Hypos on metformin

[johnledbury]

I think we settled on bounty bars as they reacted quickly. It is frustrating because I cannot walk for more than about 6 minutes without getting severe pain in my calf muscles. I am also on waiting list for stents, due to diabetes.
But, as i see it, I made it to 80, but my brother and sister, both younger than me, didn't make 70.
Neither had diabetes, and didn't smoke or drink, so I know I am lucky.

 

[rebrascora]

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.

Has anyone ever given you any advice on treating hypos? ie what to eat or drink to treat a hypo?
The reason I ask is that a Bounty Bar is not really suitable for a couple of reasons. Firstly it contains too many carbs (far more than the recommended 15g) and will push your levels back up too high and your body will therefore continue to make you feel hypo in the 5s because it is used to much higher levels. Secondly the fat in both the chocolate and the coconut will mean that the sugar doesn't work as fast as something which is just glucose like jelly babies.
I appreciate that you may feel a Bounty Bar works fine for you but there are lots of other people who may read this and think from your comment that a Bounty Bar is a good choice to treat a hypo and it isn't.

Your levels seem to be running rather too high and you are taking a lot of different medications including insulin to try to bring them down, but then when they come down, you eat too many carbs and push them right back up again, so your levels will remain high and you will continue to feel very unwell when you do come down into range and yes some people can pass out from false hypos, but it isn't a good situation to be in.
The key to good diabetes management is to bring levels down slowly so your body gradually gets used to being in the 5s and 6s and 7s rather than dropping suddenly from 15 or 20 down to 5 which would make most of us feel unwell and just have a very small amount of carbs (not a full 15g hypo treatment ) if you feel hypo at those levels. So 1 or 2 jelly babies (5-10g carbs) well chewed would be much better than a whole Bounty Bar where a single bar of a 2 finger pack is about 17g carbs, so that is double the amount of carbs you need and if you ate both fingers that is probably more than 4x what you actually need and will just be making your diabetes worse and the medication eventually need increasing.

 

[everydayupsanddowns]

Bear in mind @rebrascora that as a more mature member of the forum @johnledbury might do better at slightly higher BG levels. Several studies are suggesting different (higher) targets in older age for improved outcomes (especially if there is a risk of losing consciousness and/or falls).

I ponder whether it might be possible to very gradually reduce those levels to bring them more regularly in single figures over an extended period, to allow the ‘glucose thermostat’ to reset and avoid triggering those worrying hypo warning signs - bit it looks like John is in close contact with his Drs, and getting advice from them.

I’m with you on the Bounty bar though. I used chocolate / caramel treats as hypo treatments for years even though I knew they acted too slowly because of the fat in them.

15g of something high glucose and recheck after 15 minutes is a much quicker resolution for me than chocolate ever was.

 

[rebrascora]

@everydayupsanddowns Yes, I did consider the guidance for more senior diabetic patients to maintain higher targets which was why I didn't mention levels in the 4s, as I thought I had seen 5-8 as being recommended as their premeal targets, but perhaps they are a bit higher still. Certainly having levels in the teens is not good and eating a Bounty Bar when levels are at 5 is almost certainly going to put them back up into the teens again, so just trying to suggest that a much smaller input of faster acting carbs (say a couple of jelly babies) would be a better choice, so that levels just go up to maybe 9 or 10 and try to maintain that level. I believe the OP is suffering with diabetic complications so maintaining levels as high as they are is risking deterioration and it occurred to me that perhaps John had not been given any guidance on what or how much was a suitable hypo treatment.
For example, as a rough guide, I was told to assume 10g of carbs which is 2 jelly babies will raise your levels by 3mmols, so if you are on 5.0, 2 JBs will take you up to about 8 and 3JBs would take you up to 9.5. A whole bounty is going to take you up to about 15mmols
I found that learning to be disciplined with my hypo treatments and know roughly how much I needed, to get me back to mid range was really important in helping me to stabilize my levels. There is little worse than over treating a hypo and ending up too high and then either leaving it there or doing a correction which risks you going low again..

 

[johnledbury]

Has anyone ever given you any advice on treating hypos? ie what to eat or drink to treat a hypo?
The reason I ask is that a Bounty Bar is not really suitable for a couple of reasons. Firstly it contains too many carbs (far more than the recommended 15g) and will push your levels back up too high and your body will therefore continue to make you feel hypo in the 5s because it is used to much higher levels. Secondly the fat in both the chocolate and the coconut will mean that the sugar doesn't work as fast as something which is just glucose like jelly babies.
I appreciate that you may feel a Bounty Bar works fine for you but there are lots of other people who may read this and think from your comment that a Bounty Bar is a good choice to treat a hypo and it isn't.

Your levels seem to be running rather too high and you are taking a lot of different medications including insulin to try to bring them down, but then when they come down, you eat too many carbs and push them right back up again, so your levels will remain high and you will continue to feel very unwell when you do come down into range and yes some people can pass out from false hypos, but it isn't a good situation to be in.
The key to good diabetes management is to bring levels down slowly so your body gradually gets used to being in the 5s and 6s and 7s rather than dropping suddenly from 15 or 20 down to 5 which would make most of us feel unwell and just have a very small amount of carbs (not a full 15g hypo treatment ) if you feel hypo at those levels. So 1 or 2 jelly babies (5-10g carbs) well chewed would be much better than a whole Bounty Bar where a single bar of a 2 finger pack is about 17g carbs, so that is double the amount of carbs you need and if you ate both fingers that is probably more than 4x what you actually need and will just be making your diabetes worse and the medication eventually need increasing.

Thank you. Re Bounty bars, they just agreed with what I said.
I accept your opinion and advice, and have now got some jelly babies ready.

 

[chaoticcar]

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

If you go to Home Health UK
Gluco Navii Glucose meter and test strips I have found this to be an accurate easy to use meter
Carol (81 year old not very tech savvy )