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Question: I am diabetic since last 30 years. My HbA1C is around 7.5.
I also have thyroid but under control.
My unsolved question is that my blood sugar is always above 170 after breakfast though all other time it is within limits.
I have a reputed diabetologist as my doctor to whom I go once a month. I am not satisfiled with his answer on this. I also consulted another doctor online (MD) but did not get satisfactory answer. I am uploading my prescription for your reference. Please remember, I am not seeking solution for my problem but looking for reason why my B.S. remains high only after breakfast.
I am looking to get my answer from a endocrinologist. My doctorhas tried 3 different types of insulin starting from Wosulin 50-50 to Ryzodag to Iglucent but no reduction in my post breakfast sugar. Various tablets were also tried. Today my FBS was 86 but again post breakfast it was 196. I am on diet plan maintaining input of under 2000 kcal diet.
I also have thyroid but under control.
My unsolved question is that my blood sugar is always above 170 after breakfast though all other time it is within limits.
I have a reputed diabetologist as my doctor to whom I go once a month. I am not satisfiled with his answer on this. I also consulted another doctor online (MD) but did not get satisfactory answer. I am uploading my prescription for your reference. Please remember, I am not seeking solution for my problem but looking for reason why my B.S. remains high only after breakfast.
I am looking to get my answer from a endocrinologist. My doctorhas tried 3 different types of insulin starting from Wosulin 50-50 to Ryzodag to Iglucent but no reduction in my post breakfast sugar. Various tablets were also tried. Today my FBS was 86 but again post breakfast it was 196. I am on diet plan maintaining input of under 2000 kcal diet.
Brief Answer:
Short acting insulin before breakfast.
Detailed Answer:
Hello
I have gone through your question.
I can understand your cconcern.
I have seen your reports.
Your doctor has tried a lot of anti diabetic drugs. Most of these treatement are very effective in a lot of diabetics.
The last HbA1C result is good, but the goal is 7%. I m sure that you can reach this result.
If you were my patient i will try with an three time insulin regymen/day.
Short acting insulin before breakfast and lunch and e mix insulin before dinner + Metformine 850 mg 2x1 tb/day(morning and evening after the meals).
In my opinion with this regymen you can have good numbers after breakfast and a good control on your Diabetes all day long.
Hope i have answered to your question.
If you have other doubts,feel free and ask.
Best regards.
Short acting insulin before breakfast.
Detailed Answer:
Hello
I have gone through your question.
I can understand your cconcern.
I have seen your reports.
Your doctor has tried a lot of anti diabetic drugs. Most of these treatement are very effective in a lot of diabetics.
The last HbA1C result is good, but the goal is 7%. I m sure that you can reach this result.
If you were my patient i will try with an three time insulin regymen/day.
Short acting insulin before breakfast and lunch and e mix insulin before dinner + Metformine 850 mg 2x1 tb/day(morning and evening after the meals).
In my opinion with this regymen you can have good numbers after breakfast and a good control on your Diabetes all day long.
Hope i have answered to your question.
If you have other doubts,feel free and ask.
Best regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Doctor, you also propose short acting insulin before breakfast & lunch so how does that become a cause for high sugar after breakfast? My sugar is under control during fasting & after lunch. I need to understand logic of high sugar after breakfast. That is missing. Kindly also send your suggestive prescription to discuss with my diabetologist.
Brief Answer:
The problem is the breakfast meal.
Detailed Answer:
Hi again.
The short acting insulin before breakfast & lunch do not cause high blood sugar after breakfast BUT it can help to avoid the high blood sugar after breakfast and resolve your problem.
The logic of your high post breakfast sugar,in my opinion is the breakfast meal.
Some studies has demostrated that post-breakfast hyperglycemia in type 2 diabetics could be improved non-pharmacologically by using a high-protein, low-carbohydrate prebreakfast snack.( soya-yogurt snack prior to breakfast for example.)
You can try a low carb breakfast and a a high-protein, low-carbohydrate prebreakfast snack for a couple of days and show me if you see any improvement in your post breakfast results.
The low carb diet plan in what you need to discuss with you diabetologist.
Hope this helps.
Take care.
The problem is the breakfast meal.
Detailed Answer:
Hi again.
The short acting insulin before breakfast & lunch do not cause high blood sugar after breakfast BUT it can help to avoid the high blood sugar after breakfast and resolve your problem.
The logic of your high post breakfast sugar,in my opinion is the breakfast meal.
Some studies has demostrated that post-breakfast hyperglycemia in type 2 diabetics could be improved non-pharmacologically by using a high-protein, low-carbohydrate prebreakfast snack.( soya-yogurt snack prior to breakfast for example.)
You can try a low carb breakfast and a a high-protein, low-carbohydrate prebreakfast snack for a couple of days and show me if you see any improvement in your post breakfast results.
The low carb diet plan in what you need to discuss with you diabetologist.
Hope this helps.
Take care.
Above answer was peer-reviewed by :
Dr. Prasad
Thanks Doctor, do you mean to Say short acting insulin is something different than what I take as 50-50 combination? I take 3 dates, 3 walnuts & 3 dried figs as pre breakfast. Kindly send me your prescription. I do take metformin 1000 mg after my breakfast. Kindly refer to my prescription. Pl advise as even with almost small portion of breakfast, I get around 190 to 200 blood sugar.
Brief Answer:
Yes,these are different types of insulin.
Detailed Answer:
Hello
Short acting insulin and Combination 50-50 are different types of insulin.
The combination is a mixture of short or rapid acting insulin and an intermediare or long acting insulin.
So,even your combinated insulin contain short acting insulin(50 % of total dosis )
Is the dosis of short acting in the mixture that it is not enough for you.
For this reason i suggested to use not the mixture but the simple regular insulin to control your post-breakfast blood sugar.
I agree with Metformin after the the meals because it can enhance the action and the sensibility of insulin.
Here are somehealthy low carb breakfast ideas for you:
1)Have a small bowl of whole grain cereal or XXXXXXX cereal with ½ cup of low-fat milk. Top your cereal with fresh berries if they'll fit with your meal plan. To cut back on the amount of carb in a bowl of cereal, use unsweetened almond milk or unsweetened soy milk, which have fewer carbs and calories per serving than regular milk.
2)Mix ¼ cup of quick oats with ½ cup water and cook in the microwave for about 1 minute or until oats are cooked. Stir in 1 teaspoon Splenda Brown Sugar Blend, some cinnamon, and a small handful of dry roasted nuts. Add an apple on the side or mix in a tablespoon of dried fruit if desired.
3)Portion out ½ cup of cottage cheese and mix in ½ cup canned peaches. If you don't like peaches, try another fruit like pineapple, raspberries, blueberries or even diced tomatoes. Add a small handful of nuts on the side if desired.
Hope this is helpful.
Let me know 2h post breakfast result after you try these simple breakfast ideas.
Wish you good health.
Dr. Elona
Yes,these are different types of insulin.
Detailed Answer:
Hello
Short acting insulin and Combination 50-50 are different types of insulin.
The combination is a mixture of short or rapid acting insulin and an intermediare or long acting insulin.
So,even your combinated insulin contain short acting insulin(50 % of total dosis )
Is the dosis of short acting in the mixture that it is not enough for you.
For this reason i suggested to use not the mixture but the simple regular insulin to control your post-breakfast blood sugar.
I agree with Metformin after the the meals because it can enhance the action and the sensibility of insulin.
Here are somehealthy low carb breakfast ideas for you:
1)Have a small bowl of whole grain cereal or XXXXXXX cereal with ½ cup of low-fat milk. Top your cereal with fresh berries if they'll fit with your meal plan. To cut back on the amount of carb in a bowl of cereal, use unsweetened almond milk or unsweetened soy milk, which have fewer carbs and calories per serving than regular milk.
2)Mix ¼ cup of quick oats with ½ cup water and cook in the microwave for about 1 minute or until oats are cooked. Stir in 1 teaspoon Splenda Brown Sugar Blend, some cinnamon, and a small handful of dry roasted nuts. Add an apple on the side or mix in a tablespoon of dried fruit if desired.
3)Portion out ½ cup of cottage cheese and mix in ½ cup canned peaches. If you don't like peaches, try another fruit like pineapple, raspberries, blueberries or even diced tomatoes. Add a small handful of nuts on the side if desired.
Hope this is helpful.
Let me know 2h post breakfast result after you try these simple breakfast ideas.
Wish you good health.
Dr. Elona
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thanks Doctor, the options given by you are not XXXXXXX hence will check with my dietician. This is the last chance for me to ask a question. Pl send me a prescription without fail. Thanks once again.
Brief Answer:
You need to consult physically an endocrinologist for the prescription.
Detailed Answer:
Hi again.
I suggested to use short acting insulin pre breakfast and pre lunch and a mix insulin before dinner plus Metformine 850 mh 2x1 tb (after breakfast and dinner)
It is necessary to meet physically an endocrinologist for the prescription of insulins regymen.(These thinks can not be done on line)
Hope i have answered to all your question.
Regards.
You need to consult physically an endocrinologist for the prescription.
Detailed Answer:
Hi again.
I suggested to use short acting insulin pre breakfast and pre lunch and a mix insulin before dinner plus Metformine 850 mh 2x1 tb (after breakfast and dinner)
It is necessary to meet physically an endocrinologist for the prescription of insulins regymen.(These thinks can not be done on line)
Hope i have answered to all your question.
Regards.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Kampana
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