Young1s

Q:

I've been struggling with finding what my ideal bedtime BG should be in order to have an acceptable fasting number within range, with no great success. My numbers are all over the place and it'is frustrating me to no end. Here's a few examples: Bedtime: 116 Fasting: 148 Bedtime: 145 Fasting: 115 Bedtime: 119 Fasting: 137 Bedtime: 97 Fasting: 147 Bedtime: 166 Fasting: 134 I'm aware that some of it has to do with liver dumping, but at what point is the thing that's eluding me. Just so you know I'm Type II and only on 16 units of Lantus (long-acting) insulin, which I take in the morning. I typically eat dinner around 6:30pm and try not to eat anything else past 9:30 but not always successful. My last BG check is usually around 11pm. So I'm wondering if you have any suggestions as to how I can figure this out?

Dr. William Sullivan

A:

The usual blood glucose goals are: bedtime 90-150 with fasting glucose levels less than 130. These goals can be individualized for each patient with diabetes. Your bedtime readings are 116, 145, 119, 97, 166 – so 4 out of 5 readings are within the usual goal. Your fasting glucose levels have been 148, 115, 137, 147, and 135 – so 4 out of 5 are above the goal of less than 130. It would be worthwhile to discuss with your healthcare provider whether your Lantus dose can be slightly increased so that your fasting glucose levels will be mostly under 130. If your A1C is acceptable (under 7%), then occasional fasting glucose levels over 130 are not likely to cause long-term complications.

February 27, 2012 at 9:23 pm