Blood Glucose Rises After Breakfast
Question: I am a 50-year-old woman that has been borderline diabetic until 12 years ago when diagnosed. I am taking metformin 1000 twice a day along with Januvia in the morning. I cannot get my readings down in the morning. I am almost positive it is the dawn phenomenon. The problem is that my A1c is always between 6.0 and 6.5 but my morning readings are between 140 and 180. If I get up in the middle of the night they are always under 115. If I get up and my reading is high then eat a light breakfast, blood glucose numbers are then around 300. Don't know what to do, and have been fighting this problem for several years.
Answer: Your A1C is in the target range, but the glucose excursions are an issue. You may need a medicine in the morning to prevent the skyrocketing glucose after breakfast. The risk of starting a drug like Amaryl or Starlix for the morning meal is the risk for the side effect hypoglycemia. If you haven’t already spoken with a registered dietitian about your breakfast content (as carb-controlled meals should only cause less than a 50 mg/dl (2.77 mmol/l) point glucose rise from pre to post meal), that is worth an individualized look.
Thank you for all the questions. My apologies for not being able to answer each and every one, but you can always submit your question through dLife’s Ask an Expert where other CDEs are waiting to answer your diabetes questions.
Read Theresa’s bio here.
Read more of Theresa Garnero's columns.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
PREVIOUS: Fasting Numbers
Lime Curried Chicken Moroccan-Style Spiced Chicken Honey Butter Sweet Potatoes Stuffed Chile Peppers Crunchy Turkey Casserole Asparagus & Mushrooms Fettuccine Fruit Verde Salad Hot n' Spicy Crunchy Cajun Catfish Nuggets Mexican Style BLT Wrap Black Bean Dip
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...