Need some advice

[Oradev]

Hey guys, it's been a while. I've got a couple of questions (some old/some new).
I have severe DP in the morning, the rest of the day I'm pretty much even (ie same basil profile). Does anybody know of any meds or anything else for that matter that has been proven to lessen the liver dump in the morning? I think one of the old members on here tried some meds but i'm unsure who it was. I am currently on the pump, but have been running into infusion site problems due to my skinny build. I was going to take a pump break and try out Levemir for a month or so. Has this insulin been known to counter any liver dump?

Thanks for your help.

Adam

[JediSkipdogg]

I think the only real insulin that ever countered a liver dump is NPH and that's because of the high peak it had. It would peak just when the effects of the dawn phenomenon start therefore lessoning itself. I don't know much about levemir though, but I know Lantus won't help much.

[duck]

Metformin has been used by various people to stop liver dumping...Childrenwithdiabetes actually endorses Metformin and MDI for teens a while back, and various members here have used a similar strategy with varying success.

Be advised, met can cause gas, so I'd run it by the hunny as well. :afraid:

[DeusXM]

You can also make a couple of lifestyle changes that might help too. Drinking something alcoholic before going to bed might distract your liver from dumping in the morning. Otherwise, if you're currently not eating breakfast, try eating some carbs first thing in the morning. This will convince your liver it doesn't need to 'help' you and it should stop dumping.

[Oradev]

Metformin has been used by various people to stop liver dumping...Childrenwithdiabetes actually endorses Metformin and MDI for teens a while back, and various members here have used a similar strategy with varying success.

Be advised, met can cause gas, so I'd run it by the hunny as well. :afraid:

Thanks Duck, that's what I was thinkin of. Do you know what the primary function of Metformin is used for? What dosage would I take? When would I take it? If I suggest this to my doctor, do you guys think that they will say no.

[Oradev]

What if I started running/jogging 30 minutes each night. That would directly effect my insulin resistence in the morning right?

[duck]

Thanks Duck, that's what I was thinkin of. Do you know what the primary function of Metformin is used for? What dosage would I take? When would I take it? If I suggest this to my doctor, do you guys think that they will say no.

Metformin inhibits glucose release from the liver, which is probably what is happening to you. I have no idea about dosages, but I do know it helps to take it with food. Typically, others have tried Peanut butter before bed to inhibit a liver dump at night, so maybe you can combine therapies. Also, Deus' suggestion about alcohol works very well for some.

What if I started running/jogging 30 minutes each night. That would directly effect my insulin resistence in the morning right?

Possibly; how does exercise typically affect you? Does it lower or increase your blood glucose levels?

[DeusXM]

Also, Deus' suggestion about alcohol works very well for some.

It works very well for me!

[BlueSky]

... Does anybody know of any meds or anything else for that matter that has been proven to lessen the liver dump in the morning? ....

Adam,

As duck mentioned, metformin works quite well. It inhibits the production of hepatic glucose, which is a major driver of the Dawn Phenomenon. I have done a lot of experimentation with this. So here is my take on it.

You can try taking 500mg of metformin before bed. It acts over about 8 hours. So it should cover you until you get up in the morning. But if your DP blood glucose surge is extending into the late morning, the metformin might run out of steam. In which case you can try using the extrended release version. Or you can take a second 500mg of metformin before breakfast.

I used this technique quite successfully. It flattened out those stubborn high morning BGs. But I was not happy about taking a drug that messed with my liver (I had hepatitis some time ago and my liver never fully recovered). I also found that the effect of metformin was not always consistent. And using it introduced yet another variable into the BG control equation, making BG stabilisation more complicated than it needed to be.

I stopped using metformin for these reasons. But, at the same time, I realised that my very pronounced DP was the result of steadily advancing insulin resistance. And I decided to focus on execise to deal with it, together with a further reduction in carb consumption. This has worked really well. I have been going to the gym 4 times a week for 6 months now. And the DP effect has weakened a lot. I have been able to stop the before-bed NPH (another way of dealing with the DP), which I have replaced with additional Lantus.

I haven't tried the alcohol-before-bed trick. I don't think my liver would be too happy about that either. And I firmly believe that, the less drugs we use, the better our bodies will cope. Hope this helps :wink:

[DeusXM]

I haven't tried the alcohol-before-bed trick. I don't think my liver would be too happy about that either. And I firmly believe that, the less drugs we use, the better our bodies will cope.

One drink a day isn't going to damage your liver. Besides, you obviously haven't read the news lately!

Daily tipple could be just what doctor ordered | Special reports | Guardian Unlimited (http://www.guardian.co.uk/medicine/story/0,,1929773,00.html)

Doctors should not encourage men in good health who drink moderately to give up alcohol, according to researchers. Quite the opposite: a 16-year study of nearly 9,000 men in the US found that a regular tipple lowered their risk of heart attack.

Men who drank between one and a half and three units of alcohol a day on average had nearly a third of the risk of suffering heart attacks faced by healthy men who stayed off the booze. One unit is a glass of wine or a half-pint of beer.

But the most impressive protection from heart attack was in men who drank moderately. An average of 0.5 to 1.5 units a day nearly halved the risk compared with abstainers, while those who drank between 1.5 and 3 units a day suffered nearly a third of the risk. The results appear in the current issue of Archives of Internal Medicine.

[BlueSky]

One drink a day isn't going to damage your liver. Besides, you obviously haven't read the news lately!....
I have no problem with alcohol. I have at least one drink every day. But I do it for pleasure, not to control my DP or any other medical condition. And yes, I have seen all the hoo-ha about the beneficial effects of alcohol. For various reasons I am not convinced. But in any case, using alcohol to control cholesterol is simply another case of over-medication as far as I am concerned. :wink:

[MJM]

Hey guys, it's been a while. I've got a couple of questions (some old/some new).
I have severe DP in the morning, the rest of the day I'm pretty much even (ie same basil profile). Does anybody know of any meds or anything else for that matter that has been proven to lessen the liver dump in the morning? I think one of the old members on here tried some meds but i'm unsure who it was. I am currently on the pump, but have been running into infusion site problems due to my skinny build. I was going to take a pump break and try out Levemir for a month or so. Has this insulin been known to counter any liver dump?

Thanks for your help.

Adam

Adam, I'm skinny too and have had a similar problem to yours. What I've done is adjust my basal at night to increase to almost double what the normal daily basal rate is, for a couple of hours before I wake up. So far it's working out reasonably well. It took a bit of experimenting to find the basal figure that worked. Good luck with your efforts.

[grace girl]

I don't know much about levemir though, but I know Lantus won't help much.

When taken in one dose it doesn't help. Since I split it up I'm not having as much of a problem with the DP as I was before. I used to experience a 60-70 point rise...now its more like 30. Not a complete fix, but more managable.

[Oradev]

Thanks guys. I'm going to try the Lantis again. Still deciding on the Metformin.

[Oradev]

Adam,

As duck mentioned, metformin works quite well. It inhibits the production of hepatic glucose, which is a major driver of the Dawn Phenomenon. I have done a lot of experimentation with this. So here is my take on it.

You can try taking 500mg of metformin before bed. It acts over about 8 hours. So it should cover you until you get up in the morning. But if your DP blood glucose surge is extending into the late morning, the metformin might run out of steam. In which case you can try using the extrended release version. Or you can take a second 500mg of metformin before breakfast.

I used this technique quite successfully. It flattened out those stubborn high morning BGs. But I was not happy about taking a drug that messed with my liver (I had hepatitis some time ago and my liver never fully recovered). I also found that the effect of metformin was not always consistent. And using it introduced yet another variable into the BG control equation, making BG stabilisation more complicated than it needed to be.

I stopped using metformin for these reasons. But, at the same time, I realised that my very pronounced DP was the result of steadily advancing insulin resistance. And I decided to focus on execise to deal with it, together with a further reduction in carb consumption. This has worked really well. I have been going to the gym 4 times a week for 6 months now. And the DP effect has weakened a lot. I have been able to stop the before-bed NPH (another way of dealing with the DP), which I have replaced with additional Lantus.

I haven't tried the alcohol-before-bed trick. I don't think my liver would be too happy about that either. And I firmly believe that, the less drugs we use, the better our bodies will cope. Hope this helps :wink:


Bluesky, when did you take your NPH. My DP seems to happen from 5 - 7 am. What would be the most effective time to take my NPH? Thanks.

Adam

[Oradev]

Also, how long did it take for you to notice some DP effects after you started to work out.

[BlueSky]

Bluesky, when did you take your NPH. My DP seems to happen from 5 - 7 am. What would be the most effective time to take my NPH? Thanks.
I used to take the NPH before going to bed. It would start picking up speed by 5-7am. For me, it also filled the gap in the Lantus action. Which I was injecting the at 6.30am.
Also, how long did it take for you to notice some DP effects after you started to work out.
I started seeing a benefit after about 3 months. The DP weakened noticeably. And initially, I reduced the NPH. After 6 months, I replaced it with a second Lantus shot. I now still inject regular when I get up in tyhe morning. It covers a substantial high protein/fat breakfast. And it may still cover a residual DP effect ... :wink:

[Oradev]

Thanks Bluesky.

Right now I am taking 16 L at 11 pm and 6 L at 11 am. ( I split the dosage because it doesn't last the full 24 hours). Last night, when I went to bed at midnight my bloodsugar was 110. At 3 am 108. At 6 am 157. And at 7 am 208. Now, I have been running the last two nights and am going to make this a habit from now on.
If I'm going to add NPH (6 u at 11pm) , I will probably reduce my 11pm Lantus dose to 14 or something (if not, i will go low around 3 am).

Thanks again for the help. Did you see good effects while on the Metformin?

[Cyborg]

Drinking something alcoholic before going to bed might distract your liver from dumping in the morning.

Does for me... Completely stops my DP the next morning.

[duck]

Thanks Bluesky.

Right now I am taking 16 L at 11 pm and 6 L at 11 am. ( I split the dosage because it doesn't last the full 24 hours). Last night, when I went to bed at midnight my bloodsugar was 110. At 3 am 108. At 6 am 157. And at 7 am 208. Now, I have been running the last two nights and am going to make this a habit from now on.
If I'm going to add NPH (6 u at 11pm) , I will probably reduce my 11pm Lantus dose to 14 or something (if not, i will go low around 3 am).

Thanks again for the help. Did you see good effects while on the Metformin?

NPH, in my opinion, is a lot more powerful than Lantus, esp. when it peaks (obviously), so I would probably cut the Lantus by at least as much NPH as you take (example, if you currently take 16 Lantus, and want to add 6 NPH, I'd probably only take 10 Lantus or less). But talk to your doc before you start this, please.

[Oradev]

Does for me... Completely stops my DP the next morning.

What do you drink and how much?

[duck]

A single shot of liquor should be sufficient (and you don't need to down it like you are at a frat party, either). I think on the bernstein forum the Type 2's there endorse a gin before bed routine to deal with DP. YMMV, though.

[Oradev]

A single shot of liquor should be sufficient (and you don't need to down it like you are at a frat party, either). I think on the bernstein forum the Type 2's there endorse a gin before bed routine to deal with DP. YMMV, though.

Duck, i'll let the wife know that you are giving me permission to get drunk...

[duck]

Duck, i'll let the wife know that you are giving me permission to get drunk...

If one drink makes you drunk, you're a lightweight exceeding even the Duck. :king:

[Oradev]

Who said anything about one drink????:tee:

What about a glass of red wine? Has anyone tried that out?