Glucose at lunch always 200-250, need advice controlling it

[nyker]

Hi everyone, I'm new here. I actually got on this forum because my DM (dear mother) was diagnosed of Type 2 DB about 2 years ago. She was doing alright but always bordering on 6+ A1Cs. So recently her doc gave her a meter and she's been testing for the past week or so.

After testing she discovered that she has tons of trouble controlling her glucose for lunch. Her numbers always 200-250 for lunch. Even though, she eats exactly the same meal for dinner sometimes and at 2hr post dinner, her level can be just 170ish for the same meal.

Does anyone know why this is the case, and what could she do about this?

BTW, DM does not speak English, so I'm writing this. But she wishes to thank everyone for any help here.

[Evermont]

Welcome. The army of welcomers that follow will have answers!

[matingara]

my BGL's always go up more at lunchtime than at dinner time - even when i eat similar/identical foods.

i think this may be because i have re-introduced wine with dinner.

Having said that though, even before i re-introduced wine, i always had more trouble with lunchtime numbers.

at dinner time i can even eat ice cream (couple of scoops) and keep my BGL in the 6-8 range (108-144).

-- Joel.

[BlueSky]

The morning is the most difficult time of the day for controlling blood glucose. We tend to be a lot more sensitive to carbs in the morning. You didn't say what you DM is eating. If she can reduce carbohydrate with breakfast, she may find that her lunchtime readings are a lot better.

Welcome to the forums :)

[RobiJo]

Does she eat breakfast?

I have a harder time with lunch numbers when I haven't eatten breakfast.

Probably a midmorning liver dump after not eating since dinner the night before. When I eat breakfast (usually a can of Slimfast Optima 20g) on my to work. Very minimal but it helps a ton when it comes to lunch time bgs.

[princesslinda]

Welcome Nyker! What medication does your mother currently take for her diabetes? Is she able to exercise? Does she watch her carb intake?

I have found the eating lower carb (avoiding rice, pasta, bread, potatoes) helps keep my blood sugar at an acceptable level. Add exercise and it helps even more.

Its good that she's checking her blood sugars now...i'd suggesting testing before and then 2 hrs after the first bite of her meals, so she'll be able to see how different foods affect blood sugars, and therefore be able to make smarter food choices. When she finds a food that doesn't cause a big rise in blood sugar, she'll know she can have this often.

There are times when the same food will have a different effect on blood sugars, based on things like time of day, amount of exercise i've gotten, or if i'm feeling bad physically that day.

There's a great book i'd recommend for T2s "Type II Diabetes, The First Year," by Gretchen Becker...very informative. Not sure if they have it in her language, but you could read and translate for her. It might help answer some of her questions.

[xMenace]

Welcome.

It is most unusual for a lunch pp to be the highest. The obvious answer is to cut back the carbs.

Does she eat any breakfast and what does she eat then? I ask because some of us when we skip meals get what we call a liver dump when we next eat. This could be the case.

What's her daily schedule like? Does she sleep in till late morning? My thought here is that maybe her lunch is actually her breakfast and she's experiencing a later than normal dawn penomenon.

Does she take meds and when? Perhaps she's taking them at dinnertime and needs to split it so she takes some in the mornings too.

[nyker]

Thanks everyone for such quick replies. I believe I have not provided complete information on DM here it is:

1. DM is 64 y.o. retired. 110lb. 5"2'. Medications currently taking: Glyburide 7.5mg/daily.

2. My DM eats breakfast regularly, she gets up like 7am and eats then. Her lunch and dinner time are pretty regular at about 12-1 noon and 6-7pm respectively. So she keeps about 5 hr intervals between meals.

3. As for exercises, I got her on exercise last year, she's doing about 1-1.5 mile walking in the morning (10-11am) about daily. And I also pushed her to do weights for about 1/2 hour daily which she does before dinner time (5pm or so) almost daily. The reason for weights is because she's got osteoporosis so has to add weight training for that.

3. As for her meals, she's chinese so eats mostly Chinese food but also some Italian recipes I taught her like spagetti etc. but 80% chinese food. She keeps about 3-4 carbs per meal. 2.5 protein a meal. 5mg oil. That's what I calculated for her.

[princesslinda]

Hi Nykar: I have a lot of problems dealing with rice. I can tolerate a little of the brown rice, but even small amounts of white rice cause a rise. Perhaps your mom could try some of the brown rice and see if it improves things.

If she's having trouble with lunch numbers, i'd have less carbs at lunch time. I have more problems with my evening meals, as i'm less active then, so I have more carbs with lunch than any other meal.

If she would eat salads, salad with a vinaigarette dressing might help slow digestion and keep carbs from spiking due to the vinegar. I have a salad like this if i'm having more carbs than usual. Some people actually take vinegar capsules before meals to help with post meal spikes as well.

Sounds like she's a good weight, getting decent exercising and watching her diet. I know it must be difficult to avoid rice if it has been a staple part of the diet for so long.

Also, if she likes pasta, try the Dreamfields brand which has less absorbable carbs. I can have a serving of it without problems.

She's lucky to have such an attentive daughter.

[nyker]

princesslinda: Thanks for the advices, yes I think she's less active during lunch time so probably is a factor in this. Yes I definitely will have to look into Dreamfield brand for her pasta diets. I will also advice her maybe to cvut back on cards for lunch, since that's the easiest remedy I can see. Oh thanks for the book recommendations, I try to get a copy and read up on it then translate to her.

Thanks for your compliments. I'm actually a guy. :] There's a reason that I am so attentive about this. Few years ago my grandpa fell very ill from an auto-immune disease and that really put a terrible strain on my family, physically and emotionally. I really learned from that. And I try to keep everyone around me healthy so I don't need to worry about them.

[nyker]

Hi eveyone, many thanks for helping my mom out. I just want to make a quick report so this might actually help others. I told my mom to do about 20min walking post lunch and that did it. Her new numbers after lunch droped to 170-190ish just within bound. So this extra bit of exercises solved her hi glu problem at lunch.

[princesslinda]

Nyker, glad your mom's numbers are starting to come down. I think it would be better for her if she could manage to get them even a little closer to the 140 level.

What time of day does she take her medication? Many of us
T2s are on metformin for insulin resistance. This is a medicine that helps us better utilize the insulin we are producing. It might be that your mother would benefit from this as well...something you and she could discuss with her doctor. The Glyburide works by stimulating the production of more insulin.

Also, not sure what time she takes her medication, but it might be that you could change that time to benefit her where she needs it them most. I know most people take Glyburide with b/fast....perhaps you could ask her doctor about making taking it with lunch instead since she has the most problems with higher blood sugars then. I wouldn't adjust it without his approval though, as it can cause blood sugars to drop quickly.

[nyker]

Nyker, glad your mom's numbers are starting to come down. I think it would be better for her if she could manage to get them even a little closer to the 140 level.

What time of day does she take her medication? Many of us
T2s are on metformin for insulin resistance. This is a medicine that helps us better utilize the insulin we are producing. It might be that your mother would benefit from this as well...something you and she could discuss with her doctor. The Glyburide works by stimulating the production of more insulin.

Also, not sure what time she takes her medication, but it might be that you could change that time to benefit her where she needs it them most. I know most people take Glyburide with b/fast....perhaps you could ask her doctor about making taking it with lunch instead since she has the most problems with higher blood sugars then. I wouldn't adjust it without his approval though, as it can cause blood sugars to drop quickly.

princesslinda: Thanks for some really valuable advices. I will talk with mom and her doctor about switching medication time for her and also the possibilities of metformin for her. But so far adding extra exercises seem to make things better for her. Hopefully by adjusting diets/meds she could get it to around 140s. I will be totally rejoyced if she could manage that. And thanks so much for your help and everyone on the forum, it's just been real helpful. I will post more reports as she make progress on this.