Disappointing Results? (Is the occasional fast wrong?)

[matingara]

i am trying to be really good. extra exercise, low carb diet.

2 months into this Type 2 thing.

the last week i have had an average BGL of 108 (6.0 in the Aussie system). I test at least 7 times a day - so that average is fairly representative.

my lowest reading this week has been 59 (3.3) and my highest a 171 (9.5) two hours after i ate a Nando's wrap before art class!

all my preprandials in the last week have been below 108 (6.0) and all of my morning (FBG) readings for the last week have been below 108 (lowest was 65 (3.6).

UNTIL THIS MORNING.

i woke at 115 (6.4). so i decided to fast until lunchtime. before lunch i was at 135 (7.5) and after a lunch of tuna and home made celery soup i was way up at 166.

i am disappointed at this..... should i have fasted? am i asking too much to expect my numbers to stay consistent for more than one week?

this can be very frustrating.

-- Joel

[ant hill]

Hello Joel, I don't think that's all bad realy. If that's an fasting reading then you have done well.
You should have a look at mine. It's like a bomb has hit it. :eek:

[xMenace]

A 6.0 is fine, especially when you consider the error built into our monitors.

Fasting can actually raise your BGs. Whenever I skip breakfast I have to double my lunchtime bolus. My endo can't explain it, but it's been true every time I've tried.

Really you are doing more than you need to. I think you need to up your meds a bit and start eating a little better.

[volleyball]

I don't recommend fasting. You are better off eating something that will digest slowly.
Plus if you don't eat, you'll likely go for a bigger lunch and therefore a higher glycemic index. And you stomach will immediately start processing the food so any quick digest food (carbs) will raise you numbers. If your lunch was already prepared and you had no chance of getting anything extra, you might not spike so much

[slipperyelm]

I'm a t-2 and I can skip a meal without a BG rise, thank goodness. I say thank goodness, because even though I love to eat, once in a while I'm just not hungry, or I have a late lunch meeting scheduled, or I don't feel like preparing the food, or I just forget.

I would not draw permanent conclusions from just one fast. Try again. Also skipping lunch may be quite different for you than skipping breakfast, as the latter extends a built-in period of fast during the night. See what happens if you skip breakfast on a day when your BG was a "good" level when you woke up.

(I don't think people who take a sulfonylurea can fast safely , though. Might get hypoglycemic.)

[slipperyelm]

I just looked up your Diamicron, which is a sulfonylurea, the one also known as glicazide. Did you skip taking the Diamicron the morning of your fast? How much can Diamicron normally bring down your BG? If you took the Diamicron, I'm surprised your BG went up with a fasting. (I would've had to be peeled off the floor!)

[matingara]

hey slippery!

yes - that is where i was heading with this. diamicron mr is a slow release sulfonylurea (gliclazide).

this past week has seen my numbers for the first time below 72 (4.0). when i had the 59 (3.3) the other day i was concerned that i might go low. i have never experienced hypoclycemia and i don't want it to surprise me. then again if i have never experienced a hypo maybe i am not susceptible to hyops (???).

my key thought is that if i have reduced my numbers using the half dose of diamicron that i am on - is it possible that i can go off the meds completely? that is what i am aiming for.

-- Joel.

[slipperyelm]

So are you saying that you did skip the Diamicron the day you fasted? If so, that is looking to me like you really could use some medicine assistance with keeping you BGs down. Unless, of course you can keep them down by some other method. For me, very low carb eating helps more than any of my medicines help---though I do take two meds. Excercise helps me tremendously and I'm sure some more weight loss would help me, but I don't know if you need to do more in those areas.

Even if metformin did not agree with you the first time you tried it, I would not rule it out forever. Some people here have tried metformin later, a second time, and were able to tolerate it. Personally, I put up with the harsh gastrointestinal effects for a year and a half--I don't know, maybe I was crazy to do that.

But between the two meds you have tried --metformin and Diamicron-- personally I would prefer metformin.

Your 3.3 number seems pretty low! How did you feel at that point? Can I guess that you checked your BG at that point because you were feeling bad? Even at 4.0 you might have felt "iffy" if you are not accustomed to anything near 4.0 day in and day out. For me, at 3.3, I would definitely have to have some quick acting carbs! At 4.0, I would have some if I thought I was still on a downward trend or if I needed to make any physical exertion. Otherwise, I would just keep an eye on it, and check BG again in a half hour or so. But if you frequently get numbers like that on Diamicron, even that half dose is probably too much. You could reduce the dose or discontinue it all together?

I used to take a sulfonlyurea related to Diamicron and was on a tiny dose, but had to just go off of it completely. I went as low as 2.38 (43 mg/dl) on it and was having lows almost every day, sometimes multiple times a day. I had to take my meter with me everywhere and had to have glucose at the ready. I do much better with just eating low carb, and taking insulin sensitizing medicines like metformin.

Hope this commentary offers you something, as I'm not sure if I'm addressing your questions.

[matingara]

hi slippery!

no i did not skip the diamicron on the day i fasted. i am eating low carb (very low sometimes) and exercising. my weight is 175 pounds at 5 foot 10 inches.

exercise does help alot! it sometimes knocks my BS down by 18-36 points.

when i was down to 3.3 i felt just fine. i was a bit hungry and it was my pre-dinner standard measurement. so other than the hunger i didn't notice anything special - and i was just before dinner so i am supposed to be hungry!

i am getting a reading (or readings) in the 3's and 4's every other day or so.

what i am asking is, if i am in the range 4-8 (72-144) most of the time (4-6 preprandial most of the time) AND i am taking only half the max diamicron AND i have had readings as LOW as 3.3 - should i consider stopping the diamicron altogether. that is my main question.

:)



So are you saying that you did skip the Diamicron the day you fasted? If so, that is looking to me like you really could use some medicine assistance with keeping you BGs down. Unless, of course you can keep them down by some other method. For me, very low carb eating helps more than any of my medicines help---though I do take two meds. Excercise helps me tremendously and I'm sure some more weight loss would help me, but I don't know if you need to do more in those areas.

Even if metformin did not agree with you the first time you tried it, I would not rule it out forever. Some people here have tried metformin later, a second time, and were able to tolerate it. Personally, I put up with the harsh gastrointestinal effects for a year and a half--I don't know, maybe I was crazy to do that.

But between the two meds you have tried --metformin and Diamicron-- personally I would prefer metformin.

Your 3.3 number seems pretty low! How did you feel at that point? Can I guess that you checked your BG at that point because you were feeling bad? Even at 4.0 you might have felt "iffy" if you are not accustomed to anything near 4.0 day in and day out. For me, at 3.3, I would definitely have to have some quick acting carbs! At 4.0, I would have some if I thought I was still on a downward trend or if I needed to make any physical exertion. Otherwise, I would just keep an eye on it, and check BG again in a half hour or so. But if you frequently get numbers like that on Diamicron, even that half dose is probably too much. You could reduce the dose or discontinue it all together?

I used to take a sulfonlyurea related to Diamicron and was on a tiny dose, but had to just go off of it completely. I went as low as 2.38 (43 mg/dl) on it and was having lows almost every day, sometimes multiple times a day. I had to take my meter with me everywhere and had to have glucose at the ready. I do much better with just eating low carb, and taking insulin sensitizing medicines like metformin.

Hope this commentary offers you something, as I'm not sure if I'm addressing your questions.