Diabetes Talking

Question:

You seem to have a handle on this.  Regarding events which raise blood glucose, what do you do to counteract the dawn phenomenon and illness, if you are Type II and taking oral medication.  I am taking glucophage, having stopped the gyburide after I got under control.   I don’t know what to do to counter these things, especially the illness.  My bg hasn’t gone up as much as you have experienced, but I can definitely tell a rise in the morning.  I phoned my diabetes educator and she suggested that I reinstate 1/4 of 5 mg glyburide twice daily until my cold/sinus infection abated.  What do you think?  I can’t tell any difference, except my bg was low (56) yesterday afternoon, which it never is.

Your original post mentioned "lame" medical care through your HMO. If your HMO primary care physician is not referring you to a specialist (an endocrinologist) on the basis your current problems (which would indicate that you probably need to inject insulin instead of relying solely on oral meds), you should contact your HMO administration ASAP and DEMAND a referral to a specialist.  Using insulin makes it relatively easy to counteract and/or prevent the bg swings you detailed. Sure it’s a big step.  That’s why you need to see a specialist. [posted & e-mailed] David Cohler, South Pasadena, CA Media Access Consultancy http://members.tripod.com/~dcohler/

Response:

By how much can an illness raise bg (like a cold, flu, etc)? A minor illness like a bad cold, throat infection, usually takes me up by about 10-12mmol (200mgdl). A major illness like flu (i.e. something with a high fever) doubles that.

I’ve found this to be true for myself and other type I’s I know of.  It varies form person to person as does the serverity of many infections. Trauma can also cause comparable bg increases.  Like broken bones, bad cuts etc.  So watch out! I’s bee my expereince that most doctors and *all* diabetic "educators" insist that infections and trauma will only raise bg levels by a "couple points".  Ignore such ignorance. Recently a type I friend had a bad virus and was hopsitalized.  Apparently her bgs were consistantly 30+ (540+ mg/dl) for over a week while in the hospital and the doctors and nurses refused to take the infection into account as the reason for this.  they denied her adequate insulin to lower them.  This is the type of health care we have in Canada!  Finally a visiting specialist raised her insulin to lower the bg and guess what? she soon was good enough to be released! Darrin Parker A lie, even minor, left unchallenged, will be accepted by the ignorant and  uninformed, as the truth. Check out:  http://www.geocities.com/HotSprings/Spa/4750/intro.htm  and go FORWARD to "The Article".

Response:

You seem to have a handle on this.  Regarding events which raise blood glucose, what do you do to counteract the dawn phenomenon and illness, if you are Type II and taking oral medication.  I am taking glucophage, having stopped the gyburide after I got under control.   I don’t know what to do to counter these things, especially the illness.  My bg hasn’t gone up as much as you have experienced, but I can definitely tell a rise in the morning.  I phoned my diabetes educator and she suggested that I reinstate 1/4 of 5 mg glyburide twice daily until my cold/sinus infection abated.  What do you think?  I can’t tell any difference, except my bg was low (56) yesterday afternoon, which it never is.

Response:

Questions: By how much can the dawn phenomenon raise bg?

Personally, from the low at 3am, to 11am, it goes up about 20 mmol (350 mgdl). By how much can an illness raise bg (like a cold, flu, etc)?

A minor illness like a bad cold, throat infection, usually takes me up by about 10-12mmol (200mgdl). A major illness like flu (i.e. something with a high fever) doubles that. I know there is variation, but am wondering if there is some sort of benchmark. Jody

Best wishes, — Pat Reynolds    "It might look a bit messy now, but just you come back in 500 years time"    (T. Prattchet)

Response:

Questions: By how much can the dawn phenomenon raise bg? By how much can an illness raise bg (like a cold, flu, etc)? I know there is variation, but am wondering if there is some sort of benchmark. Jody

Response:

In article Questions: By how much can the dawn phenomenon raise bg?

Do a search in this group for articles on teh "Dawn Phenomenon".  This should give you a good overview.  Briefly, the body releases hormones each morning to get the body ready for the day.  this makes stored ebergy go into the blood stream elevating bg levels. The effect of this varies form time ot time and form person to person. some diabteics don’t notice it; some have great elevations in am bg levels and have little success in countering them.  For me only, I experience a 300+ mg/dl (20 mmol/l) increase bewtween 7:00am and 10:00am  (while I’m still asleep).  I counter this to an extent with 18 units of Lente taken at 11:00 pm the night before. By how much can an illness raise bg (like a cold, flu, etc)?

Different infections / viruses can raise the bg levels for extended periods of a day to weeks to months.  The increase again varied widely form virus ot virus and person to person.  This is countered by increaseing the basal insulin level for longer term infections.  Trauma can also elevate bg levels.  By trauma I mean broken bones, bad cuts etc. In my experiece I’ve seen bg levels elvated by over 15 mmol/l (270 mg/dl) for weeks due to a broken bone.   I know there is variation, but am wondering if there is some sort of benchmark.

Sorry but there is no benchmark.  Everyone is different and affected differently by the above problems.   As said so many times in this group Darrin Parker A lie, even minor, left unchallenged, will be accepted by the ignorant and  uninformed, as the truth. Check out:  http://www.geocities.com/HotSprings/Spa/4750/intro.htm  and go FORWARD to "The Article".

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