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Hypos on metformin

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katiee

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Hi everyone
I've have had T2 diabetes for a couple of years, diet controlled.
I've been on metformin though, for about 5 weeks. Every 2 weeks I take an extra tablet, so I'm now on 3 tabs a day, eventually I'll be on 4.
However the last 3 days I've had hypos.
I was just wondering if anybody else experienced this, or has any advice.
I haven't been able to get a phone call with GP or nurse.
 
According to my DN, it's not possible to get hypos on metformin. What levels did you go down to?

I occasionally have a false hypo as a result of spiking then rapidly dropping. I forget the condition this is called, but I'm sure someone will be able to bring it to mind. It makes me go very wobbly, unable to walk properly and generally makes me feel unwell. Could this be the case for you?
 
Vonny said:
According to my DN, it's not possible to get hypos on metformin. What levels did you go down to?

I occasionally have a false hypo as a result of spiking then rapidly dropping. I forget the condition this is called, but I'm sure someone will be able to bring it to mind. It makes me go very wobbly, unable to walk properly and generally makes me feel unwell. Could this be the case for you?
Click to expand...
Yes I found that when I goggled it, it said you don't get hypos on metformin. I don't have a machine to test my levels, but I got very shaky, and lightheaded, struggling to think straight, but after a sugary drink and a snack I felt better.
Each time, the hypo (at least I think it's a hypo) happened about 4/5 hours after last eating.
Today I've upped my carb intake and feel fine, but this seems counter productive in the long run
PS. Thank you for your reply
 
I think the term you might be looking for is Reactive Hypoglycemia.
 
Welcome to the forum @katiee

Sorry to hear about the unpleasant feelings you have been experiencing.

This is one of the downsides of GPs being reluctant to prescribe strips unless you are on meds that are generally accepted to cause hypos.

Metformin can cause low blood glucose in some people, but it is very rare. There is the possibility that it may be reactive hypoglycaemia (where the metabolism sees a big rise after a meal and then sort of over-reacts). Another possibility is that your levels may not technically be low, but might just be lower than your body is used to. If the Metformin has been working well for you, your metabolism may be mistaking in-range readings for an impending hypo, and firing the full-on warning signs as a precaution.

Perhaps it would be worth getting a Spirit Tee 2, Gluco Navii, or Contour Blue meter (they have the most affordable strips) so that you can see what your levels are, and whether you are below 4.0?
 
everydayupsanddowns said:
Welcome to the forum @katiee

Sorry to hear about the unpleasant feelings you have been experiencing.

This is one of the downsides of GPs being reluctant to prescribe strips unless you are on meds that are generally accepted to cause hypos.

Metformin can cause low blood glucose in some people, but it is very rare. There is the possibility that it may be reactive hypoglycaemia (where the metabolism sees a big rise after a meal and then sort of over-reacts). Another possibility is that your levels may not technically be low, but might just be lower than your body is used to. If the Metformin has been working well for you, your metabolism may be mistaking in-range readings for an impending hypo, and firing the full-on warning signs as a precaution.

Perhaps it would be worth getting a Spirit Tee 2, Gluco Navii, or Contour Blue meter (they have the most affordable strips) so that you can see what your levels are, and whether you are below 4.0?
Click to expand...
Thank you very much for your reply, this is very helpful actually.
I will take your advice and buy a testing thing. Then I'll take it from there. Cos right now I'm just finding that I feel better when I eat sugar or carbs, but I don't want to do that as I'm obviously trying to be healthier
 
Metformin very rarely causes 'hypos' and if BG does go low, which is totally natural with exercise and excessive alcohol intake, your metabolism works very quickly to bring it back again (For instance, a walk back from the pub after a few drinks can see my levels drop into the 3s, but 10 ten minutes later it's back up to normal. Depending on how many bags of crisps I've had :) )

Shortly after I was diagnosed I used to get similar feelings and had to sit down for a bit. I didn't start eating sugar, though. I just put it down to my body undergoing some metabolic changes and let it pass (Which it did.) without shovelling sugar down my gullet.
 
I've also been on Metformin for about 5 weeks (twice a day) and not only haven't had a hypo but the lowest my BG has been was 5.9 (I had started with 13.7).

Anyway, I hope you get some good advice from people who know more about the subject :)
 
harbottle said:
Metformin very rarely causes 'hypos' and if BG does go low, which is totally natural with exercise and excessive alcohol intake, your metabolism works very quickly to bring it back again (For instance, a walk back from the pub after a few drinks can see my levels drop into the 3s, but 10 ten minutes later it's back up to normal. Depending on how many bags of crisps I've had :) )

Shortly after I was diagnosed I used to get similar feelings and had to sit down for a bit. I didn't start eating sugar, though. I just put it down to my body undergoing some metabolic changes and let it pass (Which it did.) without shovelling sugar down my gullet.
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Thanks for that, I'll bear that in mind.
I have a physical job, working on ambulance, so didn't feel like I could just wait, I was anxious to feel better ASAP. That is interesting though, if it happens at home I'll definitely wait and see if it passes. That's good advice, thanks
 
As undiagnosed diabetes progresses, the body gradually gets used to having higher than normal blood glucose and starts to regard the higher levels as 'normal'. Hence once you start treating those higher numbers to reduce them, the body can react as if it is a real low blood glucose. Same symptoms as a real one and you have to wean your own body off doing that.

As you probably know because of your job hypoglycaemia can be a medical emergency - but these sort aren't, however the only way of telling 100% whether it's a real hypo or a false hypo - is to do a fingerprick BG test on yourself! If it ain't a real one, try and sit it out.
 
trophywench said:
If it ain't a real one, try and sit it out.
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And if you can’t sit a fake one out cos you’re too wobbly to work then very gently nudge it up rather than shovel the carbs in. That way you don’t go back to where it started but take the edge off the worst symptoms and still allow the adaptation to better lower more normal levels to continue even if slightly more slowly.

A meter would also allow you to see what the medication was achieving. Also if you test immediately before and 2hrs after eating it would show what your diet choices do too. If you don’t eat the glucose (carbs) in the first place there’s a lot less work for your body or medications to do and reduced opportunities for complications later…..

Non diabetics usually return to pre meal levels by around 2hrs, which would usually be under 6mmol as a goal and rarely going over 11mmol at any point unless it’s a very carb heavy meal. So many of us aim to get as close to this as we can manage, and ideally not more than 2mmol ish higher as an allowance for variations and the fact that you are in fact diabetic. It’s a process, not an overnight expectation and meters are not exact, precise machines. If you get an unexpected reading retake it, having checked your hands are clean.
 
trophywench said:
As undiagnosed diabetes progresses, the body gradually gets used to having higher than normal blood glucose and starts to regard the higher levels as 'normal'. Hence once you start treating those higher numbers to reduce them, the body can react as if it is a real low blood glucose. Same symptoms as a real one and you have to wean your own body off doing that.

As you probably know because of your job hypoglycaemia can be a medical emergency - but these sort aren't, however the only way of telling 100% whether it's a real hypo or a false hypo - is to do a fingerprick BG test on yourself! If it ain't a real one, try and sit it out.
Click to expand...
 
Thanks for that.
I didn't know about the false hypos, so I feel a lot better now knowing that's most likely what it is. All these comments have been really helpful. When I can I'll wait it out, and hopefully it will stop happening soon.
Just been to try and buy and monitor, but the pharmacy didn't sell them... I'll get onto it though.
I feel a lot better knowing I don't have to up my carb/sugar intake
 
You will find it cheaper to buy a BG meter online. Those mentioned by @everydayupsanddowns in post #5 above are well tried and tested by members here on the forum and found to be reliable and economical to use for those self testing. There are some cheap ones on the market that people have found less reliable so I would steer you towards one of those options mentioned above.
 
katiee said:
Hi everyone
I've have had T2 diabetes for a couple of years, diet controlled.
I've been on metformin though, for about 5 weeks. Every 2 weeks I take an extra tablet, so I'm now on 3 tabs a day, eventually I'll be on 4.
However the last 3 days I've had hypos.
I was just wondering if anybody else experienced this, or has any advice.
I haven't been able to get a phone call with GP or nurse.
Click to expand...
I am on Metformin 500mg Glicklazide and Insulin. I get hypos about once, sometimes twice a week. I cannot find a reason for this, it just suddenly happens. If my blood sugar nears 5 or lower, when I start shaking and sweating, I have a Bounty Bar, which solves that problem. I don't bother with my Surgery, being on the phone for half an hour waiting for a reply is just a waste of my time. All the best.
 
johnledbury said:
I am on Metformin 500mg Glicklazide and Insulin. I get hypos about once, sometimes twice a week. I cannot find a reason for this, it just suddenly happens. If my blood sugar nears 5 or lower, when I start shaking and sweating, I have a Bounty Bar, which solves that problem. I don't bother with my Surgery, being on the phone for half an hour waiting for a reply is just a waste of my time. All the best.
Click to expand...

5.0 is not a hypo.
I'm not sure why you are eating a bounty when 4.0+ is completely normal.
 
To me, anything under 7 has to be managed before it gets to 4. At 4.5 I have gone unconscious. I have a record of 23+ that is why the Hospital Diabetic Specialist at Bournemouth Hospital contacts me regularly by phone..
How dare you question what I wrote.
 
johnledbury said:
To me, anything under 7 has to be managed before it gets to 4. At 4.5 I have gone unconscious. I have a record of 23+ that is why the Hospital Diabetic Specialist at Bournemouth Hospital.
How dare you question what I wrote.
Click to expand...

My apologies, I just noticed that you are on insulin as well as Metformin and glic.
 
It's ok. I am also on Empaglifflozin and Furosemide 40mg. which are supposed to work on the kidneys to expel glucose. They are still trying different drugs as we go along. A good day for me is 12, whereas yes, a normal person is 4.
 
johnledbury said:
It's ok. I am also on Empaglifflozin and Furosemide 40mg. which are supposed to work on the kidneys to expel glucose. They are still trying different drugs as we go along. A good day for me is 12, whereas yes, a normal person is 4.
Click to expand...
Sounds like there is a long way to go to get the balance of your meds right, it must be very frustrating for you to have this happening.
Would standard hypo treatment not be better like jelly babies or full sugar coke rather than something chocolaty though I suppose Bounties are pretty sweet.
 
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