Low blood Glucose on Metformin

[Tezzz]

At the moment I am on 2 500mg Metformin tablets so I have one with breakfast and the other one with my evening meal. I have lost a stone in weight in the last month and would like to lose another to get to 12. My height is 5ft 11in. I briskly walk the mile to and from work each day.

I usually wake up to BG between 5 and 6 and have plain water based porridge or a few slices of wholemeal bread with Marmite for breakfast.

For a light lunch at work I either have tinned tomatoes/poached egg on plain wholemeal toast or a veggie salad as everything else on the menu is dripping in fat.

The thing is recently my Blood Glucose is regularly now in the 3.5 to 4.5 range before my evening meal which is usually between 8 and 10pm.

I feel absolutely fine with these readings - no hunger or tiredness - before my evening meal and I can't see anything wrong. I get similar readings off both meters I have, one is a Freestyle lite I have in my work jacket and the Compact Plus I have at home. I do control soloution tests and they are always correct.

My other half is worried about my BG readings before my evening meal. We nearly had an argument about it last night.

I'm personally pleased with the 'nice' low numbers as I think I am doing all the right things. My logic is that if I keep the BG nice and low then I will really delay the onset of any diabetic complications which I really want to avoid as I drive large vehicles for a living. I am loathe to the prospect of having to take any Sulphonylreas or Mealtime Glucose Regulators in the future as I want to keep my large vehicle driving licence.

Page 195 of Diabetes for Dummies says "By itself, Metformin does not cause Hypoglycaemia."

Should I be concerned?

 

[Northerner]

Hi tez, readings of 3.5-4.5 before your evening meal can be seen as completely normal - non-diabetics are in this sort of range, so you should be very pleased! Really, it's when it dips below 3.5 that it's a hypo. I also feel fine at 3.5, unless I'm actually dropping quickly and about to go below that. You're doing really well! If it does start to drop lower then you may need to have your medication adjusted to suit your new diet and lifestyle better.

 

[Caroline]

Your numbers sound pretty good.

When I asked i was told a hypo on metformin alone is unlikely but not impossible, it depends on your physical activity and how regular your meals are too. Best thing is to keep on going as you, it sounds like you have the balance about right, and then ask DSN if you need further advice.

 

[Admin]

'Officially' anything below a 4 is considered a hypo and when damage can be done to your system ? lows do as much damage as highs ? but like Northerner says - everyone is different. The reason you have those numbers before your evening meal is simple - you are going a long time in between meals - presuming you do not have a snack between lunch and dinner?

Perhaps to rise them to say 5 - and keep your partner happy - just have an apple inbetween? I do think 3.5 is a wee bit low - especially if you are driving. Personally I would never get in a vehicle to drive under 5 - but then I am a Type 1!

But Your diet exercise and numbers are all brilliant! And well done on the great weight loss🙂

Personally - I tend not to compare meters as none of them are spot on and really are only a guide.

 

[Northerner]

good point about driving - I don't drive so always forget about that! A snack would be a good idea, as your numbers would still be pretty good!

 

[tracey w]

Out of interest, i know type one diabetics need to be 5 to drive, but is it the same rule for type 2 on meds or not?

I would say 3.5 is too low to drive and is classed as hypo in medical terms regardless of lack of symptoms. Its great to have low numbers but you still need to be safe. take care 🙂

 

[Caroline]

good point about driving - I don't drive so always forget about that! A snack would be a good idea, as your numbers would still be pretty good!

I'm a non driver too. I got quite annoyed a while back as I had to go for a medical review with the occupational health people and they sent me a map so that I could drive. I was annoyed they had just assumed everyone drives and even more annoyed when I found there was no parking anyway and it is in the congestio charge zone!

 

[Lclilylee]

Hi there, Great site!! I,m new here - so sorry if i have done this wrong 😱

I am slightly confused by reading these posts (because of my doctor that is). I am type 2 and have been taking metformin 500mg for about a year, i started losing weight because of diet & exercise, but my levels were also going down to about 3.5, although they do fly up a lot higher once i have eaten. I spoke to the district nurse at work, about this and she said i need to speak to my doctor as it is just as bad to have very low levels as high. I rang my doctor, who said awe no, this is very bad, stop the metformin for a few days and see how you get on! I have done this and it is now about a week.

I had to come home from work early today as i feel awful, i keep feeling very sick, tired with a headache and dont know what to do for the best now.

I thought i would come on here and get some advice from people who are having the same problems.

Thanks Lots

Lily

 

[Northerner]

Hi there, Great site!! I,m new here - so sorry if i have done this wrong 😱

I am slightly confused by reading these posts (because of my doctor that is). I am type 2 and have been taking metformin 500mg for about a year, i started losing weight because of diet & exercise, but my levels were also going down to about 3.5, although they do fly up a lot higher once i have eaten. I spoke to the district nurse at work, about this and she said i need to speak to my doctor as it is just as bad to have very low levels as high. I rang my doctor, who said awe no, this is very bad, stop the metformin for a few days and see how you get on! I have done this and it is now about a week.

I had to come home from work early today as i feel awful, i keep feeling very sick, tired with a headache and dont know what to do for the best now.

I thought i would come on here and get some advice from people who are having the same problems.

Thanks Lots

Lily

Hi Lily, welcome to the site! Do you know what your levels are now? It sounds like, as tez has found, the lifestyle changes and weight loss have helped your body use the insulin it is producing more efficiently so there may be less need for the medication. How have your levels been over the week since you stopped the metformin?

 

[Lclilylee]

thanks Northerner, i just took it again and its 11.5. It seems to be going from one extreme to another and thats how its been

 

[Northerner]

thanks Northerner, i just took it again and its 11.5. It seems to be going from one extreme to another and thats how its been

Hi Lily, at least you know that you're not feeling poorly because of a low blood sugar, not much comfort I know! I wonder if you are sickening for something? It's not necessarily the diabetes that's making you feel poorly, but it will usually push your levels higher if you have a virus or infection. Large swings in levels can make you feel unwell too. Might be worth contacting your doctor to find out what can be done. Hope you feel better soon, and that the levels settle down.

 

[Steff]

hi ther lilylee and welcome to the site, Us diabetice are forever battling with our numbers i myself have only just really started now getting some sort of consecutivness (if thats a word) ,An example for me would be yesterday morning i tested and i was 23.1😱😱 i re-tesed 35 minutes later i was 11.5 work that out and in the morning to eat i had slice of wholemeal bread and a half glass of red topped milk. I am baffled most days but lately evening time reading have pleased me the most they have been under 10 .

 

[Copepod]

Just to add - it's best to test around 2 hours after eating - levels will be highest around 1 hour after eating, so that will give a "false" high reading.

 

[Lizzie]

Tez, I think you should be concerned. You should at least mention this to a doctor or nurse and see what they think. If your blood sugars are regularly below 4 you could begin to lose your hypo awareness. I would treat anything below 4 as a hypo personally and that has ensured I have never had a severe hypo in 16 years. That's just my opinion though.

 

[C*5_Dodger]

At the moment I am on 2 500mg Metformin tablets so I have one with breakfast and the other one with my evening meal. I have lost a stone in weight in the last month and would like to lose another to get to 12. My height is 5ft 11in. I briskly walk the mile to and from work each day.

I usually wake up to BG between 5 and 6 and have plain water based porridge or a few slices of wholemeal bread with Marmite for breakfast.

For a light lunch at work I either have tinned tomatoes/poached egg on plain wholemeal toast or a veggie salad as everything else on the menu is dripping in fat.

The thing is recently my Blood Glucose is regularly now in the 3.5 to 4.5 range before my evening meal which is usually between 8 and 10pm.

I feel absolutely fine with these readings - no hunger or tiredness - before my evening meal and I can't see anything wrong. I get similar readings off both meters I have, one is a Freestyle lite I have in my work jacket and the Compact Plus I have at home. I do control soloution tests and they are always correct.

My other half is worried about my BG readings before my evening meal. We nearly had an argument about it last night.

I'm personally pleased with the 'nice' low numbers as I think I am doing all the right things. My logic is that if I keep the BG nice and low then I will really delay the onset of any diabetic complications which I really want to avoid as I drive large vehicles for a living. I am loathe to the prospect of having to take any Sulphonylreas or Mealtime Glucose Regulators in the future as I want to keep my large vehicle driving licence.

Page 195 of Diabetes for Dummies says "By itself, Metformin does not cause Hypoglycaemia."

Should I be concerned?

Dear Tez,

I think that the advice that has been offered, especially that of Admin, should enable you to stop the lows of 3.5mmol/L. Just thought that this was an interesting post about Metformin

http://diabetesupdate.blogspot.com/

Regards Dodger

 

[Tezzz]

Thanks for all your replies about this. It made me think about it more than I was prepared to so I got in touch with the doctors today.

I've had a long chat with my doctor on the phone and we are going to try me cutting down to one 500mg tablet for two weeks with my evening meal. I'll be keeping a food/exercise diary doing more blood glucose tests (at least every 4 hours) to try and see a trend.

Let's see what happens...

I appreciate all that has been said and perhaps I was too wrapped up in keeping the numbers down.

 

[Northerner]

Great to hear that you are reducing meds thanks to your efforts tez! Well done!🙂