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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Reason For Fluctuation In Blood Sugar Levels Despite Taking Glipizide?

I have a question for you regarding my Glipizide 2.5mg. When I originally picked up the Rx the pharmacist said I could take it at any point during the day but to make sure I was taking it at the same time daily. In the beginning I was taking it around 3pm daily. As time went on, I read about it online and it said it was recommended to be taken in the am 1/2 hour before breakfast so I started doing that.

I am being very diligent about checking my sugar even though my Doctor said once a day was fine but I usually check 3 times a day. Over cautious perhaps- just want to get it under control. I usually check first thing in the morning around 6.30 then again around 3pm and then once before bed time. Here are my findings.....in the morning my sugar is usually between 140-150. By afternoon reading (3pm) it usually between 70-86 ( sometmes even lower- lol- which I know is not good) but then I eat some hummus and carrots and then all is fine. Dinner for us is usually around 6-6.30. Lately I have noticed that if I snack before bed - usually an 1/2 hour prior to bed my sugar is always under 100 - which is great! So here is the question...............if sugar is less than 100 before bed why is it when I wake up that it is between 140-150??? Should I be taking the Glipizide before bed?? What do you think????

Wed, 26 Feb 2014
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Internal Medicine Specialist 's  Response
Hi there,

Thanks for your query.

There is a condition called Somogyi effect-also called "rebound hyperglycemia." The term refers to pattern of high morning sugars preceded by an episode of hypoglycemia (usually with no symptoms, but night sweats can be a sign). Your blood sugar may drop too low in the middle of the night, so your body counters by releasing hormones to raise the sugar levels. This could happen if you took too much oral anti-diabetic drug earlier or if you did not have enough of a bedtime snack.

Apparently, the same mechanism is coming into play in your case too.

To confirm this, check your blood sugar at 2AM (about 8 hours after dinner) and with no pre-bedtime snacks. If the sugar level is quite low 70 or less, the diagnosis is confirmed.

In such case, the evening dose of Glipizide (ALWAYS taken 30 minutes BEFORE meals) should be REDUCED. Alternatively, a good pre-bedtime snacks should be taken.

If you find my response helpful and informative, do not forget an “excellent” (5-star rating) to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries.

Take care

Dr. Rakesh Karanwal
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Reason For Fluctuation In Blood Sugar Levels Despite Taking Glipizide?

Hi there, Thanks for your query. There is a condition called Somogyi effect-also called rebound hyperglycemia. The term refers to pattern of high morning sugars preceded by an episode of hypoglycemia (usually with no symptoms, but night sweats can be a sign). Your blood sugar may drop too low in the middle of the night, so your body counters by releasing hormones to raise the sugar levels. This could happen if you took too much oral anti-diabetic drug earlier or if you did not have enough of a bedtime snack. Apparently, the same mechanism is coming into play in your case too. To confirm this, check your blood sugar at 2AM (about 8 hours after dinner) and with no pre-bedtime snacks. If the sugar level is quite low 70 or less, the diagnosis is confirmed. In such case, the evening dose of Glipizide (ALWAYS taken 30 minutes BEFORE meals) should be REDUCED. Alternatively, a good pre-bedtime snacks should be taken. If you find my response helpful and informative, do not forget an “excellent” (5-star rating) to my answer, to ENCOURAGE ALL doctors- engaged in social service- to render sound advice to the FREE queries. Take care Dr. Rakesh Karanwal