Re: the lovely dawn effect

[Guest guest]

- I am curious what you consider " good control " - my FBG is

generally 85 with 95 - 100 being high for me. I do have diabetes caused

by surgery, so my case is different than normal DM. I thought good

control was anywhere up to 110 - I'm just curious since it seems there

are so many numbers around. I have also found that if I have a glass of

Merlot before bed, my FBG will always be 75-85 rather than 85-95. Of

course, 2 slices of pizza last night could be why I was 90 this morning

and not 80 ;-)

Barb in NH

Thornton wrote:

>

> I must say that you sound as if you do not have " good

> control " yet, Sky. I remember that it took me at least

> six months before my FBGs got down into the " good "

> range and then they stayed there. I guess that it

> takes the body that long to accommodate to the changed

> conditions but I have never seen that discussed

> anywhere - why it takes so long to do that.

>

>

> Regards

>

> Thornton

> Pforzheim, Germany

>

>

>

>

[Guest guest]

- I am curious what you consider " good control " - my FBG is

generally 85 with 95 - 100 being high for me. I do have diabetes caused

by surgery, so my case is different than normal DM. I thought good

control was anywhere up to 110 - I'm just curious since it seems there

are so many numbers around. I have also found that if I have a glass of

Merlot before bed, my FBG will always be 75-85 rather than 85-95. Of

course, 2 slices of pizza last night could be why I was 90 this morning

and not 80 ;-)

Barb in NH

Thornton wrote:

>

> I must say that you sound as if you do not have " good

> control " yet, Sky. I remember that it took me at least

> six months before my FBGs got down into the " good "

> range and then they stayed there. I guess that it

> takes the body that long to accommodate to the changed

> conditions but I have never seen that discussed

> anywhere - why it takes so long to do that.

>

>

> Regards

>

> Thornton

> Pforzheim, Germany

>

>

>

>

[Guest guest]

> So now I'm starting to think about the

> " dawn effect. " We have normally had our

> wine with dinner and we generally eat late,

> which is probably not good. I may give a

> try with eating dinner a bit earlier and

> having wine and some nuts before bed and see

> how it goes. He did that last night and

> his BG was 110 but so was it yesterday when

> he didn't have a glass of wine before bed!

Thanks for the information, Judy, it is very

interesting. You appear to have made up your

mind that " dawn effect " is something that

needs to be treated or at least counteracted

and I have not got that far yet. My physician

does not seem to think so and suggests that

there is no effective specific treatment for

it anyway.

> ... but hard information is very difficult

> to come by.

I had the impression that there was so much

of it that it was impossible to take it all in

without extensive expert knowledge in a wide

range of specialist fields!

> Even the " scientific " studies can be very

> confusing and not agree one with another. All

> require interpretation and everyone is ready

> to apply their interpretation to the data.

I understand that. I am not up to interpreting

clinical studies and am quite prepared to accept

" expert opinion " although I would like to have

the assurance that the guy is not just talking

off the top of his head but I cannot even find

that on the subject of " dawn effect " .

[Guest guest]

> So now I'm starting to think about the

> " dawn effect. " We have normally had our

> wine with dinner and we generally eat late,

> which is probably not good. I may give a

> try with eating dinner a bit earlier and

> having wine and some nuts before bed and see

> how it goes. He did that last night and

> his BG was 110 but so was it yesterday when

> he didn't have a glass of wine before bed!

Thanks for the information, Judy, it is very

interesting. You appear to have made up your

mind that " dawn effect " is something that

needs to be treated or at least counteracted

and I have not got that far yet. My physician

does not seem to think so and suggests that

there is no effective specific treatment for

it anyway.

> ... but hard information is very difficult

> to come by.

I had the impression that there was so much

of it that it was impossible to take it all in

without extensive expert knowledge in a wide

range of specialist fields!

> Even the " scientific " studies can be very

> confusing and not agree one with another. All

> require interpretation and everyone is ready

> to apply their interpretation to the data.

I understand that. I am not up to interpreting

clinical studies and am quite prepared to accept

" expert opinion " although I would like to have

the assurance that the guy is not just talking

off the top of his head but I cannot even find

that on the subject of " dawn effect " .

[Guest guest]

> So now I'm starting to think about the

> " dawn effect. " We have normally had our

> wine with dinner and we generally eat late,

> which is probably not good. I may give a

> try with eating dinner a bit earlier and

> having wine and some nuts before bed and see

> how it goes. He did that last night and

> his BG was 110 but so was it yesterday when

> he didn't have a glass of wine before bed!

Thanks for the information, Judy, it is very

interesting. You appear to have made up your

mind that " dawn effect " is something that

needs to be treated or at least counteracted

and I have not got that far yet. My physician

does not seem to think so and suggests that

there is no effective specific treatment for

it anyway.

> ... but hard information is very difficult

> to come by.

I had the impression that there was so much

of it that it was impossible to take it all in

without extensive expert knowledge in a wide

range of specialist fields!

> Even the " scientific " studies can be very

> confusing and not agree one with another. All

> require interpretation and everyone is ready

> to apply their interpretation to the data.

I understand that. I am not up to interpreting

clinical studies and am quite prepared to accept

" expert opinion " although I would like to have

the assurance that the guy is not just talking

off the top of his head but I cannot even find

that on the subject of " dawn effect " .

[Guest guest]

- I am not authority on DP - I believe that DP is caused because

your body is hungry and in order to keep from " starving " your liver

dumps some sugar to keep you going. I have no medical training or

anything like that - it is just how I feel about DP. I have a very large

snack (again because of my lack of digestion) before going to bed. If I

have protein with it (so that the snack lasts longer in my system) my

FBG will be 80-85. If I do not have protein with it (so the snack spikes

and then drops) the FBG will be 90-95 which to my mind means that the

snack did not sustain me long enough and the liver got in there and

dumped some sugar. I have no idea if this is " real " or not but it just

seems to be the way my body works. However, if the snack is small and

minus protein, I can spike and wind up with a reactive low 65-70, which

I try to avoid. I hope this makes some sense and I'm not sure if it is

relevant to what you are talking about or not.

Barb in NH

Thornton wrote:

>

> I would be interested to know if he takes a glass

> of wine and some nuts before sleeping and if it

> reduced his " dawn effect " ? I try to avoid taking

> anything after 8 p.m. and I go to bed at about

> 1-2 a.m. (I am retired) - I won't ask you about

> his testosterone!

>

> Thanks for the information, Judy. It gives me

> some leads to follow up.

>

> Regards

>

> Thornton

> Pforzheim, Germany

>

>

>

>

[Guest guest]

Isn't that true with all diseases, that they affect each person

differently? I have rheumatoid arthritis, and I know from my RA mailing

list that it presents itself differently in different individuals. The

same is true of RA medications, and, I believe, all medications: they

affect all of us differently. That is why the rule YMMV is so important

in diabetes as well as other diseases. Sue

On Tuesday, November 15, 2005, at 12:02 PM, judith_nicholls wrote:

>

> Re something more scientific. I'm a retired physicist so I know what

> is scientific, but hard information is very difficult to come by. One

> reason may be that " diabetes " is not a single thing but more a

> syndrome. Which is why something that works well for one person may

> not work for another depending on the details of why that person has

> high blood sugar.

[Guest guest]

> - I am curious what you consider

> " good control " - my FBG is generally 85

> with 95 - 100 being high for me. ...

> I thought good control was anywhere up

> to 110 - I'm just curious since it seems

> there are so many numbers around.

I call it " good control " when it is clear

that the patient is in charge of the diabetes

and not the other way around. When I was

first diagnosed it was obvious that the

diabetes was in control of me and it took

me a good six months before I was able to

take over with confidence.

In German it is called " gut eingestellt "

which means properly adjusted: everything

is running according to plan and the

medication and nutrition have been

optimized.

As I understand it, the 110 mg/dl is only

a diagnostic limit, and represents the

arbitrary upper limit for " normal " FBG,

while repeated FBGs above 126 mg/dl are

considered to be diagnostic of diabetes.

Values between 110 and 126 are called

" impaired fasting glucose " (IFC) and call

for further tests or observation.

The guidelines state clearly that:

" The revised criteria are for diagnosis

and are not the treatment criteria or

goals of therapy. "

The target FBGs for treatment are determined

on a patient-by-patient basis, but I have

seen <120 mg/dl mentioned together with not

more than one reported hypo incident in a

certain period (but I forget now how long

that was).

Obviously, you could medicate yourself down

to much lower FBGs if you wanted to but you

would then have to accept the increased

hypo risk. That is what the German term

" well adjusted " includes and it seems more

appropiate for FBG to me than " good control "

which is more useful to describe the

complete therapy situation.

It is clear that nobody can talk about a

patient being " in good control " when they

have just been diagnosed so it is

reasonable to have different limits for

diagnosis and for treatment and for the

treatment limit to be tailored to suit the

individual patient and that could be why

you see " so many numbers around " !

[Guest guest]

- I like your analogy of properly adjusted as opposed to good

control - I wish my childhood German was as good as your English :-) I

do have problems with low readings but they are directly connected my

lack of digestion (malabsorption) steatarrhea (fatty stool). I can drop

100 points in less than an hour if I don't eat every 2 hours or if I eat

something with too much fiber and spend too much time in the bathroom on

any given day. It is walking a tightrope to keep my readings under 120

and not go below 70. I have gotten pretty good at spotting when I am

down around 75 because from there it is a fast shot to 55. I have been

working on being properly adjusted for about 8 months now - which is

only part of the 4 years I have had DM. I had a Whipple in Dec 1998 and

DM dx was in 2000 - and denial reigned supreme for many years. Of

course, the doctor I went to said that everything was fine when my A1c's

were in the 6's but once my feet started to hurt, I knew I had to do

more. I am still hoping that my more properly adjusted good control will

help my feet to stop burning.

Barb in NH

Thornton wrote:

>

>

> I call it " good control " when it is clear

> that the patient is in charge of the diabetes

> and not the other way around. When I was

> first diagnosed it was obvious that the

> diabetes was in control of me and it took

> me a good six months before I was able to

> take over with confidence.

>

> In German it is called " gut eingestellt "

> which means properly adjusted: everything

> is running according to plan and the

> medication and nutrition have been

> optimized.

>

[Guest guest]

> - I am not authority on DP -

> I believe that DP is caused because

> your body is hungry and in order to

> keep from " starving " your liver

> dumps some sugar to keep you going.

Oh boy, Barb, you are pushing me to the

limit of my knowledge of physiology! The

trouble with all these simplified models

of how the body works is that they have

to be pretty inaccurate to fit into an

e-mail list. I don't believe that

you can " starve " the liver alone and I

am pretty sure that the liver does not

store sugar, it stores glucagon and so

do your muscles. The system is much too

complicated to be expressed in a few

words, I reckon. For a start, provided

they get enough water, humans can survive

for weeks without food. The body is equipped

to convert fat and proteins into glucose

when required so to be able to survive

for weeks, it first converts your fat

into energy and then the protein (it

starts dismantling the muscles) all to

keep your brain working, so I cannot

believe that it even misses a beat just

to get through the night!

> I have a very large snack (again because

> of my lack of digestion) before going

> to bed. If I have protein with it (so

> that the snack lasts longer in my system)

> my FBG will be 80-85. If I do not have

> protein with it (so the snack spikes

> and then drops) the FBG will be 90-95

> which to my mind means that the snack

> did not sustain me long enough and the

> liver got in there and dumped some sugar.

There you are, you see! We are all different,

I don't eat any snacks at all and I do try

not to eat anywhere near bedtime. And I have

no trouble getting through the night! Are

you sure about your being dependent on

snacks to sustain you even for a few hours?

> However, if the snack is small and minus

> protein, I can spike and wind up with a

> reactive low 65-70, which I try to avoid.

> I hope this makes some sense and I'm not

> sure if it is relevant to what you are

> talking about or not.

Well, it makes sense in that you are describing

what happens to you but it does not describe

what happens to me so we are obviously

different! As a matter of fact, my wife has

trouble getting through the night without

having a snack or two. I found out that there

are people called " night eaters " and she is

certainly one of them so you might be one, too?

There are well over a thousand Google

references to " night eater " so there must

be something to it. I haven't read them, partly

because I am really sick of being woken up

at 2, 3 and 4 a.m. by crackling paper and

snapping biscuits and tea cups clicking on

saucers! And then when all is quiet and I am

beginning to doze off again, she takes a

hefty bite out of a large apple and I am

wide awake again. I know, I know, that's

what separate bedrooms are for!

Regards

[Guest guest]

> Thanks for the information, Judy, it is very

> interesting. You appear to have made up your

> mind that " dawn effect " is something that

> needs to be treated or at least counteracted

No, I'm not sure. But Gil's BG is often quite a bit higher in the

morning than before a meal so it might be worth trying a couple of

things, now that we have the basics down. If a little snack at

bedtime, or a glass of wine, or... will make a difference, then we

might do it.

To decide if you are interested, you might try to find out how long

your BG is higher. Do some testing before your normal time of rising

on the one end and see how long it stays high in the morning on the

other end. I haven't done that yet.

[Guest guest]

Sky, wait 'till after the holidays, if possible.

A1c before hoidays: was/the lovely dawn effect

I guess I'll find out what mine is in December though I must say I dislike

the thought of having that test done just between Thanksgiving and

Christmas when I know I'm going to do some " cheating " .

sky

[Guest guest]

I useed to think the same thing , now I have the DP too~!

Are you any where near Hamburg? My exchange student is from Bad Bramstedt.

in OH

t2 dx 8-03

WOE, Lantus, Novolog

> The only aspect that has me puzzled is that I

have been reading about people having a " dawn

effect " for years and I used to wonder why I

didn't have one, too. Now I am wondering why I

suddenly get one while nothing much else has

changed (except that I am a few years older!).

I will assume that it is a sign of progression

of the diabetes and get on with my life!

Regards

Thornton

Pforzheim, Germany

[Guest guest]

Well, that's quite a switch for doctors, LOL. They usually WANT

patients to lose weight.

Sue

On Tuesday, November 15, 2005, at 09:16 PM, Barb Mandel wrote:

> I weight 150 lbs which is OK for my

> 5'5 " frame but the doctor gets concerned each time the weight goes down

> again. It started at 180. So the problem is not sustaining my appetite

> but getting enough food to sustain my weight.

[Guest guest]

Very true Sue - with malabsorption the problem can be that you keep

losing weight and sometimes it is difficult to stop the tide once it

starts - it is the same as when people have their stomachs stapled but

they don't know the long term effects of that surgery yet. Mine can

become serious if I start to lost weight and the malabsorption gets

worse and the body actually starves. I have learned to believe in the

statement " be careful what you wish for " - I was always " stout " and

wished I could eat whatever I wanted and not gain weight - well I got my

wish and would prefer to be back where I was in the beginning. I had no

diabetes, no malabsorption, no steatarrhea, no inability to digest meat

or most veggies - well the list goes on. BUT, I beat the odds with a

benign pancreatic tumor and for that will be forever thankful. My oldest

grandson turned 13 today and I never thought I would live to see him

turn 7 - so I take the trade-off and am delighted.

Barb in NH

Sue wrote:

> Well, that's quite a switch for doctors, LOL. They usually WANT

> patients to lose weight.

> Sue

>

> On Tuesday, November 15, 2005, at 09:16 PM, Barb Mandel wrote:

>

> > I weight 150 lbs which is OK for my

> > 5'5 " frame but the doctor gets concerned each time the weight goes down

> > again. It started at 180. So the problem is not sustaining my appetite

> > but getting enough food to sustain my weight.

>

>

>

[Guest guest]

> I used to think the same thing , now I have the DP too~!

It seems to be a mystery. But I still don't know how I got diabetes in

the first place so I suppose another little mystery wobble won't hurt

me!

> Are you any where near Hamburg? My exchange student is from Bad

Bramstedt.

No, , I am down in the south, not too far from Switzerland.

[Guest guest]

> in my pre-Whipple life I would have given anything

> to be able to eat and not gain weight - but now I

> have trouble maintaining my weight. I generally eat

> between 2500 and 3500 calories a day - this past

> year I have again lost 10 pounds. I weight 150 lbs

> which is OK for my 5'5 " frame but the doctor gets

> concerned each time the weight goes down

> again. It started at 180. So the problem is not

> sustaining my appetite but getting enough food to

> sustain my weight.

Barb, I wish I had your problem! I live off 1200-1500

kcal/day (two light meals) with 60 minutes fast walking

every day and still am not losing anything! And I don't

have any appetite, either. Another mystery!

> then again, being retired I tend to stay up late and

> then sleep late.

I tend to get kept up late and get woken up early, the

candle being burnt at both ends.

Regards

[Guest guest]

> To decide if you are interested, you might try to

> find out how long your BG is higher.

I go for 60 minutes fast walking every day now, often

before breakfast but in the middle of my " dawn effect " .

Recently I measured before and after the walk and had

132 mg/dl both times, i.e. I walked fast for 60 minutes

on an empty stomach at the aerobic threshold and burnt

no sugar! (since the idea is to burn fat, that is good).

I was down to 100 mg/dl again before lunch so my dawn

effect looks like a rise of 32 mg/dl or so for around

2-3 hours.

In my experience, each day is physiologically a little

different from the others so I would need to measure

every day for a week or so and take the average.

Since the " dawn effect " increase is something that my

glucose homeostasis appears to think it needs for itself

(i.e. it is not the result of me shoveling in fuel) I

am inclined to leave it that way and not to try to level

it out with wine and nuts at bedtime (however enticing

that might be - sounds like a party)!

Regards

[Guest guest]

I'm surprised the exercise before breakfast doesn't make your BG go UP

instead of letting it remain steady. I find that when I exercise before

breakfast, I get a liver dump and my BG goes up. If I exercise after

eating (and of course waiting a while), my BG will go down.

Sue

On Wednesday, November 16, 2005, at 02:14 PM, Thornton wrote:

>

> I go for 60 minutes fast walking every day now, often

> before breakfast but in the middle of my " dawn effect " .

> Recently I measured before and after the walk and had

> 132 mg/dl both times, i.e. I walked fast for 60 minutes

> on an empty stomach at the aerobic threshold and burnt

> no sugar! (since the idea is to burn fat, that is good).

[Guest guest]

> I'm surprised the exercise before breakfast

> doesn't make your BG go UP instead of letting

> it remain steady. I find that when I exercise before

> breakfast, I get a liver dump and my BG goes up.

Well, Sue, you know about the BG going up from your meter

reading but how do you know about the " liver dump " ?

Don't forget that when I do my exercise, my BG has

already gone up, I wouldn't expect it to go up some more.

[Guest guest]

Coming out of " lurk mode " for a minute here...

I *think* I've figured out how to deal with my own DP. Mind you, as a

newly-diagnosed LADA not yet on insulin, I'm a moving target. But

mornings have been my most troublesome times. Here's how I'm now

dealing with them, thanks to advice gleaned from this list.

Basically, I just eat a nearly protein-only breakfast as SOON as I get

up. I brush my teeth, test, and go downstairs and make one egg plus

some egg whites scrambled, washed down with 3 cups of coffee lightened

with half and half. Making the bed, getting dressed, making the kids'

lunches -- it all has to wait until I eat my eggs. I test 1.5 hour

later and I'm where I want to be. Then, a few minutes before heading

out for an hour-plus-long hike with the dog, I eat some carbs, such as

a small amount of Bran Buds with milk, or plain yogurt with flax.

Otherwise, I'll be dragging. I've tested after this exercise, and

still the levels are fine (excercise does wonders).

Mind you, getting those eggs into me right away means I have to be

creative about taking my thyroid pill, which needs to be taken first

thing and then requires waiting 30 minutes before eating. Lately I put

it on the nightstand and take it if I wake up @3:00 - 4:00 AM, which I

seem to be doing lately, then going back to sleep. If I didn't wake up

to take it, I'd have to decide between low thyroid levels or high BG

levels that morning, I suppose.

For me, I think it was eating as SOON as possible to break the fast

that helped me the most. I do drink red wine every night, but I don't

think it had an effect on my DP, since fasting levels could be

terrific, then go way up after I finally got around to eating

something. Now I know why my hospital blood work fasting levels were

so much higher than anything I see at home.

- H.-

>

> > I'm surprised the exercise before breakfast

> > doesn't make your BG go UP instead of letting

> > it remain steady. I find that when I exercise before

> > breakfast, I get a liver dump and my BG goes up.

>

> Well, Sue, you know about the BG going up from your meter

> reading but how do you know about the " liver dump " ?

>

> Don't forget that when I do my exercise, my BG has

> already gone up, I wouldn't expect it to go up some more.

>

>

>

[Guest guest]

On Wednesday, November 16, 2005, at 07:04 PM, Thornton wrote:

>

> Well, Sue, you know about the BG going up from your meter

> reading but how do you know about the " liver dump " ?

That is the best explanation I can think of, LOL.

> Don't forget that when I do my exercise, my BG has

> already gone up, I wouldn't expect it to go up some more.

Do you ever exercise at another time, say two hours after a meal? If

so, what is the effect on your BG?

Sue

[Guest guest]

Hi, ...sounds like you're doing fine but I have two comments.

One, since you read the material I sent you about LADA,why the

reluctance to start insulin? You should really do it, to save your

remaining beta cells.

BTW, the thought of taking insulin is usually a lot scarier than the

actuality. Using super-fine needles and shooting in my belly (where

there are relatively few nerve endings) I very rarely feel any pain at

all, hardly a prick.

The other thing is, I've been hypothyroid for 35 years (diabetic for

only 7) and I was never given an instruction to have a half hour from my

thyroid pill till eating time. I have always taken it after my meal,

along with most of my other pills with absolutely no problem. 35 years

is a long time to be doing it this way, so I think if there was a

problem with it, I'd certainly know by now.

OTOH, I DO have to take my Fosamax a half hour before eating breakfast.

Vicki

Re: the lovely dawn effect

> Coming out of " lurk mode " for a minute here...

>

> I *think* I've figured out how to deal with my own DP. Mind you, as a

> newly-diagnosed LADA not yet on insulin, I'm a moving target. But

> mornings have been my most troublesome times. Here's how I'm now

> dealing with them, thanks to advice gleaned from this list.

>

> Basically, I just eat a nearly protein-only breakfast as SOON as I get

> up. I brush my teeth, test, and go downstairs and make one egg plus

> some egg whites scrambled, washed down with 3 cups of coffee lightened

> with half and half. Making the bed, getting dressed, making the kids'

> lunches -- it all has to wait until I eat my eggs. I test 1.5 hour

> later and I'm where I want to be. Then, a few minutes before heading

> out for an hour-plus-long hike with the dog, I eat some carbs, such as

> a small amount of Bran Buds with milk, or plain yogurt with flax.

> Otherwise, I'll be dragging. I've tested after this exercise, and

> still the levels are fine (excercise does wonders).

>

> Mind you, getting those eggs into me right away means I have to be

> creative about taking my thyroid pill, which needs to be taken first

> thing and then requires waiting 30 minutes before eating. Lately I put

> it on the nightstand and take it if I wake up @3:00 - 4:00 AM, which I

> seem to be doing lately, then going back to sleep. If I didn't wake up

> to take it, I'd have to decide between low thyroid levels or high BG

> levels that morning, I suppose.

>

> For me, I think it was eating as SOON as possible to break the fast

> that helped me the most. I do drink red wine every night, but I don't

> think it had an effect on my DP, since fasting levels could be

> terrific, then go way up after I finally got around to eating

> something. Now I know why my hospital blood work fasting levels were

> so much higher than anything I see at home.

>

> - H.-

>

>

>>

>> > I'm surprised the exercise before breakfast

>> > doesn't make your BG go UP instead of letting

>> > it remain steady. I find that when I exercise before

>> > breakfast, I get a liver dump and my BG goes up.

>>

>> Well, Sue, you know about the BG going up from your meter

>> reading but how do you know about the " liver dump " ?

>>

>> Don't forget that when I do my exercise, my BG has

>> already gone up, I wouldn't expect it to go up some more.

>>

>>

[Guest guest]

> Do you ever exercise at another time, say two

> hours after a meal? If so, what is the effect on your BG?

Yes, but a couple of years ago when I was exercising

anaerobic very hard. It was always very disappointing.

Just a small notch in the BG curve on the slope down

after the peak and at about the same time as the

exercising was going on. A sustained anaerobic exercise

program has a strong long-term effect but it can take

months before it shows on the HbA1c and is not significant

in the short term.

However, with fast walking, I am reluctant to walk

around measuring BGs on the trot and since my walking

is always just below the aerobic threshold (set by

my physician after stress EKGs) I wouldn't expect

to see any effect since the aim is to burn fat and

not glucose. In fact, I am confident that there is no

significant BG effect.

[Guest guest]

> Do you ever exercise at another time, say two

> hours after a meal? If so, what is the effect on your BG?

Yes, but a couple of years ago when I was exercising

anaerobic very hard. It was always very disappointing.

Just a small notch in the BG curve on the slope down

after the peak and at about the same time as the

exercising was going on. A sustained anaerobic exercise

program has a strong long-term effect but it can take

months before it shows on the HbA1c and is not significant

in the short term.

However, with fast walking, I am reluctant to walk

around measuring BGs on the trot and since my walking

is always just below the aerobic threshold (set by

my physician after stress EKGs) I wouldn't expect

to see any effect since the aim is to burn fat and

not glucose. In fact, I am confident that there is no

significant BG effect.