RE: Overnight Sugar control

[Guest guest]

HI Bill,

Are you saying you " bottom out " at 78? This is not necessarily low bg. I

believe the " normal " fasting range is between 65-100. So, your 78 is not out of

line at all. The slight rise is pretty normal, and I don't know for sure, but I

suspect even non-diabetics will see their bg rise slightly in the morning. It

sounds like your biggest issue is the sweating. Are you sure it's related to

the low bgs? Maybe you should set an alarm for, oh, 2 or 3, and cee what it is.

Dave

Victim of a crime? Know someone who was?

http://victimsheart.blogspot.com

Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

HI Bill,

Are you saying you " bottom out " at 78? This is not necessarily low bg. I

believe the " normal " fasting range is between 65-100. So, your 78 is not out of

line at all. The slight rise is pretty normal, and I don't know for sure, but I

suspect even non-diabetics will see their bg rise slightly in the morning. It

sounds like your biggest issue is the sweating. Are you sure it's related to

the low bgs? Maybe you should set an alarm for, oh, 2 or 3, and cee what it is.

Dave

Victim of a crime? Know someone who was?

http://victimsheart.blogspot.com

Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

HI Bill,

Are you saying you " bottom out " at 78? This is not necessarily low bg. I

believe the " normal " fasting range is between 65-100. So, your 78 is not out of

line at all. The slight rise is pretty normal, and I don't know for sure, but I

suspect even non-diabetics will see their bg rise slightly in the morning. It

sounds like your biggest issue is the sweating. Are you sure it's related to

the low bgs? Maybe you should set an alarm for, oh, 2 or 3, and cee what it is.

Dave

Victim of a crime? Know someone who was?

http://victimsheart.blogspot.com

Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

Hi Bill,

Type 2 diabetics produce some insulin. The pills either help your pancreas

to produce enough insulin or to help your body utilize the glucose.The

progressive levels could either be a rebound effect after bottoming or the

dawn phenomenon which is your body's way of kick starting the body in the

morning. It could also be simply that your meds are coming to the end of

their time and it is time to take more pills to renew the supply of insulin

controlling drugs.

Ruth

From: blind-diabetics

[mailto:blind-diabetics ] On Behalf Of Bill Powers

Sent: Monday, July 14, 2008 12:47 PM

To: blind-diabetics

Subject: Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

Hi Bill,

Type 2 diabetics produce some insulin. The pills either help your pancreas

to produce enough insulin or to help your body utilize the glucose.The

progressive levels could either be a rebound effect after bottoming or the

dawn phenomenon which is your body's way of kick starting the body in the

morning. It could also be simply that your meds are coming to the end of

their time and it is time to take more pills to renew the supply of insulin

controlling drugs.

Ruth

From: blind-diabetics

[mailto:blind-diabetics ] On Behalf Of Bill Powers

Sent: Monday, July 14, 2008 12:47 PM

To: blind-diabetics

Subject: Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

Hi Bill,

Type 2 diabetics produce some insulin. The pills either help your pancreas

to produce enough insulin or to help your body utilize the glucose.The

progressive levels could either be a rebound effect after bottoming or the

dawn phenomenon which is your body's way of kick starting the body in the

morning. It could also be simply that your meds are coming to the end of

their time and it is time to take more pills to renew the supply of insulin

controlling drugs.

Ruth

From: blind-diabetics

[mailto:blind-diabetics ] On Behalf Of Bill Powers

Sent: Monday, July 14, 2008 12:47 PM

To: blind-diabetics

Subject: Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

Hi Bill,

It is certainly can be a scary thing to go to bed, knowing that you could bottom

out sometime during the night. 

You are on glipizide, which I understand can cause low blood sugars. Could this

be causing you to have lows in the night? Could the timing of the drug be

causing this to happen? Or maybe doseage? These questions right now are

rhetorical of course, answers for which you won't know. But your doctor should

be able to work with you to get the answers to these questions. Even if the

doseage you are on previously worked for you, diabetes is a moving target, which

makes this disease particularly " interesting " (tongue firmly in cheek here), and

doseages and your own condition will change over time. The lows are certainly a

concern, and should not be taken casually. I strongly suggest that you talk to

your physician about this. 

One thing to note about eating before bed. The dietician recommended that both

my husband and I eat a small amount of carb and some protein right before bed -

he has type 2 on metformin, and I have type 1 on insulin, and the recommendation

for us both is the same. If my numbers are in the normal range at bedtime, I

might choose to have a just a few crackers (you won't need a lot) and a piece of

cheese, or maybe some cottage cheese, which has some carbs, but also protein, or

perhaps a small handful of nuts. It doesn't need to be a huge amount. The

protein is supposed to stabilize the bg response. Generally speaking, a small

amount of carb at bedtime, especially when you are bottoming out sometime during

the night, wouldn't be a bad thing, I should think.

Finally you mention that your blood sugars rise at around 7-ish - in many

diabetics this is common, called the Dawn Phenomenon. This may or may not be

happening here. But as I understand it (and others correct me if I don't get

this right), this is the body's natural response in the process of waking up -

the liver dumps a hormone that causes a rise in bgs to get the body ready for

getting up. I deal with this as well, and if I don't take insulin and have

breakfast when I get up, my number can be quite high a couple of  hours later.

That is for me though, as a Type 1, and of course, your mileage may vary, both

as a Type 2 which is quite different than Type 1, and for your own personal

condition.

One of my endos from years ago always told me that a short term, occasional high

is not as dangerous as the immediate danger that a low can be. That being said,

it might be a recommendation to risk a higher BG overnight for the short term,

until you sort out the rest of it with your physician.    

 

[Guest guest]

Hi Bill,

It is certainly can be a scary thing to go to bed, knowing that you could bottom

out sometime during the night. 

You are on glipizide, which I understand can cause low blood sugars. Could this

be causing you to have lows in the night? Could the timing of the drug be

causing this to happen? Or maybe doseage? These questions right now are

rhetorical of course, answers for which you won't know. But your doctor should

be able to work with you to get the answers to these questions. Even if the

doseage you are on previously worked for you, diabetes is a moving target, which

makes this disease particularly " interesting " (tongue firmly in cheek here), and

doseages and your own condition will change over time. The lows are certainly a

concern, and should not be taken casually. I strongly suggest that you talk to

your physician about this. 

One thing to note about eating before bed. The dietician recommended that both

my husband and I eat a small amount of carb and some protein right before bed -

he has type 2 on metformin, and I have type 1 on insulin, and the recommendation

for us both is the same. If my numbers are in the normal range at bedtime, I

might choose to have a just a few crackers (you won't need a lot) and a piece of

cheese, or maybe some cottage cheese, which has some carbs, but also protein, or

perhaps a small handful of nuts. It doesn't need to be a huge amount. The

protein is supposed to stabilize the bg response. Generally speaking, a small

amount of carb at bedtime, especially when you are bottoming out sometime during

the night, wouldn't be a bad thing, I should think.

Finally you mention that your blood sugars rise at around 7-ish - in many

diabetics this is common, called the Dawn Phenomenon. This may or may not be

happening here. But as I understand it (and others correct me if I don't get

this right), this is the body's natural response in the process of waking up -

the liver dumps a hormone that causes a rise in bgs to get the body ready for

getting up. I deal with this as well, and if I don't take insulin and have

breakfast when I get up, my number can be quite high a couple of  hours later.

That is for me though, as a Type 1, and of course, your mileage may vary, both

as a Type 2 which is quite different than Type 1, and for your own personal

condition.

One of my endos from years ago always told me that a short term, occasional high

is not as dangerous as the immediate danger that a low can be. That being said,

it might be a recommendation to risk a higher BG overnight for the short term,

until you sort out the rest of it with your physician.    

 

[Guest guest]

Hi Bill,

It is certainly can be a scary thing to go to bed, knowing that you could bottom

out sometime during the night. 

You are on glipizide, which I understand can cause low blood sugars. Could this

be causing you to have lows in the night? Could the timing of the drug be

causing this to happen? Or maybe doseage? These questions right now are

rhetorical of course, answers for which you won't know. But your doctor should

be able to work with you to get the answers to these questions. Even if the

doseage you are on previously worked for you, diabetes is a moving target, which

makes this disease particularly " interesting " (tongue firmly in cheek here), and

doseages and your own condition will change over time. The lows are certainly a

concern, and should not be taken casually. I strongly suggest that you talk to

your physician about this. 

One thing to note about eating before bed. The dietician recommended that both

my husband and I eat a small amount of carb and some protein right before bed -

he has type 2 on metformin, and I have type 1 on insulin, and the recommendation

for us both is the same. If my numbers are in the normal range at bedtime, I

might choose to have a just a few crackers (you won't need a lot) and a piece of

cheese, or maybe some cottage cheese, which has some carbs, but also protein, or

perhaps a small handful of nuts. It doesn't need to be a huge amount. The

protein is supposed to stabilize the bg response. Generally speaking, a small

amount of carb at bedtime, especially when you are bottoming out sometime during

the night, wouldn't be a bad thing, I should think.

Finally you mention that your blood sugars rise at around 7-ish - in many

diabetics this is common, called the Dawn Phenomenon. This may or may not be

happening here. But as I understand it (and others correct me if I don't get

this right), this is the body's natural response in the process of waking up -

the liver dumps a hormone that causes a rise in bgs to get the body ready for

getting up. I deal with this as well, and if I don't take insulin and have

breakfast when I get up, my number can be quite high a couple of  hours later.

That is for me though, as a Type 1, and of course, your mileage may vary, both

as a Type 2 which is quite different than Type 1, and for your own personal

condition.

One of my endos from years ago always told me that a short term, occasional high

is not as dangerous as the immediate danger that a low can be. That being said,

it might be a recommendation to risk a higher BG overnight for the short term,

until you sort out the rest of it with your physician.    

 

[Guest guest]

Sometimes a rapid decrease in your blood glucose can fool the body into thinking

it is having a low - in your case, the night time sweats. You could also try

setting the alarm for an hour or two before you typically get that awful sweaty

feeling, to find out where you are at, and see if you are dropping quickly. Dave

is right, 78 isn't really that low (I'm in Canada so I hadn't done the math for

our mmol measurement to your mg measurement), but the fact that you are waking

up with that awful feeling is something to look into further and perhaps discuss

with your doctor.

[Guest guest]

Sometimes a rapid decrease in your blood glucose can fool the body into thinking

it is having a low - in your case, the night time sweats. You could also try

setting the alarm for an hour or two before you typically get that awful sweaty

feeling, to find out where you are at, and see if you are dropping quickly. Dave

is right, 78 isn't really that low (I'm in Canada so I hadn't done the math for

our mmol measurement to your mg measurement), but the fact that you are waking

up with that awful feeling is something to look into further and perhaps discuss

with your doctor.

[Guest guest]

I would recommend you give your beta cells a rest instead of pounding them to

death with glyburide and metformin. Starting insulin now is the key.

Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

I would recommend you give your beta cells a rest instead of pounding them to

death with glyburide and metformin. Starting insulin now is the key.

Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

I would recommend you give your beta cells a rest instead of pounding them to

death with glyburide and metformin. Starting insulin now is the key.

Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

Type2's, who start insulin therapy, have little to fear regarding going low, as

long as carb intake and insulin dosage is balanced, since they type2's still

have some remaining beta cells, which can still function, as long as they are

not beaten to death. Insulin will ease the strain caused by drugs.

Re: Overnight Sugar control

Hi Bill,

It is certainly can be a scary thing to go to bed, knowing that you could

bottom out sometime during the night.

You are on glipizide, which I understand can cause low blood sugars. Could

this be causing you to have lows in the night? Could the timing of the drug be

causing this to happen? Or maybe doseage? These questions right now are

rhetorical of course, answers for which you won't know. But your doctor should

be able to work with you to get the answers to these questions. Even if the

doseage you are on previously worked for you, diabetes is a moving target, which

makes this disease particularly " interesting " (tongue firmly in cheek here), and

doseages and your own condition will change over time. The lows are certainly a

concern, and should not be taken casually. I strongly suggest that you talk to

your physician about this.

One thing to note about eating before bed. The dietician recommended that both

my husband and I eat a small amount of carb and some protein right before bed -

he has type 2 on metformin, and I have type 1 on insulin, and the recommendation

for us both is the same. If my numbers are in the normal range at bedtime, I

might choose to have a just a few crackers (you won't need a lot) and a piece of

cheese, or maybe some cottage cheese, which has some carbs, but also protein, or

perhaps a small handful of nuts. It doesn't need to be a huge amount. The

protein is supposed to stabilize the bg response. Generally speaking, a small

amount of carb at bedtime, especially when you are bottoming out sometime during

the night, wouldn't be a bad thing, I should think.

Finally you mention that your blood sugars rise at around 7-ish - in many

diabetics this is common, called the Dawn Phenomenon. This may or may not be

happening here. But as I understand it (and others correct me if I don't get

this right), this is the body's natural response in the process of waking up -

the liver dumps a hormone that causes a rise in bgs to get the body ready for

getting up. I deal with this as well, and if I don't take insulin and have

breakfast when I get up, my number can be quite high a couple of hours later.

That is for me though, as a Type 1, and of course, your mileage may vary, both

as a Type 2 which is quite different than Type 1, and for your own personal

condition.

One of my endos from years ago always told me that a short term, occasional

high is not as dangerous as the immediate danger that a low can be. That being

said, it might be a recommendation to risk a higher BG overnight for the short

term, until you sort out the rest of it with your physician.

[Guest guest]

Type2's, who start insulin therapy, have little to fear regarding going low, as

long as carb intake and insulin dosage is balanced, since they type2's still

have some remaining beta cells, which can still function, as long as they are

not beaten to death. Insulin will ease the strain caused by drugs.

Re: Overnight Sugar control

Hi Bill,

It is certainly can be a scary thing to go to bed, knowing that you could

bottom out sometime during the night.

You are on glipizide, which I understand can cause low blood sugars. Could

this be causing you to have lows in the night? Could the timing of the drug be

causing this to happen? Or maybe doseage? These questions right now are

rhetorical of course, answers for which you won't know. But your doctor should

be able to work with you to get the answers to these questions. Even if the

doseage you are on previously worked for you, diabetes is a moving target, which

makes this disease particularly " interesting " (tongue firmly in cheek here), and

doseages and your own condition will change over time. The lows are certainly a

concern, and should not be taken casually. I strongly suggest that you talk to

your physician about this.

One thing to note about eating before bed. The dietician recommended that both

my husband and I eat a small amount of carb and some protein right before bed -

he has type 2 on metformin, and I have type 1 on insulin, and the recommendation

for us both is the same. If my numbers are in the normal range at bedtime, I

might choose to have a just a few crackers (you won't need a lot) and a piece of

cheese, or maybe some cottage cheese, which has some carbs, but also protein, or

perhaps a small handful of nuts. It doesn't need to be a huge amount. The

protein is supposed to stabilize the bg response. Generally speaking, a small

amount of carb at bedtime, especially when you are bottoming out sometime during

the night, wouldn't be a bad thing, I should think.

Finally you mention that your blood sugars rise at around 7-ish - in many

diabetics this is common, called the Dawn Phenomenon. This may or may not be

happening here. But as I understand it (and others correct me if I don't get

this right), this is the body's natural response in the process of waking up -

the liver dumps a hormone that causes a rise in bgs to get the body ready for

getting up. I deal with this as well, and if I don't take insulin and have

breakfast when I get up, my number can be quite high a couple of hours later.

That is for me though, as a Type 1, and of course, your mileage may vary, both

as a Type 2 which is quite different than Type 1, and for your own personal

condition.

One of my endos from years ago always told me that a short term, occasional

high is not as dangerous as the immediate danger that a low can be. That being

said, it might be a recommendation to risk a higher BG overnight for the short

term, until you sort out the rest of it with your physician.

[Guest guest]

Dave,

I should have been a little clearer on what I meant by bottoming out. With a

morning fasting of 78 when I actually wake up, I know that during the night

my sugar will have been lower than that. When I wake up in the middle of the

night I know that feeling of being " out of it " that I've become very

familiar with when my sugar dives. I don't really feel like getting up at

that point even though I should, in order to check my sugar level, but at

the same time I know it will rise shortly, so I let it pass. But when I feel

a really low sugar I tend to sweat, not necessarily a cold sweat, but it

just seems to happen when I suspect my sugar is rather low.

Hope that clears up what I was trying to say before.

Bill Powers

[Guest guest]

Dave,

I should have been a little clearer on what I meant by bottoming out. With a

morning fasting of 78 when I actually wake up, I know that during the night

my sugar will have been lower than that. When I wake up in the middle of the

night I know that feeling of being " out of it " that I've become very

familiar with when my sugar dives. I don't really feel like getting up at

that point even though I should, in order to check my sugar level, but at

the same time I know it will rise shortly, so I let it pass. But when I feel

a really low sugar I tend to sweat, not necessarily a cold sweat, but it

just seems to happen when I suspect my sugar is rather low.

Hope that clears up what I was trying to say before.

Bill Powers

[Guest guest]

You know it just dawned on me that I did make note of an experience one

night when I felt particularly " out of it " at around 2:00 to 3:00 in the

morning, and I had the sense to get up and take my blood sugar reading. It

was 46. It was all I could do to think what to do next, but I managed to

think " glucose tablets " so I took one. Within about 10 minutes, the feeling

seemed to subside and I could attempt to go back to sleep. I don't think my

lows usually get THAT low, and I certainly don't want to wake up every

morning at around 3 to give myself a sugar tablet, but therein something

tells me that something needs to be checked. Now that I have the note in

front of me I'll take this with me to my doctor.

Bill

[Guest guest]

I wouldn't recommend this, but I've been in the low and mid 20s on occasion, and

not unconscious. I did pass out one time in my office, and thanks to God's

intervention, who prompted my wife to call me, which set a chain of events in

gear that saved my life, I was found. The paramedics found me, unconscious,

slumped over in my office chair, and my reading at that point was 14. I have

speculated since that day that I was probably lower than that at some point,

since the body actually pulls glucose from organs to keep itself alive.

Dave

Victim of a crime? Know someone who was?

http://victimsheart.blogspot.com

RE: Overnight Sugar control

You know it just dawned on me that I did make note of an experience one

night when I felt particularly " out of it " at around 2:00 to 3:00 in the

morning, and I had the sense to get up and take my blood sugar reading. It

was 46. It was all I could do to think what to do next, but I managed to

think " glucose tablets " so I took one. Within about 10 minutes, the feeling

seemed to subside and I could attempt to go back to sleep. I don't think my

lows usually get THAT low, and I certainly don't want to wake up every

morning at around 3 to give myself a sugar tablet, but therein something

tells me that something needs to be checked. Now that I have the note in

front of me I'll take this with me to my doctor.

Bill

[Guest guest]

Bill

I'm definitely no expert, but if I were you, I'd ask the doctor about not

taking a Medforman before bed.

Becky

_____

From: blind-diabetics

[mailto:blind-diabetics ] On Behalf Of Bill Powers

Sent: Monday, July 14, 2008 1:47 PM

To: blind-diabetics

Subject: Overnight Sugar control

I generally have good sugar control during the day using a combination of

Metformin, Glyburide and one Lisinopril taken in the evening. The biggest

battle I have is controlling sugars overnight, so I'm looking for your

thoughts on this. What I typically find is that I have a good sugar level

near bedtime, and on average my fasting sugar is 80, but sometime during the

night I must bottom out, which causes me to sweat a lot. A very early

morning fasting (say, 4:30 a.m.) is around 78, but on days I wake up later,

like 7:00 a.m., my fasting is more like 92-98. That said, does this indicate

that my body is still producing its own insulin, or what else would cause

the progressive level before medication and eating?

If my theory is then correct that my body is producing some of its own

insulin, I then am always fighting the rollercoaster battle every night. If

I have a light snack usually 3 hours before bedtime, it has minimal

difference in fasting sugars. I would not snack before bedtime because I

think we all know that's a setup for high sugars. But the question begs to

be asked then, how to keep from bottoming out during the night (which just

might diminish the sweating problem, too).

Keep in mind I take one Metformin before bedtime. So I'm taking Metformin,

Glyburide, Plendil and Triamterene in the morning, Metformin at noon,

Metform, Glyburide and Lisinopril at dinner and then Metformin at bedtime.

My current doctor worked on this with me to get to this point and except for

the overnight problem, the plan seems to work OK for me.

I will be seeing him shortly and will ask for his input, but thought I'd

bring it to the list and see what your thoughts are.

And in light of talking about insulin, I am very curious to know if I could

attain more constant control using insulin than with pills.

Obviously, big pharma wants us all on pills for the rest of our lives, but I

just don't see that in my plans. Not if insulin will make me healthier.

Bill Powers

[Guest guest]

Metformin typically doesn't cause low blood glucose numbers, which is why it is

the most commonly prescribed first medication. But the Glyburide might cause a

low.

>>>>>>Bill

I'm definitely no expert, but if I were you, I'd ask the doctor about not

taking a Medforman before bed.

Becky

[Guest guest]

I just thought it might be the problem since he takes it at bedtime.

_____

From: blind-diabetics

[mailto:blind-diabetics ] On Behalf Of Naessens

Sent: Monday, July 14, 2008 8:24 PM

To: blind-diabetics

Subject: Re: Overnight Sugar control

Metformin typically doesn't cause low blood glucose numbers, which is why it

is the most commonly prescribed first medication. But the Glyburide might

cause a low.

>>>>>>Bill

I'm definitely no expert, but if I were you, I'd ask the doctor about not

taking a Medforman before bed.

Becky

[Guest guest]

Dave,

I didn't think you could actually get a glucose reading in the 20s let alone

down to 14. I would have thought you'd be dead if your reading was down to

30. I can remember one time a few years ago when my mom told me she went

down to 39 the night before, and I told her that was very unsafe and to

notify her doctor immediately that she had such a low. That was scary. Of

course she did nothing, she didn't want to be bothered. At that point I

could only sit back and when she complains about her sugar ups and downs, I

just have to tell her politely I don't want to hear about it, because

nothing will change anyway. Still, a low of 39 is very scary and if it

happened to me, I'd be on the phone ysterday.

Bill Powers

[Guest guest]

Dave,

I didn't think you could actually get a glucose reading in the 20s let alone

down to 14. I would have thought you'd be dead if your reading was down to

30. I can remember one time a few years ago when my mom told me she went

down to 39 the night before, and I told her that was very unsafe and to

notify her doctor immediately that she had such a low. That was scary. Of

course she did nothing, she didn't want to be bothered. At that point I

could only sit back and when she complains about her sugar ups and downs, I

just have to tell her politely I don't want to hear about it, because

nothing will change anyway. Still, a low of 39 is very scary and if it

happened to me, I'd be on the phone ysterday.

Bill Powers