a low in the night and your body tries to correct it, resulting in hyperglycemia. Try checking your BG around 2-3am to see if you are going low. The best way to fix this, is to avoid going low in the first place. Have a little snack with some sort of protein in it that will hold your BG up a bit (like a piece of whole wheat toast with peanut butter). Go to bed with a little higher of BG than maybe you usually do.

Dawn phenomenon is a little different. It occurs becasue the body naturally realeases hormones in the early morning to sort of "jump start the body" for the day. These hormones cause a rise a blood glucose. Of course for the diabetic that doesnt have enough insulin (or ability to use it properly), this causes high AM blood sugars. What I have been told to try and fix this is to maybe exercise later in the evening, or have a lower carb higher protein dinner. Neither of thiose things have had much effect for me but I keep trying what I can. The only thing that "fixes" mine is to get up....eat breakfast (I know that seems wrong when its high already) and take my insulin to cover it. That usually brings it down fairly quickly. I am just starting on a pump so we are hoping that maybe that will fix mine

Sorry for the long reply, but hope it helped some. Good luck![/QUOTE]

 

[onaughmae]

Hi, Pam-

I'm glad the foot pain for you subsided, and that your neuropathy appears to be limited. I'll wait to see how the Metanx plays out over the next few months. How long have you been taking the vitamins?

[/QUOTE]

I have been taking a multi-vitamin everyday, along with milk thistle and fish oil everyday for about the last 4 months. I dont know how much its helping...but I sure feel better

My foot pain is not bad at all anymore. I notice it more when I have been working a lot and been up on my feet alot.

Keep in touch and let us know how you are doing!