Suggestions for lowering fasting blood glucose?

MrsL2B · May 2014

Has anyone had any success in getting a stubborn fasting number to come down?

Recap: I've been a type 2 diabetic for five years. I switched from metformin to glyburide after getting pregnant. My post-prandial numbers have been been doing great with 2.5 mg twice a day, but my fasting numbers are generally still too high. I can't raise my evening glyburide dose without crashing a few hours after I go to sleep (scary and dangerous, since I don't feel the lows at all now). This past week my fasting number was consistently around 130, which I don't think my doctors are going to like. My numbers after dinner are always great, and then I have a bedtime snack that's usually protein & lots of fiber. I workout first thing in the morning (cardio or weights followed by cardio), then have breakfast (30 g carb, 20 g protein) and my morning glyburide dose, and my glucose usually drops into the 60s within a couple of hours and stay normal (80-110) for the rest of the day. I could really use some suggestions!

MamaPharmD · May 2014

Why did your doctors take you off metformin? I would think that staying on metformin (but probably with a lower dose of glyburide) would help. I was on metformin before I got pregnant and my fasting numbers were too high as well. My doctor kept me on metformin but recently started me on glyburide only with dinner. It's been a hell of a ride so far as I've also been having trouble with my numbers dropping too low. I'm hoping this last decrease in dosage takes care of the lows though.

My only other suggestion would be to maybe adjust your nighttime snack. The nutritionist I met with said that the later you eat, the higher your fasting levels tend to be. Eating your snack a little earlier might help, though it doesn't seem to me that should be an issue since your snack is protein and fiber. Maybe you're still dropping too low at night which is making your body release glucose stores and causing your fasting levels to rise? Have you tried adding some carbs to your snack, like peanut butter on wheat toast or something to that effect?

At the end of the day though, I would just talk with your doctors and see what they suggest. I hope you can get everything straightened out!

MrsL2B · May 2014

My OB initially switched me to glyburide, saying it was safer in pregnancy than metformin, but my MFM said that metformin is perfectly safe. But he kept me on the glyburide since I was doing ok with it (that was 5 weeks ago, though). I have another appointment with my MFM in a little over a week, so I'll see what he thinks then. I think I might ask him about trying metformin at night and glyburide in the morning, since my pre-pregnancy fasting numbers were always pretty good on metformin.

MamaPharmD · May 2014

Hopefully you'll be able to come up with a plan that works for you! Just as a note though, with the way metformin and glyburide work and the fact that your fasting numbers are the ones giving you problems, your doctor might have you take metformin in the morning and glyburide at night.

MrsL2B · May 2014

I check it when I'm up in the middle of the night, and it does seem to rise slowly after about 2:00, regardless of whether I crash before then or not. So I think it's mostly just the dawn phenomenon and my over-productive liver. Drinking a nice big glass of wine at bedtime works nicely to keep my fasting number down, but that's out for now!

hgtvmom · May 2014

What carbs are you doing at bed time? If I do too much fiber with my bed time snack, it forces me down too far and then I rebound and go high. It doesn't matter if it is food intake or fiber pills (sugar free) that my ob suggested to help with constipation weeks ago. Cutting out the high fiber at bed time keeps my fasting numbers more controlled.

MrsL2B · May 2014

@Pup4gdb‌ Lately I've been having prunes with low-fat cottage cheese at bedtime. Yummy, right? I've never noticed that fiber has much of an effect either way on my post-prandial numbers, but sugar alcohols have always caused them to be much lower than expected. And I think prunes have sorbitol in them, so maybe there's something there? Hmm.

EMarieMe · May 2014

Yoga. I know right? Random, but if I did yoga every night I would be below 90. No yoga, 92-94. Must have been a stress thing.

JackieP1023 · May 2014

I don't know about T2 diabetes, but I had GD and ended up on low-dose nightly insulin because of stubborn fasting numbers. The rest of the day, I could control with diet.

tshelby85 · May 2014

I just got diagnosed with gd. I had my information class yesterday. They said daily exercise will lower your fasting number.

poca1313 · May 2014

@EMarieMe‌ although I don't exercise as much as I should I totally believe stress has to do with it. I went on vacation mid April and my numbers were way lower then they are now. Because we were on the go all the time I didn't even follow my diet plan exactly. Literally the day before we came home that morning I got my high fasting #s and they've been high ever since.

MrsL2B · May 2014

I get higher overall numbers on the weekends when I'm home with my husband, so there's definitely something to the stress factor!

SLGILL1978 · May 2014

I am a diabetic and I was on metformin pre pregnancy. You can or cannot take it. It's up to your OB. My OB chose for me not to take it during my pregnancy. I was on insulin instead. How far along are you? When I was consistently high for more than 2-3 days it was time to raise my insulin units.

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