Hypo?

[Vonny]

Hi folks, as you probably know I'm T2 with a good hba1c of 36, controlled by diet and 1 x metformin per day. I think (but not sure) I've just had a hypo...went very shaky and wobbly and I did bloods and they came out at 3.7. I'm never that low! Admittedly I'd had my usual Thursday carb-heavy lunch of half a wholemeal roll with bacon and mushrooms and a Costa flat white (my Thursday treat while visiting my 94 year old dad) but that is every Thursday and this has never happened before. If you spike, does your bg drop rapidly after? I thought after nearly 18 months that I'd got a grip on T2 but clearly not. Is this usual in T2s on metformin? Sorry to be so thick but I felt I'd been jogging along nicely with my condition and all suggestions/advice would be very welcome!

 

[helli]

For someone treating their diabetes with insulin, a hypo is anything below 4.0.
I recently discovered, paramedics will not consider anyone else hypo unless their levels are below 3.0.

That said, if you body is unfamiliar with levels that low, you will experience hypo symptoms when it is lower than usual.
I don't believe blood sugar levels drop fast because they spiked. I have not experience it but, with Type 1, I use injected insulin which works slower than "real insulin".

I have read that some people with pre-diabetes experience reactive hypoglycaemia after eating a carby meal. This may be worthwhile researching if you experience this again.

 

[Vonny]

Thanks @helli, that's really useful info to have. To be honest it shocked me because it's never happened before. Maybe I should split my treat carbs between 2 days, ie half a wholemeal roll one day and a flat white the next, so 2 days of treats instead of one!

 

[Drummer]

I suspect, from the timing that it indicates that you are still able to produce or even over produce insulin.
The bread and milk might have panicked your pancreas into overdoing things, and so you overshot your normal levels.
The Metformin inhibits your liver's ability to release glucose, so it might have made the situation worse, but actually it should be considered a good sign.
I find bought coffee rather strong for my taste, and if yours was a similar dose of caffeine that might have been involved as well - possibly.
I am just conjecturing here, of course, and it might be as well to mention it to your GP.

 

[AndBreathe]

Thanks @helli, that's really useful info to have. To be honest it shocked me because it's never happened before. Maybe I should split my treat carbs between 2 days, ie half a wholemeal roll one day and a flat white the next, so 2 days of treats instead of one!

@Vonny - sounds like you felt a bit rough.

To be frank, personally, I wouldn't change anything, base on a one-off event - especially as this is a routine you have followed for some time. Again, personally, I would carry on as normal, but just be a bit prepared should the situation recur.

It would be a shame to change a routine you seem to have been enjoying, based on something that could have been caused by many things. For example, if you had been a bit more active than usual before your treat?

I hope it doesn't happen again for you.

 

[TheClockworkDodo]

According to my diabetes consultant, officially a hypo is anything below 3.4 - people on insulin are told to treat if it is below 4.0 because it's dangerous to let your blood sugar get too low if you're on hypo-inducing meds.

My partner has reactive hypoglycaemia - it's a very rare condition which causes your blood sugar to spike after eating carbs and then plummet into a hypo (it's basically a timing issue with the body's own insulin supply). I don't think people normally plummet after a spike unless they have RH (or unless they are on insulin and very insulin-sensitive like me!). If you had RH you would always spike and plummet after eating a lot of carbs though, so you'd be feeling awful regularly every Thursday. If that starts happening to you, Wikipedia has a useful article on RH, or feel free to pm me for more info.

If you start having a lot of readings below 4 then I should see your GP just to be on the safe side as there are other conditions which can cause hypos. But at the moment I'd agree that it's not worth worrying or changing anything, just be prepared in case it happens again. As you're not on any hypo-inducing meds, if your blood sugar goes below 4 and you start shaking again, you shouldn't need too much in the way of fast-acting carbs to treat it - a dried apricot or a few raisins is R's hypo treatment of choice, or you could get a bag of jelly-babies and just have one and see whether that is enough. You don't want to overtreat and spike up again.

 

[Drummer]

I lowered my carb intake drastically after diagnosis and I had several wobblies where my blood glucose was probably dropping rapidly. I can only conjecture on the reason, but it did pass over as I returned to more normal numbers.