Hypos

Newbie777

Newbie777

Well-Known Member
Relationship to Diabetes
Type 2
Hello,

I have been type 2 Diabetic for quite. A number if years, usually suffering from high glucose levels through lack of care and sometimes knowledge, but as my kidneys recently started to fail EGFR read of 43, I decided I was going to do something about my blood sugar control. To make meters though due to my kidneys I had to take less Metformin, reduced from 2000mg to 1000mg, so my blood sugars did spike.

Now I am on a low carb diet, eating protein, full fat and some vegetables and some fruit.

My medicine got changed and I am taking 1000mg Metformin, 100mg invokana, 160mg Glicizide and now 5mg of Trajenta.

My issue is the last 3 out of 5 mights I am been in hypo mode of 3.6/3.7 and in teg past this used to be 3am but now and then.

I usually will eat an apple, 2 glucose tablets and a few biscuits, but it takes a long time for the blood sugar to normalise to 4.5 plus, I would say 15 minutes and then eventually my blood sugars go to about 12 and then they are high around 10 in the morning.

I now have three choices

1. Reduced the Glicizide to 80mg for the morning only
2. Take the 2 Glicizides and stop the Trajenta
3. Up my car and food intake and keep medicine as they are.

GP is stuck as does not know, wants me to be referred to specilaist Diabetic service, who won't touch me as I am not on insulin and will not go insulin as my body is producing it!

I am now looking for advice on what to do when I have a hypo and eat and any measures to prevent this.

Thanks
 
Newbie777 said:
Hello,

I have been type 2 Diabetic for quite. A number if years, usually suffering from high glucose levels through lack of care and sometimes knowledge, but as my kidneys recently started to fail EGFR read of 43, I decided I was going to do something about my blood sugar control. To make meters though due to my kidneys I had to take less Metformin, reduced from 2000mg to 1000mg, so my blood sugars did spike.

Now I am on a low carb diet, eating protein, full fat and some vegetables and some fruit.

My medicine got changed and I am taking 1000mg Metformin, 100mg invokana, 160mg Glicizide and now 5mg of Trajenta.

My issue is the last 3 out of 5 mights I am been in hypo mode of 3.6/3.7 and in teg past this used to be 3am but now and then.

I usually will eat an apple, 2 glucose tablets and a few biscuits, but it takes a long time for the blood sugar to normalise to 4.5 plus, I would say 15 minutes and then eventually my blood sugars go to about 12 and then they are high around 10 in the morning.

I now have three choices

1. Reduced the Glicizide to 80mg for the morning only
2. Take the 2 Glicizides and stop the Trajenta
3. Up my car and food intake and keep medicine as they are.

GP is stuck as does not know, wants me to be referred to specilaist Diabetic service, who won't touch me as I am not on insulin and will not go insulin as my body is producing it!

I am now looking for advice on what to do when I have a hypo and eat and any measures to prevent this.

Thanks
Click to expand...
Your situation seems quite complex as you are taking several medications but your HbA1C is high yet you are getting low night time levels.
It may be worth your while getting a free trail of a Libre from Abbott so you can see what is going on 24/7. you would need a compatible phone.
A couple of those medications are ones where low carb is not recommended so it may be you are actually not eating enough carbs for the doses of medication.
There are people who still produce insulin who do take injected insulin so that may be a possibility for you. It sounds as if your GP is out of his depth with your problems.
 
Thank you, I am using the Libre 2 and my Hba 1c on there is 73 over the last 4 months, so still better than than 117 read from before, plus this is taking into account the 3 weeks of high blood sugars.

I am taking 4 different types of diabetes medicines and the recommended are 3.

I am happy to increase my carb intake for the medicines, and eventually I want to go to the gym but oy once my blood sugars are stable and no hypos.

Regarding insulin, my parents were on this for a number of years, certain cancer drugs don't work and my issue is my pancreas is working and am still producing insulin. The question I ask is why would you take paracetamol for headache you don't have, sorry am a bit stubborn on this front.

Yes insulin is cheaper for the NHS and the Diabetic specialist will see me, but I still believe medicines are working, just need to get the balance right.

Yes unfortunately my GP is not up to scratch with my case and issues.
 
Hi, do you have one of the hypo kits, eg: tube of sugary tabs, tube of sugary liquid, and a tube of sugary gel, usually about £10 off Amazon. On the rare occasion I had a hypo, before being officially diagnosed T2D, I would just have a sugary tab from the hypo pack and would be ok again after 5 mins. Obviously thats just me, and everyone is different...
 
Thank you and no I haven't, to be honest I have not been In a position before to get hypos as I always have had high sugar.

But I will get the kit, also the dextrose tablets I have two at a time, but it should be 5 or 6.

Cheers
 
Newbie777 said:
Thank you, I am using the Libre 2 and my Hba 1c on there is 73 over the last 4 months, so still better than than 117 read from before, plus this is taking into account the 3 weeks of high blood sugars.

I am taking 4 different types of diabetes medicines and the recommended are 3.

I am happy to increase my carb intake for the medicines, and eventually I want to go to the gym but oy once my blood sugars are stable and no hypos.

Regarding insulin, my parents were on this for a number of years, certain cancer drugs don't work and my issue is my pancreas is working and am still producing insulin. The question I ask is why would you take paracetamol for headache you don't have, sorry am a bit stubborn on this front.

Yes insulin is cheaper for the NHS and the Diabetic specialist will see me, but I still believe medicines are working, just need to get the balance right.

Yes unfortunately my GP is not up to scratch with my case and issues.
Click to expand...
Do you have the alarm set on your Libre so you get a warning of the night hypos and are you checking those with a finger prick before treating and testing again after 15 mins. are you feeling as if you are hypo.
How many carb are you needing to bring your level back up. Does it then stabilise.0
 
Alarm set as 4.2, when I get hypo the only condition is blurry vision, no headaches, sweating or confusion, I wake up 4 times at night, so always check my BG levels.

My carb intake for the full day is to keep below 100g.

When I get the hypo. I eat a red apple so about 40 to 50g, 2 malted biscuits 30 g? and 3 dextrose tablets?not sure, but looks I may be looking at 70 to 90g if carbs!

To. Normalise to 4.5 I would say it take about 30 minutes.

After reading off the forum today it will take 5 dextrose tablets, 2 biscuits and monitor after 15 mins then white bread toast.

Also will order the glucose gels from Amazon
 
Newbie777 said:
Alarm set as 4.2, when I get hypo the only condition is blurry vision, no headaches, sweating or confusion, I wake up 4 times at night, so always check my BG levels.

My carb intake for the full day is to keep below 100g.

When I get the hypo. I eat a red apple so about 40 to 50g, 2 malted biscuits 30 g? and 3 dextrose tablets?not sure, but looks I may be looking at 70 to 90g if carbs!

To. Normalise to 4.5 I would say it take about 30 minutes.

After reading off the forum today it will take 5 dextrose tablets, 2 biscuits and monitor after 15 mins then white bread toast.

Also will order the glucose gels from Amazon
Click to expand...
Maybe set your alarm a bit higher so you can stave off the hypo with less carbs, as you are having nearly as many carbs for treating your hypos as you are having in the rest of the day.
I think you should discuss your diet in relation to the medication with your Diabetic nurse as certainly the gliclazide needs carbs in order to work properly. When do you take the gliclazide, once a day or each meal
 
Sorry do you know which medications where they don't work as well on low carbs, thanks
 
Leadinglights said:
Maybe set your alarm a bit higher so you can stave off the hypo with less carbs, as you are having nearly as many carbs for treating your hypos as you are having in the rest of the day.
I think you should discuss your diet in relation to the medication with your Diabetic nurse as certainly the gliclazide needs carbs in order to work properly. When do you take the gliclazide, once a day or each meal
Click to expand...
I take 1 Glicizide with breakfast around 8.00am and the other one with lunch at 12.00pm
 
Satan’s little helper said:
Hello, Libres for me can delay in the reading on recovery from a low. It reads interstitial fluid. A finger prick using a meter can give a more accurate gauge of your blood glucose level around the 15/20 minute mark.
Click to expand...
I have the blood sugar monitor too and yes great idea, I also notice that the Libre 2 reading are actually 3 units higher, so when I checked my sugar it was 5.3 on the finger pick an it was 5.6 on the CGM
 
Leadinglights said:
Maybe set your alarm a bit higher so you can stave off the hypo with less carbs, as you are having nearly as many carbs for treating your hypos as you are having in the rest of the day.
I think you should discuss your diet in relation to the medication with your Diabetic nurse as certainly the gliclazide needs carbs in order to work properly. When do you take the gliclazide, once a day or each meal
Click to expand...
Yes I now realise this and my blood sugar is a out 10 or 11 in the morning, I think they are the next steps, thank you
 
Yes that's good for me too, used to prick every morning and sugars were 6 to 8, did not check in the evening when I had my high carb food, they must have 20 plus so I could not understand why my Hba1c was high all the time, a little knowledge..
 
Newbie777 said:
Yes that's good for me too, used to prick every morning and sugars were 6 to 8, did not check in the evening when I had my high carb food, they must have 20 plus so I could not understand why my Hba1c was high all the time, a little knowledge..
Click to expand...
I think you should at least get referred to a Diabetes Specialist Nurse? Time for a medication review on what you are prescribed?
 
I did see one and they wanted me to go on Insuli, asked about Mounjaro and she said try Trajenta, only supposed to take 3 diabetic medicines, she asked about all my diet and did not once say low carbs affects some of the medicine!

At that time my kidneys were bad and my blood sugars were super high as I had to reduce my metformin from 2000mg to 1000mg.

So another review is required
 
Newbie777 said:
I take 1 Glicizide with breakfast around 8.00am and the other one with lunch at 12.00pm
Click to expand...
I was wondering if you were taking your gliclazide in the evening with a low carb meal so it would not have had enough carbs so your pancreas would have been producing more insulin than it had carbs to work on.
Can you give some examples of the meals you have.
 
When I get the hypo. I eat a red apple so about 40 to 50g, 2 malted biscuits 30 g? and 3 dextrose tablets?not sure, but looks I may be looking at 70 to 90g if carbs!

Unless ‘red apple’ is some sugar-coated toffee apple type thing, then an apple (red or green) is around 15g carbs not 40 to 50g! It sounds like you’re over-estimating the carbs a lot. The best treatment for a hypo is something like Dextro tablets followed by a digestive biscuit or two.
 
Newbie777 said:
I did see one and they wanted me to go on Insuli, asked about Mounjaro and she said try Trajenta, only supposed to take 3 diabetic medicines, she asked about all my diet and did not once say low carbs affects some of the medicine!

At that time my kidneys were bad and my blood sugars were super high as I had to reduce my metformin from 2000mg to 1000mg.

So another review is required
Click to expand...
I appreciate your reluctance for insulin. It’s not my place to change your mind on that one. It’s good you have means to test & spot how your bloods are trending.
 
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