Need some advice please!!!

[Worriedwife]

Looking for some advice as nothing I am reading on the internet helps!

My husband is type 2 diabetic and takes a tablet called metaphormine (?!) at night.

He has been fainting periodically since last Easter. It's always in the morning between 7-8 and usually just before or just after breakfast.

At first it was put down to low blood pressure (but he is on high blood pressure meds). He has now been taken off his meds and hasn't fainted in quite some time. However other weird stuff is happening.

In the morning he has REALLY weird conversations with me. It's just out of the blue and totally odd but it only last for maybe a minute and then he is back to normal. He just rambles about odd things. But then denies that he said any of it.

At the same time I think he goes very pale and goosebumps.

It can happen a couple of times a week and then not again for 3/4 weeks.

I also think he seems more irratable than usual and is complaining of feeling tired all the time-even first thing in the morning. He also seems more lethargic than normal.

Drs just keep saying its low blood pressure but I don't agree as just after these incidents happen we take his blood pressure and its normal/high.

He has had heart scans, blood tests, a CAT scan. And nothing seems abnormal.

He is 66.

Does anyone think this might be the diabetes? I just think it's weird that the "odd conversations" only happen in the morning and not at any time of the day-so it has to be blood pressure/blood sugar or something similar.

Really worried

 

[Redkite]

Some people can have issues with low BP when they first get up out of bed (can't remember what it's called!) - this would give symptoms of feeling dizzy and faint, and then an adrenalin reaction (the "fight or flight" panic hormone) would cause a subsequent rise in BP, so if you measured it after these incidents it would read as normal/high. Advice would be to get up slowly, ie first rise to a sitting position, pause, then swing legs down to floor and sit there for a minute or so before actually standing up.

It doesn't seem likely to be a diabetes problem because I don't think metformin leads to hypos. Has your husband ever had 24hr ambulatory blood pressure monitoring? This could be useful to see what's going on throughout the day/night.

 

[Worriedwife]

Hi

Thanks for your reply. The thing is that he can be up for 30-45mins before passing out. And the same length of time before the weird conversations.

He has had 24 blood pressure and 24 hour ecg. Both were normal. Which is good, but doesn't give me any answers

 

[Redkite]

I can see why you're worried. And it always happens at the same time of day? Is he taking any other meds? Perhaps keep a detailed diary of times and what happens, and go back to the GP? Hope you can get to the bottom of it soon.

 

[Worriedwife]

Thanks.

Been to doctor numerous times and had SO many tests. But nothing is turning up! Searching for my own answers now!

Been referred to a neurologist now. But don't think it is brain related because it only happens in the morning, I think is physiological.

 

[Redkite]

I may be reaching here, but something rings a bell re trapped nerves in the neck - could this be a problem with neck vertebrae?

 

[Worriedwife]

Mmmmm. Does suffer from neck/back problems.

But surely this would not explain the weird conversations in the morning????

 

[Northerner]

Do you know what his blood sugar levels are like in the mornings? Do the conversations/fainting problems take place before or after breakfast? Just wondering as very high blood sugar levels can be disorientating in some people.

 

[Amigo]

My mum was like this with postural hypotension and we ended up calling the paramedics on 2 occasions.
I agree with Redkite about the need for a blood pressure monitor being fitted for a period to plot what's happening and check his glucose levels during these episodes.

Seeing a neurologist is a good idea though. They'll consider neurological and physiological function.

Good luck, it must be a worry. Ever thought of videoing the episodes to show the medics? Especially the disorientation.

 

[Worriedwife]

Fainting/conversations either take place before breakfast or LITERALLY as he finishes eating (conversations usually happen between finishing food and then while we are sitting chatting as he is finishing his tea).

Have videod the episodes. Usually happen so fast and are over quickly. But might try that-at least to prove to him it's happening!!!!

Heart consultant did mention fitting a "wear all year" blood pressure monitor which gets put under his skin.

He doesn't measure his blood sugar at all. It's just monitored by the nurse every 6 months and is usually about 7-8.

Do you think it is worthwhile starting to keep track of it?

 

[Northerner]

I think it would be worth knowing what blood sugar was, if only to rule it out 🙂 How long has he been diagnosed?

 

[zuludog]

There are two things which would not in themselves cure your husband's problem, but would help to show what is going on

Do some regular blood sugar/glucose tests. You should already have a home testing kit
Do some blood pressure tests. You can buy a basic meter for about £20

Both of these will, of course require his co operation
Blood sugars should be in the range about 4 to 10. If they are regularly much outside that there is a problem
For both blood glucose, BG, and blood pressure, BP, tell us your results on this forum and you will get the appropriate comments

 

[Amigo]

I think the neurologist is probably a good port of call worried wife because it sounds like a vasovegal episode or a post prandial (after eating) hypotension episode. Many years ago I had a problem where I was very dizzy after food and the GP basically described it to me as over stimulation of the vagus nerve (and was associated with the need for the loo too). Its apparently more common than people think but this disorientated speech needs looking into.

Glucose testing is always a good idea though because the test the nurse is doing every 6 months sounds like the HbA1c test which is different to the regular finger prick measurements for checking what's going on daily.
If his HbA1c test is 7-8 it's not in the ideal range (not massively bad) but could explain some spikes.

You'll find the answer if you persevere and I hope the neurologist can pin point the reason.

 

[Worriedwife]

Northerner-diagnosed maybe 6-7 years ago. Never really been a problem though. Only ever goes for 6 monthly check up. Gets told he is "fine" and told to come back in 6 months!

Zuludog-We have a BP monitor and have had to do it LOADS in recent months generally sits about 140-150/80-90. And that is unmedicated. Consultant wants him to stay off meds just now as whenever he goes back on the fainting starts again.

I describe the conversation thing as "it's like a light flickering but the full power cut doesn't come" ie fainting.

Amigo-had a look at postpradial. Sounds possible. But ONLY happens at breakfast time. Not at any other meal. Is there a cure for this, or do you just have to live with it?

 

[Amigo]

Worried wife, it could be that breakfast time is when your husband is most insulin resistant as this is common. Obviously your doc needs to give the advice and offer guidance based on a definitive diagnosis but it might help to make breakfast as low carb as possible because postprandial hypotension occurs when carbohydrates and proteins in food trigger the release of a gut hormone, which causes the peripheral arteries to dilate, which in turn deprives blood from the heart and the brain. This is what was happening to me but strangely only at lunch. Also a lot more fibre and smaller portions in his diet will slow down this process. I'm wondering what he has for breakfast. Incidentally, does this sometimes coincide with the need for a bowel movement?

It's just a practical suggestion whilst the medics get to the route of this. But I honestly would start testing at home. Sometimes the medics are happy with a less than brilliant HbA1c which shows averages over a period of months but doesn't really tell you what's happening every morning to his blood sugars.

There's so many possible reasons for the episodes. You might find this link useful;

http://www.stars.org.uk/patient-info/conditions/syncope

Good luck!

 

[Worriedwife]

Thanks amigo

Usually only has a slice of toast for breakfast. Bowel movement often just after breakfast-but not always!!!

Will def get a blood sugar monitor.

Thanks for advice.

 

[Northerner]

Thanks amigo

Usually only has a slice of toast for breakfast. Bowel movement often just after breakfast-but not always!!!

Will def get a blood sugar monitor.

Thanks for advice.

Regarding blood sugar monitors, the cheapest option we have come across here is the SD Codefree Meter with test strips at around £8 for 50. The main expense with monitors is the cost of test strips, some makes can cost up to £30 for 50! 😱

 

[Ralph-YK]

feeling tired all the time-even first thing in the morning. He also seems more lethargic than normal.

Upto last December, when I was diagnosed diabetic, that's how I felt a lot. And I head felt, well I guess wooly headed/foggy. No idea why. It had gone. earlier this year.

 

[DaveB]

Hi. I think it will be worth the cost of a meter and strips to eliminate the possibility of low blood sugar at the time the problems occur.

 

[Worriedwife]

Thanks northerner-monitor bought!!