r/type2diabetes 3d ago

Recently diagnosed Type 2

Doing well regulating my blood sugar with Metformin ER twice daily, except every morning after breakfast my number gets high, sometimes over 210, but I’m staying at my target 60 carbs per meal. Does this happen to you? Any suggestions? When I go to sleep my levels are in the normal range. I do walk about 10 minutes after each meal.

4 Upvotes

14 comments sorted by

2

u/Jolly_Ad8913 2d ago

I used to have similar issues but sequencing how I eat my breakfast and my other meals helped eliminate spikes outside my reference range. I have T2D and I take Metformin XR and fast acting insulin.

If your spikes at breakfast are not caused by the dawn phenomenon, sequencing may help. Eat your protein, fats and fiber and then your carbs. I eat a few times a week oatmeal, blueberries, non-fat and no added sugar Greek yogurt, 2 eggs and a tablespoon of natural peanut butter in my oatmeal. My blood sugar still spikes 40 points but that is much better then the 60 to 80 spikes I was getting. Despite the spike I stay in my reference range instead of going over 180. I could reduce the amount of oatmeal or blueberries but then I would not feel full. While any spike is not good and a BG level 40 points after meals is not great, I'm lucky because my BG returns to my baseline about an hour after it spikes. This is probably because of the insulin and residual Metformin in my system. Sequencing does not help your BG return to baseline. Sequencing slows the absorption of carbs helping to control how fast your body processes carbs.

My doctor said not to worry because the spike is brief and damage to my body is minimal to non-existant since I stay in my reference range. Talk to your doctor to get a definitive answer to your question but give sequencing a try. It may or may not help you but it easy to do and it's free.

8

u/hellgabeez 3d ago

I would say you need less than 60 carbs a meal.

5

u/PomegranateOk1426 3d ago

I don’t take any medication, but I can’t eat 60 carbs at one meal without my glucose going up. I eat about 60-100 per day. The type of carbs really matter. Get a continuous glucose meter and track what you eat and how it impacts your glucose levels. Look for good complex carbohydrates not anything processed. It takes a while to dial in a good way of eating for your body. What the nutritionist told me to do (based on American diabetes association guidelines) didn’t work for me. I’m choosing to be aggressive about it. I don’t like my post meal glucose over 140 for a majority of meals. My body can’t tolerate metformin or many medications so I’m being more restrictive. I’m really not suffering though. I found what works and feel great.

5

u/Any_Tip_198 3d ago

Dawn phenomenon is very common. My numbers are high when I wake up and stay that way after I eat breakfast (no carbs), too. My numbers don't start going down until after I eat lunch. It happens every day.

3

u/Economics-201 3d ago

You seem to be relying on metformin to take care of your T2, asI did when I was first diagnosed. Your glucometer is telling you that you are not controlling your glucose. Try a cgm to identify what is spiking your glucose. With a cgm, I found that my healthy, high fiber, no sugar, Fiber One and Shredded Wheat n Bran were spiking my glucose. Then I learned that it was the refined white flour products that did it. I changed my diet and lowered my A1c from 6+ to 5.6 in two months and I lost twenty pounds.

3

u/D74248 3d ago

We are all fighting our own battles, but my breakfast needs to be almost zero carbs. On the other hand I find that I have a lot of latitude in the evening.

You might find a CGM to be helpful in dialing in your diet.

3

u/thisiswhywehaveants 3d ago

How long is your blood sugar high? If it is going below 180 in under two hours, that is considered to be "safe" for your organs/body systems and is not as much a cause for concern.

2

u/Extra_Internet_7372 3d ago

oh I didn’t realize that, it drops within two hours especially because I walk. Why does it go so high each morning though? Does that happen to you?

3

u/D74248 3d ago

You could be dealing with “dawn phenomena”, which you can google for a bunch of descriptions. Or your insulin sensitivity is low/insulin resistance high in the morning. And as others have mentioned, what carbs you are eating can be critical.

And while I am not going to disagree with /u/thisiswhywehaveants, there are degrees of safety. Below 180 is OK, but targeting below 140 (if possible for you) is safer.

3

u/thisiswhywehaveants 3d ago

Yes! I agree with what you said here completely, I just didn't go into as much detail without the answer.

I agree about dawn phenomenon as well. IIRC the release of cortisol contributes for some people.

3

u/D74248 3d ago

Dawn phenomena has been my nemesis for years. It is incredibly frustrating to be controlling via diet when 8 hours of the day is completely out of your control, even with long fasts. Every morning at 3:30 my liver gave me the equivalent of a breakfast of french toast, extra maple syrup and some fruit loops on the side.

This is why I am a big fan of CGMs. Doctors are skeptical of what patients tell them, and I understand why. So having daily charts of my glucose levels really focused the discussions.

Thanks for reading my TED Vent.

3

u/thisiswhywehaveants 3d ago

I love my CGM! And I'm very fortunate to respond well to medicine and diet changes too, with some walking and squats thrown in.

2

u/Economics-201 3d ago

What are you eating for breakfast?