Hypo on metformin

[becca19962014]

i had to stop metformin after I found I was getting hypos when taking an antibiotic and it's been restarted again as my blood sugars were going high.

Today just before I had lunch I went to bed as I was feeling unwell I checked my blood sugar after just before I made my lunch as I felt much worse and it was 3.5mmol. I've managed to get it up again by eating but I was led to believe this is impossible if taking metformin. I'm feeling a lot better now (blood sugar is at 6.8 now and climbed steadily).

The only thing I've done differently today is not gone out, food wise as normal.

I've been struggling a lot with mental health and developing agoraphobia which means bad panic symptoms before going out and I'm wondering if that could have an impact.

I'd try my GP but given I'd need to ring 111 and here you're looking at 12 hours before you're seen by the time you've spoken to the nhsdirect nurse and GP and then the local nurse and GP I'd rather ask here. Obviously if it happens again I'll phone.

 

[Ljc]

It’s a good job you tested when you did. I am glad you’re feeling better now. Hypo’s are horrib,e aren’t they.

Though they do say Metformin doesn’t cause hypo’s, I have read on here of two or three people who used to post on here where it did.
I too am thinking the stress etc could be lowering your BGs.

The standard treatment for hypo’s is 15 g of fast acting carbohydrates such as , a small glass of fruit juice, some jelly babies or dextrose tablets, basically sugar , test at 15 minute intervals and treat as above till your above 4.0 , some people like to have a carby snack such as a biscuit or two afterwards, personally I don’t unless I am going to bed or it’s a stubborn one.

While hypo and for a while afterwards it’s possible to feel very hungry which can be very hard to resist.

 

[becca19962014]

I'm wondering if I've been having them more than I thought. The symptoms were those of a nasty panic attack for me, which can lead to seziures and blackouts. Am intending now to test when having panic attacks just in case it's blood sugars instead.

I've got jelly babies in but decided to have sandwich instead (it was a sugary sandwich not my usual).

Now I'm up to 9.0, headache and feeling ill. I'm considering missing metformin tonight. Last night I needed several jelly babies to get it to a reasonable level before bed so I could avoid hypos over night, despite having a carby snack before bed it remained at 5. I need to hase something small now to have the meds I'm due but it won't be much.

It worked ok before but I guess my mental health was more stable then so less moving around/panic attacks which I guess burn sugar unfortunately the mental health team ended my care the day before they closed for Christmas so things are particularly difficult.

 

[Ralph-YK]

From what you say, I gather you have been having more than the one hypo. Keep a record of them to show the doctor. Maybe a food diary too, along with anything else you think relevant. If you think your mental health/mood is involved, would keeping a note of that be of help to you?
I don't know about the metformin causing hypos. Either way, hopefully the info will help. At least you'll have something to show the Dr what is happening.

 

[becca19962014]

I have had a few. Especially in the last two weeks since I upped the metformin to twice a day. Including during the night which means I'm panicking the moment I go to bed it'll happen again. I'm now sleeping with jelly babies again. I try to aim for about 7.5 before bed, but am having a lot of nightmares/terrors and am wondering if that's effecting it too.

Am thinking I'll go back to one in the morning. Due to see GP this week so can let them know.

I'm on slow release but I wonder if it's dumping in my system as I've had happen with other so called slow release meds.

My mental health is pretty much constantly severe depression with anxiety/agoraphobic attacks daily. Had one this afternoon, an exact mirror of the hypo but my blood sugars were 7.9. Unfortunately referring for another mental health assessment due to deterioation meant everything else stopped until assessment which won't be for weeks, if ever, as the assessing cpn has demanded my GP stops giving me daily medication collection from pharmacy saying I must show willing by taking responsibility for the choice to end my life and my GP won't do this due to duty of care - the point of the referral was she's concerned for my welfare!

It's frightening to find I'm having hypos on top.

I cant see diabetes team as my last hbA1bc was 40, not that they were helpful, all I was told was zero carbs and sugar and lots of fruit and veg (which didn't work for me at all), lots of exercise (physical disability makes that hard) and aim for readings in the low 4s (I was having many many hypos on that advice).

 

[becca19962014]

Thankyou both for the support!

 

[Ljc]

Hi becca. You are really having a rough time of it {{{hug}}}

Please bear in mind that I am no medic, but what I would be inclined to do is temporarily stop taking the Metformin till you see your Gp , I am only saying this as your Hb1ac at 40 is really good
Or if you were fine on one Metformin a day then by all means go back to that. My thinking is, that you have enough going on right now without the additional worry of hypo’s. Obviously keep to your dietary regime as it is obviously working well for you.

 

[becca19962014]

I see GP Thursday. I'm thinking I'll go down to one a day and see what happens. It's only a couple of days anyway so shouldn't be too much of a problem. I keep a daily diary of my meds now so I know exactly what I've taken otherwise I forget.

My diet is mostly carbs and it makes no sense to anyone how I've managed to do it. Personally I suspect it's due to other things I've had going on like seizures as well as the anxiety attacks, though I'm seriously thinking maybe what's happening is my BG is dipping and my body response is so similar to anxiety that it's triggering attacks. I definitely find my mental state effects it as it effects my blood pressure and heart rate making them dangerously high (also dangerously low so can't have meds).

It's ok right now - 7.0.

 

[Ralph-YK]

and aim for readings in the low 4s (I was having many many hypos on that advice)

I hesitate to tell you to have another target. Do what you can to see someone else and get further advice on this. You could be having hypos because of being in the low 4s, a small change will be a big %, and can take you into hypo.

My diet is mostly carbs and it makes no sense to anyone how I've managed to do it.

What sort of levels are you getting after eating?

though I'm seriously thinking maybe what's happening is my BG is dipping and my body response is so similar to anxiety that it's triggering attacks. I definitely find my mental state effects it as it effects my blood pressure and heart rate making them dangerously high (also dangerously low so can't have meds).

I believe your BG level can affect how well your brain works. As can low blood pressure. Have you been specifically been told both BP and heart rate have been dangerously high or low? Would you have had a particular type of heart rate/rythem (some things have names)?

 

[becca19962014]

I'm not aiming for 4. I stopped that as I was finding I was constantly feeling very unwell. There isn't anyone else here to see as very rural.

After eating it's usually around 7 maybe 8 depending on what I ate. I do eat every couple of hours usually because of taking a lot of meds for other conditions.

I've been diagnosed with severe hypotension and hypertension (low and high) blood pressure at different times in the day and brachycardia and tachycardia (low and high) heart rate at different times in the day as well after wearing monitors. Treating either makes the other worse. It's due to autonomic problems. Obviously I don't have both at the same time but I get them throughout any given day.

 

[Madeline]

Do you have POTS by any chance? Just my elder daughter’s boyfriend has just been diagnosed, and his symptoms sound very similar with the BP and heartrate swings.

 

[becca19962014]

Not POTs but generalised autonomic dysfunction and Ehlers danlos syndrome.

 

[Ralph-YK]

After eating it's usually around 7 maybe 8 depending on what I ate.

That's not high at all for after food. I did wonder if your body was reacting to going hight and going the other way.

I've been diagnosed with severe hypotension and hypertension (low and high) blood pressure at different times in the day and brachycardia and tachycardia (low and high) heart rate at different times in the day as well after wearing monitors. Treating either makes the other worse. It's due to autonomic problems. Obviously I don't have both at the same time but I get them throughout any given day.

*sigh* I don't like to guess or go on my limited knowledge. I do suggest chasing these things up. Both in relation to your mental health and generally.
I've got high blood pressure. Because of the meds, after some years, my BP was low I suspect for six months. The light headiness and wooziness won't help you cope.
I'm also suspetable to a particular tachycardia (I had one when I was monitored, though not had one for a bit).
I'm still working some of these things out myself.

 

[Annette&Bert]

I didn’t think you could get hypos on metformin. Can someone describe a hypoto me because I wonder if I’ve had any and not realized?

 

[becca19962014]

Unfortunately I can no longer get to the specialist unit for autonomic dysfunction, there's only one in the uk, in London which is too far for me to travel. It's definitely not caused by meds/mental health but my autonomic system not working properly. I can't remember all the details but a lot of it is to do with defective collegen from the Ehlers danlos.

Mental health gave me meds but they worsened my medical conditions and I ended up being forced to choose and it was dreadful. I really cannot go through that again.

 

[becca19962014]

Today it's gone as high as 9, but I'd eaten something unusual.

I only found th hypo because I tested. It felt like a really bad panic attack. I don't know how else to describe it.

 

[Annette&Bert]

About 20 minutes or so after I have a meal I go into a deep sleep for just over an hour, sometimes longer.

 

[TheClockworkDodo]

Hi @becca19962014 - sorry to hear you're having such trouble with hypos. I do too - and I also have a condition which causes autonomic dysfunction (mine is ME, which overlaps quite a lot with EDS). My symptoms also include weird blood pressure (supine hypotension), weird breathing (tachypnoea), and palpitations, among many other things. The one thing I don't have is mental health issues on top, that must be a nightmare for you. It's difficult enough juggling ME and diabetes without anything else.

In my case it's partly that I'm very sensitive to insulin, I think - that's less likely to be an issue in your case if you're type 2, but you may find you are more insulin sensitive/resistant at different times of day so (eg) you might need the Metformin in the morning and not at night (or it might be vice versa, whatever time works for you depending on how long the Metformin takes to work in your system).

With EDS your digestion is presumably peculiar, like mine? - so meds and foods may not go through at the rates they're supposed to (I've had meds which were supposed to take half an hour to go through stay undigested in my stomach for 13 hours). I'd guess eating little and often might help? And having a fatty snack at night might help too, if you can tolerate fatty foods - if my blood sugar's low I have a couple of savoury biscuits and a chunk of cheese before bed. My partner, who has Reactive Hypoglycaemia, and so has hypos even though he's not diabetic and not on any kind of meds, eats a yogurt before bed every night. Something fatty like that is better for stopping night-time hypos than something carby, because it lasts longer and keeps your blood sugar more level.

Good luck - I hope you're able to find out what works for you, and also that you can get some help soon, though I suspect if you're anything like me you'll find medical professionals a bit baffled by the need to take all your different conditions into consideration - I've found diabetes consultants really don't understand how ME effects me. Nurses are usually better at seeing the whole picture, so perhaps it would be worth asking your GP to refer you to a diabetes specialist nurse (at the hospital, not a surgery nurse) if you're not already seeing one?

 

[TheClockworkDodo]

@Annette&Bertie - hypo symptoms vary quite a bit from person to person, so you might do better starting your own thread to ask about what symptoms different people have, but they can include sweating, shaking, dizziness, fatigue, and not knowing what you're doing or understanding what's going on, as well as panicking, like Becca. Going into a deep sleep sounds more like high blood sugar to me, especially as you're doing it just after a meal, but it could be a hypo - I sometimes get sleepy with mine (I more usually get sleepy if my bgl's high, so sometimes I'm sleepy and I test expecting it to be 15 and it's 2, and I stare at the meter for a bit and think - that must be a mistake ). I think the only way you'll know what's causing your sleepiness is to test - do you have a meter?

 

[Annette&Bert]

Hi Juliet, yes I have a meter and test but, the more I think about it falling into a deep sleep within say half an hour does make me think it’s BG related. I was diagnosed in 2016, but before I was diagnosed, I fell asleep a lot, which possibly meant I had typ2 well before I was diagnosed, at least a couple of years and the tendency is to put it down to other factors. I bought this house in 2010 and had to do a lot more than I thought when I bought it, I was also looking after my aunt who had dementia. So basically I put a lot down to stress. My aunt died aged 93 in 2014, but I still have a different kind of stress to deal with, and to be honest I don’t think I’m eating the right things.m