Chia and/or açai causing low sugar levels?

[afcchris]

Hi all

New member here. Diagnosed with type 2 in early March. Doing well so far. Lost 10kg steadily and taking metformin and Ozempic.

I have a question about my sugar levels suddenly dropping below 70. I have generally having my levels between 70 and 180 and on 2 occasions have not breached the low or high levels for 4 weeks. Both times this happened my good record suddenly stopped when I hit levels below 70 and as low as 55 overnight. Then it took some adjustment to my diet to get back on track. The first time I went from 2 metformin tablets to 1 at the request of the doc, which seems like good progress overall to me!

The main question I have is whether chia or açai bowls can cause this rapid drop. I have been eating chia with coconut milk and some berries and also açai blended with frozen fruit and coconut milk/shredded coconut and eaten with fruit on top. Both times the levels dropped into the red level I had eaten more of these puddings which have never been an every day thing for me. So I have started wondering whether these are actually the cause, or it’s just that I should be eating something with a bit more sugar than these bowls

Your view would be great

 

[rebrascora]

Hi and welcome.

Can I ask how you are monitoring your BG levels? If these drops occurred during the night and you use Freestyle Libre I am wondering if they are actually compression lows. If Libre or similar CGM did you double check the low reading with a finger prick or were you just noticing the low level on your graph the next morning.
I think I can say with reasonable confidence that chia and Acai berries are not capable of causing you to have a hypo but I am actually just wondering if in fact you haven't really dropped low at all but just laid on your sensor which caused it to read low?

 

[Docb]

Hi @afcchris and welcome to the forum. Can I just clarify the numbers you are quoting? Are they results from finger prick testing? If so, then I suspect you have got a meter that reads in mg/dl.

 

[rebrascora]

Hi @afcchris and welcome to the forum. Can I just clarify the numbers you are quoting? Are they results from finger prick testing? If so, then I suspect you have got a meter that reads in mg/dl.

I was assuming the OP was in the USA and that was why they were using mg/dl.... but I guess as a Mod you can see where in the world they are, so perhaps an incorrect assumption on my part.

 

[afcchris]

Hi and welcome.

Can I ask how you are monitoring your BG levels? If these drops occurred during the night and you use Freestyle Libre I am wondering if they are actually compression lows. If Libre or similar CGM did you double check the low reading with a finger prick or were you just noticing the low level on your graph the next morning.
I think I can say with reasonable confidence that chia and Acai berries are not capable of causing you to have a hypo but I am actually just wondering if in fact you haven't really dropped low at all but just laid on your sensor which caused it to read low?

Thanks for the reply. I am checking using Freestyle Libre app on my phone with sensors on my upper arm and alternating arms each time i change the sensor after 14 days . I am open to the fact that the sensor readings can be affected when you are sleeping but have been using the sensors since March and the only times this has happened was in the 2 periods of low sugar which i mentioned. I didn't have a reading below 70 mg/dl before these issues at night or any other time.

On this occasion and the previous one the low readings continued the next day so that seems to show it is actually a low sugar issue and not something happening just when i was sleeping. As mentioned before, on the first occasion i went to my doc and with a combination of reducing the metformin to 1 tablet a day and increasing the sugar intake i went back to normal after about 4 days. I haven't seen the doc this time but again i have adjusted my diet to get my average back to a good figure and after 2 nights of many low sugar events i had just a very brief one last night. I am averaging 84 mg/dl now when before this issue i was around 95-100 consistently for weeks.

so overall it does look like a genuine low sugar period or 2. I am still adjusting to the condition and i wonder whether i just took too much sugar out of my diet on some occasions. My doc says it's easily done...

 

[rebrascora]

Did you double check any of these low readings with a finger prick? Libre consistently reads about 1mmol lower than my BG so a 3.5 on the Libre is usually a mid 4 if I double check it.... which I am supposed to do as an insulin dependent diabetic. Many Type 1s find that Libre reads low at the lower end of the range and higher when we are hyper, so the readings we get that suggest we are low or high should always be double checked before we take action.
If I wasn't on insulin I would not be perturbed about my levels dropping below 3.9 (or 70 to you). Non diabetic people can drop to mid 3s quite naturally. Warmer weather, more activity, alcohol... and probably quite a few other things can cause levels to drop a bit lower. Our liver is quite capable of releasing glucose from it's stores to bring us back up.

 

[trophywench]

It was warning me just before dinner that my BG was low, it said it was 4.1. I tested my BG though cos I was literally about to eat and it was actually 4.9. Even if yours was 4.1, it isn't actually dangerously low cos you don't have any glucose lowering drugs in your body.

 

[afcchris]

Did you double check any of these low readings with a finger prick? Libre consistently reads about 1mmol lower than my BG so a 3.5 on the Libre is usually a mid 4 if I double check it.... which I am supposed to do as an insulin dependent diabetic. Many Type 1s find that Libre reads low at the lower end of the range and higher when we are hyper, so the readings we get that suggest we are low or high should always be double checked before we take action.
If I wasn't on insulin I would not be perturbed about my levels dropping below 3.9 (or 70 to you). Non diabetic people can drop to mid 3s quite naturally. Warmer weather, more activity, alcohol... and probably quite a few other things can cause levels to drop a bit lower. Our liver is quite capable of releasing glucose from it's stores to bring us back up.

i haven't been able to check with finger pricks as have been on the freestyle from the off and never had a way of testing by finger prick. I will speak to my doc or look for something online to have a back up in these situations.

 

[afcchris]

It was warning me just before dinner that my BG was low, it said it was 4.1. I tested my BG though cos I was literally about to eat and it was actually 4.9. Even if yours was 4.1, it isn't actually dangerously low cos you don't have any glucose lowering drugs in your body.

can you explain more about which glucose-lowering drugs you mean?

 

[rebrascora]

i haven't been able to check with finger pricks as have been on the freestyle from the off and never had a way of testing by finger prick. I will speak to my doc or look for something online to have a back up in these situations.

Ah! That puts a whole other slant on things and you really should have been made aware that Libre is not so accurate at low levels and high levels and can read up to 2mmols out even when you are in range. More than 2 mmols out and Abbott with replace it.
For example, this morning my Libre showed me on 3.6mmols but a finger prick immediately afterwards showed my BG level as 5.2 and therefore not hypo at all and in fact a perfectly healthy waking number, so I didn't take any hypo treatment. My Libre has continued to show me "in the red" for nearly 2 hours since then and just come up but finger pricks suggest I didn't go lower than 4.2.
I think you would be wise to invest in a cheap BG meter so that you can at least do a calibration check when you start a new sensor and double check any low or high readings it gives you, but as someone whose diabetes is only being treated with Metformin, there should be no concern about dropping too low or needing sugary treats or increasing your sugar or carb intake at other times of day to prevent this because your body is quite capable of regulating those low levels itself if it needs to.... and it is quite natural for your levels to drop very low (even below 70mg/dl) in the deepest part of your sleep, the only concern for those of us who are insulin dependent is that if there is too much insulin, the liver won't be able to counteract it and bring us back up and we end up dropping dangerously low and that it erodes out hypo awareness which is important for keeping us safe. Metformin is just not capable of dropping your levels dangerously low, even if you actually drop below 70 (rather than just Libre suggesting you did 🙄 .... Once you check it regularly you soon learn that it exaggerates)

 

[afcchris]

Ah! That puts a whole other slant on things and you really should have been made aware that Libre is not so accurate at low levels and high levels and can read up to 2mmols out even when you are in range. More than 2 mmols out and Abbott with replace it.
For example, this morning my Libre showed me on 3.6mmols but a finger prick immediately afterwards showed my BG level as 5.2 and therefore not hypo at all and in fact a perfectly healthy waking number, so I didn't take any hypo treatment. My Libre has continued to show me "in the red" for nearly 2 hours since then and just come up but finger pricks suggest I didn't go lower than 4.2.
I think you would be wise to invest in a cheap BG meter so that you can at least do a calibration check when you start a new sensor and double check any low or high readings it gives you, but as someone whose diabetes is only being treated with Metformin, there should be no concern about dropping too low or needing sugary treats or increasing your sugar or carb intake at other times of day to prevent this because your body is quite capable of regulating those low levels itself if it needs to.... and it is quite natural for your levels to drop very low (even below 70mg/dl) in the deepest part of your sleep, the only concern for those of us who are insulin dependent is that if there is too much insulin, the liver won't be able to counteract it and bring us back up and we end up dropping dangerously low and that it erodes out hypo awareness which is important for keeping us safe. Metformin is just not capable of dropping your levels dangerously low, even if you actually drop below 70 (rather than just Libre suggesting you did 🙄 .... Once you check it regularly you soon learn that it exaggerates)

Thanks for your helpful response. I am new to all this as mentioned. It would help me a bit more if you could explain the doc's recommendation to reduce the metformin to one 1000mg tablet a day from two. This seemed to help but it might have been a coincidence as i was trying to increase my sugar levels a bit. Are you able to explain more about how metformin helps? As mentioned before the doc seemed happy that in less than 3 months i was able to reduce my meds already. Just to add that my HBA1C was tested at 11 on 5th March and then 6.6 on 27th May so i am making good progress

 

[rebrascora]

Hi. Congrats on the great HbA12c reduction.

Metformin works in two ways...

It inhibits the liver from releasing so much glucose .... The liver is like our back up battery to keep our vital organs supplied with energy (glucose) when we are not eating/digesting food.... ie through the night or when fasting at other times. When people develop Type 2 diabetes, one of the things that can happen is that fat builds up in and around the liver and pancreas and prevents them communicating effectively. (The pancreas produces insulin, the liver produces glucose and both are needed to balance Blood Glucose (BG) levels. There are substances which each organ releases to switch the other on/off to balance BG levels. The visceral fat can lead this very sensitive system to not function correctly and the liver starts to churn out too much glucose, so Metformin helps to suppress this a little.

Metformin also helps to facilitate the uptake of glucose from the blood by the cells of the body which have perhaps become insulin resistant. The typical description of how it works is that insulin unlocks the door to the cells for the glucose to pass through but the locks have become rusty and Metformin works to oil the locks and make the doors open more smoothly and easily.

Losing weight/fat will help the liver and pancreas to function in better harmony as that visceral fat is burnt off and losing weight will also enable the cells to be able to accept that glucose more readily because their storage facility is no longer chock full and bursting at the seams. Any surplus glucose in the blood is stored as fat but if the cell's fat storage capacity is at ful, they just done want to take anymore because they have no where to put it. Losing weight enables then to have some storage capacity again, but if you start eating too much sugar and carbs it will soon fill up again and the situation will reverse.

 

[afcchris]

Hi. Congrats on the great HbA12c reduction.

Metformin works in two ways...

It inhibits the liver from releasing so much glucose .... The liver is like our back up battery to keep our vital organs supplied with energy (glucose) when we are not eating/digesting food.... ie through the night or when fasting at other times. When people develop Type 2 diabetes, one of the things that can happen is that fat builds up in and around the liver and pancreas and prevents them communicating effectively. (The pancreas produces insulin, the liver produces glucose and both are needed to balance Blood Glucose (BG) levels. There are substances which each organ releases to switch the other on/off to balance BG levels. The visceral fat can lead this very sensitive system to not function correctly and the liver starts to churn out too much glucose, so Metformin helps to suppress this a little.

Metformin also helps to facilitate the uptake of glucose from the blood by the cells of the body which have perhaps become insulin resistant. The typical description of how it works is that insulin unlocks the door to the cells for the glucose to pass through but the locks have become rusty and Metformin works to oil the locks and make the doors open more smoothly and easily.

Losing weight/fat will help the liver and pancreas to function in better harmony as that visceral fat is burnt off and losing weight will also enable the cells to be able to accept that glucose more readily because their storage facility is no longer chock full and bursting at the seams. Any surplus glucose in the blood is stored as fat but if the cell's fat storage capacity is at ful, they just done want to take anymore because they have no where to put it. Losing weight enables then to have some storage capacity again, but if you start eating too much sugar and carbs it will soon fill up again and the situation will reverse.

Thanks for the informative response. Still having issues with the sugar going to the red zone overnight. My 90 day “time in target” average was 99% before this week and for the current week it’s showing 81%. Average blood sugar is down to 82%. I have no symptoms that you are generally supposed to get when you go low. Been reading a lot about sensor positioning but it’s not easy to just change the sensor when these things are so expensive. I might try this time though

 

[rebrascora]

If I was you, I really wouldn't worry about it. The lower readings just tell you that what you are doing is working. I hate it when Libre ruins my Time in Range because it reads lower than it should but I refuse to eat sweet stuff when I don't need to... and I am insulin dependent so the red on my graph is a lot more significant because it can be dangerous for me because I take insulin. It really isn't dangerous for you and non diabetic people drop below 4 quite frequently, particularly during the night, so this just shows that your diabetes is going into remission.

 

[afcchris]

If I was you, I really wouldn't worry about it. The lower readings just tell you that what you are doing is working. I hate it when Libre ruins my Time in Range because it reads lower than it should but I refuse to eat sweet stuff when I don't need to... and I am insulin dependent so the red on my graph is a lot more significant because it can be dangerous for me because I take insulin. It really isn't dangerous for you and non diabetic people drop below 4 quite frequently, particularly during the night, so this just shows that your diabetes is going into remission.

Thanks. Your message did give me some comfort. I have decided to get a blood sugar monitoring device to make sure the results of the freestyle libre are accurate. I was speaking to my doctor on email and she has recommended that i stop taking the metformin altogether. I guess this should be taken as good news? I will wait for the device to arrive and do a few days of testing before i stop though...