type 2 but frequent hypos

[ianmacleod]

Hi all. I've not been on here for a while.

I'm getting more and more frustrated at the control that diabetes is having on my life. I have had 8 hypos in the last 14 days. Normally between 11am and 12.30am. I am on Metformin (1500mg, 1 morning, 2 evening) and Gliclazide (160mg, 2 morning, 2 evening). I always eat a breakfast. I work in an office, so am not doing anything physically strenuous.

Is there anything on the meds front that can help rectify this problem?

My DSN & diabetologist have both hinted, from initial diagnosis (24/04/2012), that I may be type 1.5 / LADA, so may need to go on insulin sooner or later.

Would insulin instead of gliclazide help?

I constantly feel lethargic, although tiredness is not an issue at present. I also suffer from mood swings - driving my wife mad.
At work I am entering into a particularly heavy / stressful period (4 months) and concerned whether I will cope.
I have an appointment with DSN & Diabetologist 06/09/12, so would like to raise the problems with them to resolve.
Can anyone relate to my problems and / or suggest a plan of action to help?

Sorry for lengthy post. I think this is one subject matter!

 

[Northerner]

Hi Ian, sorry to hear about the problems you are having I would suspect that it's the gliclizide that's the problem as it encourages your pancreas to produce more insulin - sounds like the dose might need reducing. In answer to your question, I think insulin would help in so far as it would be more controllable - you could adjust your doses to your requirements. The lethargy and mood swings could also be due to your widely fluctuating levels, so being able to fine tune your control would probably help with this also. If it is decided to put you on insulin I would recommend that you ask to go on a basal/bolus regime, also known as MDI (multiple daily injections). This involves a slow acting insulin taken once or twice a day and a fast acting insulin with your meals.

How low are you going with your hypos? It might be a good idea to try and preempt any lows by testing and having a snack prior to the time you normally experience the lows.

 

[ianmacleod]

How low are you going with your hypos? It might be a good idea to try and preempt any lows by testing and having a snack prior to the time you normally experience the lows.[/QUOTE]

I recognise a hypo from 3.9. My lowest tests are only 3.1 - luckily I spot my symptoms before they go below this, but worry that I may not notice as early when in deep concentration. But, my problem intensifies when I'm busy and lose track of time, then the first thing I realise the time is when my hands start shaking. The times that I have a hypo seem to be getting earlier and earlier in the morning.

 

[Northerner]

I recognise a hypo from 3.9. My lowest tests are only 3.1 - luckily I spot my symptoms before they go below this, but worry that I may not notice as early when in deep concentration. But, my problem intensifies when I'm busy and lose track of time, then the first thing I realise the time is when my hands start shaking. The times that I have a hypo seem to be getting earlier and earlier in the morning.

Sounds familiar! I've often had my head deep into something and suddenly realised I ought to do something! Make sure you have something sugary on hand so you can deal with it quickly - two or three jelly babies normally does the trick for me, or a sugary drink like non-diet coke. It does look like your medication needs reducing, might be worth making an appointment before the one that's due so that you can see if the doctor agrees.

 

[PattiEvans]

and Gliclazide (160mg, 2 morning, 2 evening)

Since your hypos are at a specific time pre lunch it may say that your morning dose of glic is a bit too much. Discuss with your team whether you can halve the morning glic. Hope this helps.

 

[ianmacleod]

Since your hypos are at a specific time pre lunch it may say that your morning dose of glic is a bit too much. Discuss with your team whether you can halve the morning glic. Hope this helps.

.

Thank you Patti, but, previously (until mid June) I was on 500mg metformin and 40mg gliclazide in the evening, with my morning doses being unchanged from my present dosage, and I was constantly suffering high readings before bed and on awakening, that were causing me to be tired. When I say tired, I mean, falling asleep at my desk and having to go home to sleep. The dosage was increased to combat the highs.
My job involves regular tight deadlines. So the tiredness and inability to complete a full weeks work were affecting my stress levels for fear of my job.

Is there a balance that can be obtained? Would the insulin route as suggested by Northerner help? Or is it a matter of a continual trial and error with tablet dosage?

 

[KateF]

Ian, I am the partner of a LADA, originally miss-diagnosed as T2.

You can ask whether you are producing sufficient insulin (I think it is the C-Peptite they test for that tells them).

You can buy a book called Think Like a Pancreas by Gary Schneider. It is quite readable and informative and if you are LADA it will be very helpful. I got mine from Amazon and it was only around ?10.

If you go on insulin then it can help your pancreas have some breathing space so you will continue to produce a small amount of insulin for longer, rather than your current meds wringing all the insulin out of your pancreas sooner.

In our case my OH was falling asleep all the time, looked sicker and sicker, eventually his body was eating his own muscle mass and he felt terrible (and his blood sugars were very high). He was on v high metformin and glic, with v little benefit. He was being sent home frequently from work and couldn't work all week either. I wish he had been able to start insulin earlier than he did, as he now looks healthier and although he isn't yet 100% it is really a miracle how much his life is improving.

We went to the DUK "Big Event" and met quite a few other people in a similar situation - you think you are alone as a LADA but you really aren't.

I'm at work so this is probably a terrible post as I've done it inbetween other stuff. Tell them how ill you are, and how it is impacting your quality of life, read Think Like a Pancreas and talk to people here about how you are doing.

If you think my rambings could help/want contact with another LADA then feel free to PM me.