Hi guys. I’m having trouble with my blood sugars being on the low side with gastroparesis. I’ve not been officially diagnosed with it but I’m 99% sure I have it as I also have EDS/POTS/SFN/AD etc and slight symptoms have been coming in for some time. Then Covid and the loss of my mum last year ramped things up. I started to have more gut issues in April and became very unwell had three lots of antibiotics as a UTI was suspected and I’ve been in flare since then. Apart from the obvious nausea, poor motility, gas and constipation I’m concerned about my lower blood sugars. Even an hour or so after eating carbs my blood sugar drops to a low figure under 4. I’m type 2 diabetic and take 80mg of Gliclazide. Even at best the figure never goes much above seven and it’s mostly fives and low fours. I know it’s most likely because of slow transit. My GP is reluctant to prescribe me anything because of side effects and my age but I really need some help. He reluctantly referred me to a gastroenterologist and I won’t see them until the end of the year. I’ve already lost a stone in a month, any ideas? Thank you
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Low Blood Sugar with Gastroparesis
- Thread starter TCP36C
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Inka
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Your blood sugar is low after eating carbs, but you make no mention of it going up later @TCP36C - does it? You say that it doesn’t go much above 7, so I’m presuming not? Are you counting your carbs in each meal and eating the same amount each day, eg 30g or whatever for breakfast each day? Have you tried reducing your Gliclazide or increasing your carbs slightly?
What are your gut issues? Has some kind of inflammatory bowel condition been ruled out? How long have you had diabetes? Don’t assume it’s gastroparesis just because you have diabetes.
What are your gut issues? Has some kind of inflammatory bowel condition been ruled out? How long have you had diabetes? Don’t assume it’s gastroparesis just because you have diabetes.
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Sorry to hear about the blood glucose fluctuations and unpleasant gastric effects you have been experiencing @TCP36C 
Nausea and bloating can be a sign of delayed stomach emptying, but they are associated with other things too.
If your BG levels are consistently dropping after food, and then failing to rise much later on, perhaps you could talk to your GP about your Gliclazide dose, and your risk of hypoglycaemia. I’m not sure if it would be worth delaying taking your medication until some time has passed after eating as one might do with gastroparesis and injected insulin.
Glic stimulates the pancreas to deliver more insulin than it normally would, but I don’t know if simply delaying taking it might help balance with delayed gut transit if your hunch about Gastroparesis is correct.
A question for your Dr or a pharmacist really - they will know if any research/studies have been carried out.
Nausea and bloating can be a sign of delayed stomach emptying, but they are associated with other things too.
If your BG levels are consistently dropping after food, and then failing to rise much later on, perhaps you could talk to your GP about your Gliclazide dose, and your risk of hypoglycaemia. I’m not sure if it would be worth delaying taking your medication until some time has passed after eating as one might do with gastroparesis and injected insulin.
Glic stimulates the pancreas to deliver more insulin than it normally would, but I don’t know if simply delaying taking it might help balance with delayed gut transit if your hunch about Gastroparesis is correct.
A question for your Dr or a pharmacist really - they will know if any research/studies have been carried out.
Hello. Thank you for your reply. It never seems to go up much above seven now. No I’m not counting carbs as I’ve been trying to raise my blood sugar and it depends on what I can manage to eat. I have increased like today and it’s still low. I’m going to reduce the Gliclazide as the last two blood tests have been 36.
I’ve had IBS for years but this isn’t it. It’s been coming on for a year. Early satiety, bloating, pain, gas, severe nausea, constipation and more. I have Ehlers Danlos, POTS and autonomic dysfunction which is linked to it. I’ve also developed TMJ/TMD over the past month, too, and I’ve been chatting to other people with gastroparesis. My GP thinks I have it and the surgery nurses thought so, too. I’ve had diabetes since going on steroids in 2017. I think the symptoms, medical history seem to point to this.
Inka
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@TCP36C Counting carbs doesn’t mean limiting them. It simply means counting to eat the correct amount - correct for you and your medication, that is. If you’re on Gliclazide, you’re normally better off eating the same amount of carbs each day so that the Gliclazide has the same consistent carb amount to deal with.
As an example, if you eat 50g carbs for your meal one day and only 20g the next, it’s possible that on the day you only ate 20g your sugars will be too low after your meal. Note - those figures are just examples not recommendations.
If your last HbA1C was 36, you might not need it anyway, or, at least, need your dose adjusting.
As an example, if you eat 50g carbs for your meal one day and only 20g the next, it’s possible that on the day you only ate 20g your sugars will be too low after your meal. Note - those figures are just examples not recommendations.
If your last HbA1C was 36, you might not need it anyway, or, at least, need your dose adjusting.
Hi. Thank you for your reply. I did mention this to my GP a couple of weeks ago and he wasn’t concerned that my BS went as low as 2.6 one night. I may try and talk to someone else this week. I understand over the weeks why it gets low with the slow transit. It kind of makes sense.Sorry to hear about the blood glucose fluctuations and unpleasant gastric effects you have been experiencing @TCP36C
Nausea and bloating can be a sign of delayed stomach emptying, but they are associated with other things too.
If your BG levels are consistently dropping after food, and then failing to rise much later on, perhaps you could talk to your GP about your Gliclazide dose, and your risk of hypoglycaemia. I’m not sure if it would be worth delaying taking your medication until some time has passed after eating as one might do with gastroparesis and injected insulin.
Glic stimulates the pancreas to deliver more insulin than it normally would, but I don’t know if simply delaying taking it might help balance with delayed gut transit if your hunch about Gastroparesis is correct.
A question for your Dr or a pharmacist really - they will know if any research/studies have been carried out.
I use the finger pricks
Also symptoms started to come on last year in the summer. In August my HbA1c was 43. In February this year it was 36 and May 36.
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I agree. He was very laid back about it all and also said that basically he couldn’t give me anything for the gastroparesis! I need to talk to someone else at the surgery.
Yes, whatever I eat at the moment the blood sugar is low. I’m guessing my stomach is emptying so slowly that nothing is registering. I’ll have my dose of Gliclazide and see how it goes. Thank you.
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Unfortunately there aren’t many meds for gastroparesis which have very good evidence
There are a few things that can be tried, which have been shown to offer limited improvements, but sadly, like some of the other autonymous nervous system problems, they seem pretty treatment-resistant
There are a few things that can be tried, which have been shown to offer limited improvements, but sadly, like some of the other autonymous nervous system problems, they seem pretty treatment-resistant
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In my (entirely medically unqualified opinion) it sounds like your Glic dose needs adjusting downwards. You are taking a med which forcefully reducing your BG levels, and currently your menu and stomach can’t keep up with the extra insulin being released.
The risk if you keep ‘feeding’ the glic is that you may gain weight - which seems unlikely to help your diabetes management
Yes, you’re right I’m getting that impression. The doctor didn’t think that the luminal gastroenterologist would be able to help either. Time will tell I guess.Unfortunately there aren’t many meds for gastroparesis which have very good evidence
There are a few things that can be tried, which have been shown to offer limited improvements, but sadly, like some of the other autonymous nervous system problems, they seem pretty treatment-resistant
On a side note if the gastroparesis is causing the low blood sugars do you think they should have suggested dosing down last month when the 2nd blood test was at 36 again? Should I still actually be taking it now? I’m feeling so unwell and just had a reading of 1.9 so quickly took glucose and got it up to 8.1 the highest it’s been for a month! I’m OK now. It’s scary though as I get shaky, weak and nauseated and they can the same symptoms as with the gastroparesis and autonomic dysfunction. Bodies, eh? Thanks for your input.
Inka
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If you’re getting a 1.9 confirmed by fingerprick, I’d stop the Gliclazide right away if it were me. It might well be that you no longer need it anyway. You’d then also be able to judge how your stomach and blood glucose behave without it.
That’s not medical advice, just what I’d do in that situation. It’s your decision.
That’s not medical advice, just what I’d do in that situation. It’s your decision.
Lucyr
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Well done