Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group T2 Diabetics:Blood Glucose goes up when flaring?

Well Bill is type 2 and he takes victoza and he has arthritis it seems like everything affects his his diet, when he doesn't feel, when he feels a flare coming on I think it's all related diabetes the pancreas the pain inflammation levels going up just when he feels pretty good his BS is pretty stable
Lisa

Hi,

I've been measuring my sugar right before and 2-3 hours after each meal the last few days (I've done this some weekends in the past) and learning some interesting things.

1. We're all a bit different.

2. I was surprised to learn that I can eat a little starch, a little sugar in the form of fruit breakfast, lunch, basically before "dinnertime" and my sugar will go back down to either the 90s or 100s, so long as I haven't eaten too much overall, haven't eaten more than ~30 grams of carbs (15-20 grams is best), have been up and about.

But, if I eat any carb other than non starchy veggies, dinner or later, my Blood glucose takes forever to come down or doesn't. On nights where I've eaten a later dinner, by the time I go to bed, my blood glucose is in the 120s or higher and when I wake up, its pretty much the same thing.

3. I know about the liver dumping (dawn affect). My body doesn't exactly seem to work that way. More like from about 5 or 6 pm until the next morning, my body doesn't know how to clear sugar from my blood stream (no insulin? liver dumping? I don't know but will ask the GP, though he doesn't seem to know more than the basics about diabetes.

4. I thought beans, since they digest slower and I'm fine with them for lunch, were a good carb source for me. But if I eat them (bean soups, etc) at dinner or in the evening, they raise my blood glucose as much as if I'd eaten a big bowl of pasta.

My GP wanted me on a low fat vegan diet for my cholesterol. Wanted me eating beans at every meal, as my main protein source.

Great for cholesterol if one doesn't have diabetes. Terrible for cholesterol if one has diabetes and terrible for diabetes.

Good idea, but not for a diabetic like me.

Wonder what the GP will say when I tell him what I've discovered regarding beans and the "dusk effect" (I made up that term as I see lots on the dawn effect but very little on what I've observed, reading only about it on forums discussing kids with type I diabetes, where their parents note the same thing for their kids that I see for myself.

5. This week, first week of my 2 week Humira cycle, I feel so much better than last week, and yet my Blood glucose has been a lot worse in the morning…..

now I know its not due to flaring, but due to eating bean soup for late dinners due to working late a few times this week.

Today I ate it earlier and will test my sugar to see if I can handle it for an early dinner.

If not, then bean soups will have to be relegated to lunch only and dinners will have to be only meat or fish and veggies, no beans, no starches, no fruit.

Or, I need more metformin ER.

Or, I am still battling the constipation (always except for a few days after Humira) and so even though my joints aren't flaring, obviously my GI tract stilll is…..

thanks lisa,

it is all connected, so makes a lot of sense.

Sue, I asked and my sweetie would definitely agree that there is a connection.

He would also say that if he keeps his blood sugar absolutely stable with his diet, he can go without pain killers for some time. He also regrets it if he has a large meal right before bed. And the pain in his feet is directly related to his blood sugar levels, as well.

Interesting discussion, Sue. Thanks very much!!!

Love and warm hugs,

Hi Sue,.. this is off topic but I thought you might be interested, since I think current research seems to be leaning toward the opposite conclusion in regard to dose.

Immunogenicity

Patients in Studies RA-I, RA-II, and RA-III were tested at multiple time points for antibodies to adalimumab during the 6-to 12-month period. Approximately 5% (58 of 1062) of adult RA patients receiving HUMIRA developed low-titer antibodies to adalimumab at least once during treatment, which were neutralizing in vitro. Patients treated with concomitant methotrexate (MTX) had a lower rate of antibody development than patients on HUMIRA monotherapy (1% versus 12%). No apparent correlation of antibody development to adverse reactions was observed. With monotherapy, patients receiving every other week dosing may develop antibodies more frequently than those receiving weekly dosing. In patients receiving the recommended dosage of 40 mg every other week as monotherapy, the ACR 20 response was lower among antibody-positive patients than among antibody-negative patients. The long-term immunogenicity of HUMIRA is unknown.

You might find this interesting, from Medscape: Antidrug Antibodies (ADAb) to Tumour Nec...matory Diseases

Will be great to have more research to give us all a better guide on these sorts of decisions.

Cheers!
mig

Mig,

Thank you. I did not know that; I need to read more.

and my rheumy is good, but he obviously didn't know that.

I'll make him aware of this; I see its right on the Humira website…..

I'm always saying week 1 is good and week 2 is always worse, much more of a struggle.

And now with this info, no real good reason not to do it weekly instead biweekly.

I think this is important enough for everyone to know that:

1. I'm glad you stepped in and said something, so thank you.

2. Either you or I should start a new thread about this in the biologics topic area. If you don't, I will in the next few days.

Thanks again!

Hey, glad it was helpful Sue!

I don't think it is new info particularly, my Rheumy told me years ago that a treatment delay could theoretically open a window for the development of antibodies to the med (in my case Remi). Serum levels have been suspected of being a possible factor in loss of efficacy but theory vs fact needed to be explored.

Another interesting bit that my Rheumy mentioned, was that the longer I was on Remicade, the lower the likelihood was that it would stop working for me. Not that it can't happen but less likely is nice. I think that is also true of Humira. I'm 9+ yrs on Remicade. Still works.

I guess the hard evidence is building... but a ways to go before they can test us to determine levels and personalize the best course of action in terms of dose for the individual.

You are right mig, its not new news, my rheumy should have known. Maybe it was just a brain fart on his part.

But I should have investigated it myself too, well, at least there are people here to catch us when we are misinformed.

And like you said, it does make sense, as I knew people said when they missed a dose or doses of their biologic, due to infection, etc, that that was when it might stop working.

And what you said about the longer it works, the more likely it is to keep working: when I first started on the humira, I remembered reading that if one had an early positive response, the chances of having a long happy relationship with the drug were pretty good. That made me happy cause I felt the effects first day: came home to prep lunch and standing in the kitchen, my feet felt "lighter" as I told my husband. And the next day and the day after that, I couldn't believe the improvement in my bathroom experience…if you know what I mean

Anyway, thanks again! Doc and I will be having a little conversation next visit!

And so glad that you and remicade have had a long happy relationship!