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Type 2 diabetic. Why do I have high fasting glucose level compared to post lunch sugar level?

Aug 2012
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Answered by

Practicing since : 1999
Answered : 362 Questions

Dear Doctor ,
My wife is 62 year old.She is diabetic since 2004 (Type II) and is on medication since then. Right now she is taking Glycomet 375 mg twice after breakfast and and after dinner.
she takes 2 chapthis and a cup of curd every night or some light food . She does not normally do regular morning walk but does lot of house hold work. She never sits idly at home and is always on the move. Her blood sugar values ( Lab values) are as under for the past few months

8/9/11 16/3/12 14/6/12 21/10/12 24/1 /13
Fasting 123 139 90 119 137
post lunch 138 108 127 --- 104

Besides glycomet she takes stamlo 5 mg, TGTor 5 mg, ASA50, Shell call 500 mg =one tablet each per day.
My question is
1.Why her fasting blood sugar values are normally on the high side and her post lunch values are less than fasting?.Kindly eloborate. you think in your opinion, that her present drug is to be increased? Or do you think that she should be prescribed a combination of drugs?

kindly advise
Posted Thu, 14 Feb 2013 in Diabetes
Answered by Dr. Madhuri Patil 1 hour later

Thank you for the query.

1. The tendency to have higher fasting glucose compared to post lunch sugar is common as a person with type 2 diabetes has uncontrolled sugar coming from liver during fasting hours, especially when the dose of medication if not sufficient.
2. The current reading of her fasting sugar suggests she should take higher EVENING dose of tab metformin (Glycomet). No need of combination of other drugs as of now. For this you please take prescription from your doctor. Her morning dose can be kept the same. But you should also check her sugars after breakfast and let me know. Her average sugar value (HbA1c) should also be done.
Please get back for further query.
Above answer was peer-reviewed by
Follow-up: Type 2 diabetic. Why do I have high fasting glucose level compared to post lunch sugar level? 11 minutes later
Doctor, I have forgotten to tell you that her HB A1 c value reads at 6.2% as on 24/1/2013. Mean blood glucose is 143.

Her Hb A1c levels in the past period is as under

8/9/2011 16/3/2012 14/6/2012

HBA1c 6.3 % 6.7 % 6.5%

Kindly evaluate
Answered by Dr. Madhuri Patil 46 minutes later
Her average control is very good for her age. But still increasing the evening dose of metformin is suggested if you consistently notice fasting sugar more than 120 mg/dl.

Please check her fasting sugar for two more consecutive days (can be done on a meter at home) and take the decision. Otherwise she's doing good.

take care and get back for any related query.
Above answer was peer-reviewed by
Follow-up: Type 2 diabetic. Why do I have high fasting glucose level compared to post lunch sugar level? 2 days later
Dear Doctor,
good morning. I have forgotten to tell you my eating habits, which may help you further to evaluate. I go for 4 km morning walk and after that i will have a cup of coffee. AT 9 am i take 3 idlis.At 1 pm I take small quantities of rice, dhal, rasam and veg curry and butter milk. Again at 4 pm i will take a cup of coffee.Again at 8 pm i take two chapatis or pulkas or upma and butter milk. From 1.30 pm to 8 pm in between i do not take any food except a cup of coffee at 4 pm. Are my eating habit is desirable ? Or do i have to change anything?kindly advise.Does this not taking snacks between lunch and dinner gives rise to elevated sugars during night?
Dear Doctor, I am sorry I have by mistake written as "I am" but it is my wife. of course the same habit i too have. My wife do not go for walk in the morning.Evening she dont take any thing. May be a glass of water.Sorry i am inconviniencing you in this regard.Please bear with me.
Answered by Dr. Madhuri Patil 2 hours later
Going for a walk during evening hours will help your wife and also taking a small meal before 8 pm everyday should be tried. If she's not eating anything in the evening then it's really a huge gap in the evening hours and not healthy too. In that case how does she take her tablet Glycomet?
The diet you have described for the rest of the day is fine and I do not see any problem in the daytime meal gaps as she is on medication which is unlikely to make her sugars low in anyway.
Please ask her to go for a walk in the evening hours and also to have a small meal before 8 pm. This will set things right. Take care.
Above answer was peer-reviewed by
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