Dawn phenomena or Diabetes getting worse! Need help

Hi Tash,

First off the higher morning number is indeed the "dawn phenomenon" so don't worry about that, it happens to most of us.  HOWEVER, your Byetta needs some help as your 2 hour numbers should be  below 100.  Your endo is right on the money to prescribe you extra meds.  Amaryl is a med that will "increase your sensitivity" to insulin and one of the major factors of Byetta is to increase your insulin production in response to your blood sugar load.  So the Amaryl will just give the Byetta a little extra help in getting your numbers down and keeping them down. 

Now, skipping your evening dose of Byetta is NOT a good thing.  Even if you don't eat anything, as long as your blood sugar is over 100, you should be taking your evening meds.  If the Byetta and Amaryl push you to 60's or 70's then the dawn phenom. will pull you back up to just under 100 and you are right where you want to be.  And remeber, the Byetta makes your body react to the sugar levels in your blood stream, so if you don't eat and your blood sugar isn't that high, the Byetta will have a negligible effect. Hopefully the extra meds are just what you need to keep your numbers mostly under 100.  Good luck.

 Warren

Im a type 2 on Byetta and I take metformin and Glipzide.  I used to take Avandia but the Byetta got me off the stuff.  So...without any meds I'll run high 300's for a BS reading.  With just the orals I'll be somewhere in the 200's.  We are talking morning fast here.  With the 10mg of Byetta I'll be 75-100 for my morning numbers and 2 hours after eating (which is when the Byetta REALLY kicks in full strength) I'll be 60-80.  Now this is assuming I haven't loaded up on carbs like a huge plate of french fries or had ice cream or something with lottsa sugar.  So the Byetta definately is responsible for the lower numbers, but it has the help of the orals.  Without the Orals, my numbers aren't below 100.

To answer your second question, the Amaryl is like metformin only stronger.  It is there to promote and enhance the insulin sensitivity in your body, not stimulate your insulin production.

140 is the number that Endos would like Diabetics to shoot for, less than or equal to 100 2-hours after a meal is where normal people are and what you should probably shoot for as a Byetta user. As I said before, as long as your numbers are above 100 at night, even if you don't eat dinner, I don't think it will hurt you to take the Byetta.  If your BS SHOULD dip to low, you will feel the effects (you'll feel cold, shakey, etc.) and you can then drink some orange juice to very quickly pull your BS back up.  However, without a spike in your BS, I don't think the Byetta will pull you that low on an empty stomach.  Otherwise, people that take it an hour before a meal would be in danger of going to low. Remember, Byetta's major feature is to be able to work on high BS and then shut off its effect as your levels return to normal.  Hope this helps.

 Warren

 Warren