Hi Looking For Some Advice.

[Campbell]

Hi,
I was diagnosed with type two three weeks ago, my initial reading was 27.6. I was prescribed Metformin(500mg) which I was to build up to four a day over four weeks and Gliclazide(40mg), one per day. Since the diagnosis I have not touched sugar, not eaten anything sweet, gone over to green topped milk, all home cooking more veg and fruit and started golfing again. Previously I would have at least seven coffees a day, a heaped spoonful of sugar with each, marmalade trowelled on, no portion control, etc etc, I've always been slim and my weight never varied. I look at my sugar consumption now compared to three weeks ago and I shudder. prior to my diagnosis I lost 20 lbs mainly due to thrush in my mouth.
By last Tuesday I'd got my numbers way down and agreed with my doctor to carry on with just the two Metformin that I was on at that point and to stop the Gliclazide. Since then my numbers have been around the high fours, with only a couple of readings over five with a couple of 3.8. Is this too low and should I consider cutting down my meds again? I'm eating sensibly but not starving by any means.

 

[Amity Island]

Hi,
I was diagnosed with type two three weeks ago, my initial reading was 27.6. I was prescribed Metformin(500mg) which I was to build up to four a day over four weeks and Gliclazide(40mg), one per day. Since the diagnosis I have not touched sugar, not eaten anything sweet, gone over to green topped milk, all home cooking more veg and fruit and started golfing again. Previously I would have at least seven coffees a day, a heaped spoonful of sugar with each, marmalade trowelled on, no portion control, etc etc, I've always been slim and my weight never varied. I look at my sugar consumption now compared to three weeks ago and I shudder. prior to my diagnosis I lost 20 lbs mainly due to thrush in my mouth.
By last Tuesday I'd got my numbers way down and agreed with my doctor to carry on with just the two Metformin that I was on at that point and to stop the Gliclazide. Since then my numbers have been around the high fours, with only a couple of readings over five with a couple of 3.8. Is this too low and should I consider cutting down my meds again? I'm eating sensibly but not starving by any means.

Great job!
And yes 3.8 is just a touch too low...(generally 4 is the minimum) but I'd wait for another type 2 to help you with what to do regarding meds. You also have to bear in mind that if your blood sugars are border line low, it doesn't give much room for manoeuvre if you want to exercise, as exercise can reduce blood sugars further..

 

[NotWorriedAtAll]

I stopped my Metformin once I decided I wasn't eating enough carbs to justify taking them.
That was about 3 months after starting on them I think. I would have stopped earlier if I'd had more confidence in my diet and I think it would have made things easier for me as I had some unfortunate symptoms from the meds..

I've been managing my levels by diet since then - around a year and a half.

I found if I eat a meal that is a bit high in carbs - as happens now and then - a mug of peppermint tea sorts it out, or a decaff coffee with cream and plenty of cinnamon stirred in.

 

[Campbell]

Great job!
And yes 3.8 is just a touch too low...(generally 4 is the minimum) but I'd wait for another type 2 to help you with what to do regarding meds. You also have to bear in mind that if your blood sugars are border line low, it doesn't give much room for manoeuvre if you want to exercise, as exercise can reduce blood sugars further..

Thanks for the reply, I'm sure you're correct, I feel at this level I don't have a lot of wiggle room.

 

[Campbell]

I stopped my Metformin once I decided I wasn't eating enough carbs to justify taking them.
That was about 3 months after starting on them I think. I would have stopped earlier if I'd had more confidence in my diet and I think it would have made thing easier for me as I had some unfortunate symptoms from the meds..

I've been managing my levels by diet since then - around a year and a half.

I found if I eat a meal that is a bit high in carbs - as happens now and then - a mug of peppermint tea sorts it out, or a decaff coffee with cream and plenty of cinnamon stirred in.

Thanks for the reply, how much carbs per day to you aim to consume?

 

[NotWorriedAtAll]

I aim for fewer than 20g a day.
I probably vary between 20g and 50g and on a 'bad' day 70g

 

[Ralph-YK]

Anything under a BG of 4 is considered a hypo. 4s and 5s are good. As Amity says, being close to 4, while being perfectly ok in itself, doesn't leave much room for you to go down.
Discusse meds with your doctor, taking along a record of your levels. When are you getting the 4's? Are you testing before and after eating? Keeping a food diary, along with a record of your levels, may help.

 

[Drummer]

As you are a type two then you don't really need to worry about low readings, all should get back into balance once your metabolism stops staggering about with the shock of it all.
I did not get on at all with Metformin so stopped taking them. I used a meter to check that I was eating few enough carbs to stay in the normal range after meals and that seems to have worked.
If you are no longer on the Gliclazide then you can go as low carb as you feel is necessary, but I like to have low carb veges in stir fries and salads, just for the variety and the amount of vitamins and minerals they provide. I'd advise, be guided by your blood glucose levels.

 

[Campbell]

Anything under a BG of 4 is considered a hypo. 4s and 5s are good. As Amity says, being close to 4, while being perfectly ok in itself, doesn't leave much room for you to go down.
Discusse meds with your doctor, taking along a record of your levels. When are you getting the 4's? Are you testing before and after eating? Keeping a food diary, along with a record of your levels, may help.

I'm taking my readings before breakfast and dinner, then before lunch and supper the following day, I've been keeping a food diary as you suggest and noting my levels each day. I'm getting the fours breakfast and pre dinner.

 

[Campbell]

As you are a type two then you don't really need to worry about low readings, all should get back into balance once your metabolism stops staggering about with the shock of it all.
I did not get on at all with Metformin so stopped taking them. I used a meter to check that I was eating few enough carbs to stay in the normal range after meals and that seems to have worked.
If you are no longer on the Gliclazide then you can go as low carb as you feel is necessary, but I like to have low carb veges in stir fries and salads, just for the variety and the amount of vitamins and minerals they provide. I'd advise, be guided by your blood glucose levels.

Thanks I'm trying to build up a picture of what I can eat and what I have to avoid.

 

[Campbell]

I aim for fewer than 20g a day.
I probably vary between 20g and 50g and on a 'bad' day 70g

I've been on about 100g or so, I'm having toast at breakfast and a sandwich at lunch so room for manoeuvre.

 

[trophywench]

Try this regime for testing instead https://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html

 

[everydayupsanddowns]

Well done on your terrific start @Campbell - great to see such an effective reduction in your levels.

Checking BG after 2hrs meals as well as immediately before may help you assess which meals your body is able to cope well with more easily.

And yes it seems prudent to discuss your lowish levels with your GP. Im not sure how long Glic hangs around, but i would imagine after a week without there wouldnt be much if any effect left.

 

[grovesy]

When i stopped taking Gliclazide it took me about a week to feel the difference.

 

[Campbell]

Well done on your terrific start @Campbell - great to see such an effective reduction in your levels.

Checking BG after 2hrs meals as well as immediately before may help you assess which meals your body is able to cope well with more easily.

And yes it seems prudent to discuss your lowish levels with your GP. Im not sure how long Glic hangs around, but i would imagine after a week without there wouldnt be much if any effect left.

Thanks for the reply, I'm off the Glic for a week now, as you say I'd imagine the effect has now left my system. I'm going to have a word with the doc. about my levels, last night I'd toast before bed as my supper reading was 4.5 and I thought that would be prudent?

 

[rebrascora]

You might be better having something like cheese and a couple of savoury biscuits before bed rather than toast. The combination of fat and protein in the cheese and the small amount of carbs in the biscuits will keep you stable for longer than a slice of toast which may be digested and gone in 2 hours.

 

[Becka]

last night I'd toast before bed as my supper reading was 4.5 and I thought that would be prudent?

Just to reiterate what Drummer said, Metformin alone cannot cause hypos. If you have not taken Gliclazide for a week then you should not need to do anything to keep your levels up, your body can do that for itself. No need to give it extra work to do!

If you are still experiencing hypos then you definitely need to speak to your doctor as it might be due to a different cause.

 

[grovesy]

Although in theory Metformin is supposed to not cause hypos a number of posters over the years have posted getting them.

 

[rebrascora]

I think people have posted low BG readings under 4 with Metformin but taking into consideration that non diabetic people may have their BG drop below 4 and we would never know about it because they don't test, I don't think it is of serious concern.
The definition of a Hypo is also a bit sketchy.... DAFNE for instance suggests that a Hypo is 3.5 or below... rather than 4. Also a low BG reading caused by over medication with Gliclazide or injected insulin has the ability to drop you unnaturally low quite quickly, thereby causing risk of unconsciousness. I cannot see how Metformin could cause this. To me a "hypo" poses a risk, a low BG reading whilst on Metformin shouldn't.... ie it is not likely to go progressively downward without a hypo treatment.... unless perhaps the person has some significant alcohol in their system or has just run a marathon and not refuelled.
I personally think that anyone who is getting some readings in the 4s or below should not be taking Metformin though because it is not necessary..... just my opinion.

 

[Drummer]

I certainly went wobbly a few times in the early days of recovery as - I imagine there was loads of insulin sloshing around which my cells would sometimes respond to and other times ignore.
After a while everything settled down, but at the time a warm drink and a tiny amount of carbs sorted it out. I drank herbal teas as my sense of taste was made really weird by the tablets I'd taken.
There is a lot going on when turning diabetes around, so I don't think it is anything to worry about - particularly as you were consuming a lot of sugar before and are still in the early stages. If it gets worse or goes on for some time then there could be something else going on, but at the moment I strongly suspect it is just the shock of no more sugary input.