I was diagnosed with type 2 diabetes 14 years ago this month. For the most part, my daily fasting numbers averaged 107 while taking three oral medications (2k Metformin, 3 mg Glimepiride, 50 mg Januvia).
Recently (maybe three weeks) my daily average has hovered around 148. Any ideas? Nothing has changed in my diet or activities.
Dear Dr. Charles:
There are many reasons why people can suddenly experience higher blood sugars.
Sometimes higher blood sugars are a precursor to being sick. Good and bad stress can also raise your blood sugar.
Over time people with type 2 diabetes may experience higher blood sugars because their current prescription may become less effective, requiring their medications to be increased to achieve the targeted blood sugar range.
When you start feeling sick, your body’s immune system will fight the infection by releasing hormones and glucose. If you treat your illness with over-the-counter cold and flu medications, you need to be aware that some medications may have sugar in the ingredients. Make sure to read the labels first. Medications that numb your throat may also contain sugar.
There is no question that the American lifestyle is more stressful than most other countries’. We have less time off, work longer, and get paid less. The American dream of a one-income family is not realistic for most. We are juggling a plethora of administrative things that we need to take care of on a daily basis, such as keeping a schedule, going to work, buying groceries, paying bills, raising children, taking care of animals, family parties, and the list goes on. I do not know about you, but I feel stressed just reading my list. Add diabetes self-management to all your daily tasks and the stress tower may start looming behind you.
We also experience good stress. Being excited about an event or completing something that was a goal can also raise your blood sugar. What happens when the adrenaline and cortisol hormones are released? It raises your blood sugar and blood pressure.
The Dawn Phenomenon
Nothing is more frustrating than waking up in the morning, checking, and seeing a high blood sugar level. You took your medication and had not eaten through the night, so what happened?
The human body releases extra glucose in the early morning just before waking up. Called the “dawn phenomenon,” the increased glucose production provides energy for getting up and facing the day. In people who do not have diabetes, the rise in blood glucose levels is easily controlled by the release of insulin. In type 1s and type 2s, the increase in glucose levels is not controlled by a release of insulin because either your pancreas does not make insulin or you are insulin resistant.
Sometimes when you think you are eating well, you are consuming some form of sugar, which can be an ingredient in any dish you order. We do not usually think to ask if sugar is in our entree. If you check your blood sugar and it is higher than expected after a meal, then it may have a hidden or unknown ingredient that is the culprit. Checking your blood sugar gives you feedback so you can make the adjustment you need to make to deal with a post-meal high blood sugar reading.
Your Healthcare Professional
To isolate the reason why your blood sugars are higher than normal, call your healthcare professional that prescribed your medication and share your food log, time medication was taken and your activity log. This will help them isolate what might be occurring allowing them to recommend a newer therapy that will help you reach your targeted goal.
Hope this helps.
Wishing you the best in health!
Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professional’s therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.
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