hypos and fibro flare ups

[Brambleberry]

It has occured to me that the day after a slight increase in activity I have a a hypo. Also the next day I have a big flare up of my fibro and chronic fatigue...I see a pattern as it has happened 3 times in 6 weeks. Definitely seeing GP when I get back. I am spending more time trying to keep BG up than get it down! I read hypos cause inflammatory responses so that ties in with the flare ups.I carry jelly snakes with me when out on my travels just in case and I keep nuts in the car for snacks.Having said that I have now lost 24lb since 19th Oct last year without making many changes just watching carbs eating more nuts for snacks, and restricting chocolate intake without deprivation.

 

[Leadinglights]

It has occured to me that the day after a slight increase in activity I have a a hypo. Also the next day I have a big flare up of my fibro and chronic fatigue...I see a pattern as it has happened 3 times in 6 weeks. Definitely seeing GP when I get back. I am spending more time trying to keep BG up than get it down! I read hypos cause inflammatory responses so that ties in with the flare ups.I carry jelly snakes with me when out on my travels just in case and I keep nuts in the car for snacks.Having said that I have now lost 24lb since 19th Oct last year without making many changes just watching carbs eating more nuts for snacks, and restricting chocolate intake without deprivation.

Perhaps your gliclazide dose is too high for the amount of carbs you are having. You said you had reduced your dose before and did that make any difference.

 

[everydayupsanddowns]

Sorry to hear about your hypos and flare-ups @Brambleberry

If you are having repeated hypos it does sound as if your meds may need adjusting following your weight loss?

Hope you manage to make some tweaks and that the hypo gremlins leave you alone.

 

[Brambleberry]

Perhaps your gliclazide dose is too high for the amount of carbs you are having. You said you had reduced your dose before and did that make any difference.

I was better on none at all I think. Over Christmas day and boxing day I went to half the dose cutting my 80 mg tablets into 40 mg halfs. That worked well until we had a day in the city shopping and even then it went falling . But on quieter days because we were stuck in the house and I was limited with my food which meant eating a lot more bread or I would not have had carbs at all , and then other extremes where we went out to dinner, or they decided to order in leaving me not much menu choice ( and they cannot be disagreed with this pair) I made the decision to go back on 80mg. This worked well safeguarding me from the lack of choice and inherent trots that the meformin caused ( first ever) and I knew why that was!
But on day of flying back to mainland I omitted the glicoside all together for safety and resumed it on Tuesday so it gook to Thursday to see another hypo. We are out for dinner for sons birthday tonight its a BBQ restaurant so I should be ok with the 80mg....I can only play it by ear. Thankfully yesterday we traveled to my sister in the outback who cooks a wonderful vegan meal and she uses non grains starches in her baking so her vegan pizza was fabulous. I had my two jelly snakes when I arrived and dinner and a small amount of crumble home made and her vegan home made icecream and after 2 hrs BM was 7.3. Down to 5.3 before evening dinner. So I think I got it all just right. I am wondering when back to normal routine at home if 80mg will become right for me again or as someone else said the 24lb weight loss means I need less...quite possible.

 

[Brambleberry]

Sorry to hear about your hypos and flare-ups @Brambleberry

If you are having repeated hypos it does sound as if your meds may need adjusting following your weight loss?

Hope you manage to make some tweaks and that the hypo gremlins leave you alone.

Hi Mike
I think you could be right it might be the loss in weight. Before I was diabetic, for many years I could run hypos at work. I only knew because working on wards I could test myself when lunch was skipped due to being over busy or a student used us as guinea pigs and one day ran to 2mm.As I got older then I was less tolerant and an hour after lunch I fainted in the operating theatre whilst scrubbed up.
I can tell you that yesterday I had no symptoms at all I ad even had a snack in the car...I think such a danger because it sounds like if I had not tested and had been on my own I could have done exactly what I did in theatre- zonk!

 

[everydayupsanddowns]

I think such a danger because it sounds like if I had not tested and had been on my own I could have done exactly what I did in theatre- zonk!

Yikes! Scary. 😱

You’ll have to be really careful to follow the DVLA guidance if there’s any sign of impairment of your hypo warning signs.

Do you always get symptoms eventually? At what level do they reliably come?

 

[Lucyr]

I can tell you that yesterday I had no symptoms at all I ad even had a snack in the car...I think such a danger because it sounds like if I had not tested and had been on my own I could have done exactly what I did in theatre- zonk!

Sounds like you need to speak to your GP to adjust meds and the DVLA as you may need to have your licence revoked. I’m not sure if you could save your licence by changing medication to one that doesn’t cause hypos? Would definitely stop driving until you’ve discussed with GP

 

[Brambleberry]

Yikes! Scary. 😱

You’ll have to be really careful to follow the DVLA guidance if there’s any sign of impairment of your hypo warning signs.

Do you always get symptoms eventually? At what level do they reliably come?

I just don't really get any symptoms most of the time. I once got a headache and flushed face and felt a bit off balance and checked BG. But then it happened another time and it was in the 6s! So....I am not driving at present as away on holiday. But I need to drive for a living sometimes. So If it is the glicozide doing it then it will most certainly have to go. I am on my own and the roof over my head is more important.

 

[Brambleberry]

Sounds like you need to speak to your GP to adjust meds and the DVLA as you may need to have your licence revoked. I’m not sure if you could save your licence by changing medication to one that doesn’t cause hypos? Would definitely stop driving until you’ve discussed with GP

Yes as soon as I get back I will be reporting it. My gut feeling is I only need the metformin now. I think an long term infection plus pain and a particular antibiotic has given them a false impression of the severity of my case. I do not think I was T2. Perhaps drug induced prediabetes....and maybe that is the problem. My pancreas has had a rest and is working fine now with the tweaks to my already healthy diet. I am not driving at present as anyway. I do plan to keep up some walking when weather permits when I return home for exercise and so insulin sensitivity should be maintained. GP only put me on glicozide as I had symptoms. But I have a dry mouth due to fibro meds anyway and I just think they have not listened...GPs are so big pharma dictated to NICE is too keen to comply. So when I get back I will be having the discussion as I have to drive or lose my job.

 

[Lucyr]

I’ve just checked the DVLA guidance for diabetics on tablets for you and unfortunately it looks like you do by law have to inform them of your difficulty recognising hypos.


What you need to tell us about
By law you must tell us if any of the following applies:
• You suffer more than one episode of severe hypoglycaemia within the last 12 months while awake. You must also tell us if you or your medical team feel you are at high risk of developing severe hypoglycaemia. For Group 2 drivers (bus/lorry), one episode of severe hypoglycaemia must be reported immediately.
• You develop impaired awareness of hypoglycaemia. (Difficulty in recognising the warning symptoms of low blood sugar).
• You suffer severe hypoglycaemia while driving
• You need treatment with insulin.
• You need laser treatment to both eyes or in the remaining eye if you have sight in one eye only.

The page you need to use to inform them is here

Check if a health condition affects your driving

Check if you need to tell DVLA about a health or medical condition, how to report medical conditions to DVLA

www.gov.uk

 

[Brambleberry]

I’ve just checked the DVLA guidance for diabetics on tablets for you and unfortunately it looks like you do by law have to inform them of your difficulty recognising hypos.


What you need to tell us about
By law you must tell us if any of the following applies:
• You suffer more than one episode of severe hypoglycaemia within the last 12 months while awake. You must also tell us if you or your medical team feel you are at high risk of developing severe hypoglycaemia. For Group 2 drivers (bus/lorry), one episode of severe hypoglycaemia must be reported immediately.
• You develop impaired awareness of hypoglycaemia. (Difficulty in recognising the warning symptoms of low blood sugar).
• You suffer severe hypoglycaemia while driving
• You need treatment with insulin.
• You need laser treatment to both eyes or in the remaining eye if you have sight in one eye only.

The page you need to use to inform them is here

Check if a health condition affects your driving

Check if you need to tell DVLA about a health or medical condition, how to report medical conditions to DVLA

www.gov.uk

Hi Yes
I have seen it before bit it says severe hypos. Mine since diabetic have not go below 3.5 or so. I will be checking with my GP and seek advice re the 'severe' thing. See what she says about discontinuing the glicozide and DVLA.

 

[Lucyr]

Hi Yes
I have seen it before bit it says severe hypos. Mine since diabetic have not go below 3.5 or so. I will be checking with my GP and seek advice re the 'severe' thing. See what she says about discontinuing the glicozide and DVLA.

No the severe hypos is a seperate bullet point. It’s either severe hypos OR hypo unawareness that you need to tell them about. This sentence below has no mention of severe hypos, just difficulty in recognising the symptoms

“You develop impaired awareness of hypoglycaemia. (Difficulty in recognising the warning symptoms of low blood sugar)”

 

[everydayupsanddowns]

I will be checking with my GP and seek advice re the 'severe' thing.

Severe Hypos are defined as ones where a person in unable to treat themselves, and needs the help of a third party to recover,

But yes, as Lucy says, if you have lost hypo awareness you should stop driving and need to contact DVLA.

Hope you recover your hypo warning signs if and when you reduce or stop the gliclazide.

 

[Brambleberry]

I expect most people are going to have some teething problems getting meds right. I will be speaking to my GP when I return home. I understand the signs of a hypo and with a change in medications or discontinuation that should sort out the problem. I will take it from there once I return to the UK. I am sure strategies can be put in place to prevent issues.

 

[Lucyr]

I expect most people are going to have some teething problems getting meds right. I will be speaking to my GP when I return home. I understand the signs of a hypo and with a change in medications or discontinuation that should sort out the problem. I will take it from there once I return to the UK. I am sure strategies can be put in place to prevent issues.

This is the last I’ll respond on the driving issue, but whatever you do, please be careful. I know informing the DVLA could mean losing your licence for a short time but it is against the law not to inform them of this. So choosing not to tell them means you are choosing to break the law, and it could have all sorts of consequences should you have a crash because of it, eg being charged with driving without a valid licence or insurance, on top of whatever other consequences there are from the crash.

As i said, you know the risks and illegality now so I won’t mention it again, it’s your decision from here.

I’m fairly passionate about safe driving having had my immediate family experience something quite horrific from a driver doing something illegal that they presumably thought wasn’t a risk (using a phone in a dashboard phone holder to read a message), that then had life changing consequences for my whole family, but particularly for the one that had been in the car.

 

[Brambleberry]

This is the last I’ll respond on the driving issue, but whatever you do, please be careful. I know informing the DVLA could mean losing your licence for a short time but it is against the law not to inform them of this. So choosing not to tell them means you are choosing to break the law, and it could have all sorts of consequences should you have a crash because of it, eg being charged with driving without a valid licence or insurance, on top of whatever other consequences there are from the crash.

As i said, you know the risks and illegality now so I won’t mention it again, it’s your decision from here.

I’m fairly passionate about safe driving having had my immediate family experience something quite horrific from a driver doing something illegal that they presumably thought wasn’t a risk (using a phone in a dashboard phone holder to read a message), that then had life changing consequences for my whole family, but particularly for the one that had been in the car.

I can assure you I am not taking any risks. I am in Australia at present and have been for 6 weeks. I cannot do anything about this until I get home. If I had been at home I would not have had more than one hypo because I would have spoken to my GP at that point and at that point I had detected something was not right. It is an unusual situation.
I will indeed be discussing it with GP and with DVLA once I return home. I have a duty of care to maintain the safety of the public in my job. I am not likely to do anything to jeopardise that.Here done under I am currently not driving due to the situation. I cannot do any more until then.

 

[everydayupsanddowns]

Here down under I am currently not driving due to the situation. I cannot do any more until then.

Good to hear you are being cautious and avoiding driving until you get this sorted @Brambleberry

Hopefully this can all be resolved once you return to the UK.

 

[Brambleberry]

Good to hear you are being cautious and avoiding driving until you get this sorted @Brambleberry

Hopefully this can all be resolved once you return to the UK.

Im sure it will.