Newly diagnosed and feeling unwell on metformin

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Misery70

Misery70

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Type 2
Hi everyone, I'm 3 weeks in being diagnosed type2 and I don't have a clue what's happening. I'm on metformin SR now 500mg twice daily. I get symptoms of awful cold sweats all over my body, hair soaking wet, sweat running down my face. I also feel sick, shaky, dizzy and exhausted. This happens about 4-5 times daily and I'm waking up 3 or 4 times a night to go to the loo, so hungry and with milder symptoms, sweat and feeling sick.
My nurse at my GP says wait to speak to the diabetic nurse. I feel I have had no info apart from a diabetes UK printed info sheet
My blood sugar is normally between 7 and 8 when I have these symptoms. Surely I'm not having hypos? I've read that T2 don't get hypos on metformin. Any info would be appreciated. Apologies for the long post, I'm at my wits end here.
 
Firstly, welcome to the forum.
It sounds like it would be best to talk with your Diabetic nurse or GP or whoever prescribed the medication. Hypos are not caused at 7 or 8 on your blood Bmmol machine. However, if you are on a low-carb diet I did feel flu-like and a bit like you coming down from the twenties to below ten and you may have gone on the diet too strictly at first.
I would chat with your health provider as they know what else is happening with you.
 
It could be that you are unable to tolerate even the slow release metformin but the effect is usually on the stomach, but as mentioned if your blood glucose has been high the sudden drop can give you those 'hypo' symptoms even if blood glucose is not in the usual hypo territory.
Have a word with your nurse but dropping down to just 1 tablet for a while to see if that helps should not be a problem as dietary changes are going to have just a much impact.
What was you HbA1C that has given you your diagnosis.
 
Thank you, Nayshiftin and geodesy. I've looked up false hypos and that makes sense now. I feel better knowing that I've obviously went low carb, and taking smaller portions too quickly. This has altered my set point blood sugars. It makes sense now. Now to start planning meals, the dietician appt can't come quick enough.
I appreciate your time in answering. Thanks again.
 
Leadinglights said:
It could be that you are unable to tolerate even the slow release metformin but the effect is usually on the stomach, but as mentioned if your blood glucose has been high the sudden drop can give you those 'hypo' symptoms even if blood glucose is not in the usual hypo territory.
Have a word with your nurse but dropping down to just 1 tablet for a while to see if that helps should not be a problem as dietary changes are going to have just a much impact.
What was you HbA1C that has given you your diagnosis.
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Thanks Leadinglights, I've no gastro symptoms, I fought for the SR as my Mum has horrendous Gastro symptoms on met. My nurse says wait till I see the dietician. My HbA1c was pre-diabetic for 4 months before now becoming di
Misery70 said:
Thank you, Nayshiftin and geodesy. I've looked up false hypos and that makes sense now. I feel better knowing that I've obviously went low carb, and taking smaller portions too quickly. This has altered my set point blood sugars. It makes sense now. Now to start planning meals, the dietician appt can't come quick enough.
I appreciate your time in answering. Thanks again.
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abetic. I think I've been prediabetic for 18 months before, giving my symptoms. I will call the nurse again and ask to drop to one, the symptoms did get worse when I upped them to two. Thank you!
 
Misery70 said:
Thanks Leadinglights, I've no gastro symptoms, I fought for the SR as my Mum has horrendous Gastro symptoms on met. My nurse says wait till I see the dietician. My HbA1c was pre-diabetic for 4 months before now becoming di


abetic. I think I've been prediabetic for 18 months before, giving my symptoms. I will call the nurse again and ask to drop to one, the symptoms did get worse when I upped them to two. Thank you!
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Unless your blood glucose shot up dramatically from being prediabetic then I am surprised that you were prescribed metformin before being given the opportunity to make dietary changes first for 3 months.
If you are going low carb then this link may be useful. https://lowcarbfreshwell.com/
By following the principals I reduced my HbA1C from 50mmol/mol to 42 in 3 months. There are meal plans but I find that too rigid as I tend to make things that we would have for 2 consecutive days, like curries or chilli and then meat, fish and veg dishes on others.
 
Can I ask what your diagnostic hba1c was? Do you know what sort of levels your meter was showing before/when you began treatment?

It if was prediabetic just 4 months before it seems a little odd that in that short a time it shot up high enough to create such strong false hypo symptoms. Maybe it’s not that but some sort of intolerance to Metformin and the 2nd tablet tipped the balance.
 
HSSS said:
Can I ask what your diagnostic hba1c was? Do you know what sort of levels your meter was showing before/when you began treatment?

It if was prediabetic just 4 months before it seems a little odd that in that short a time it shot up high enough to create such strong false hypo symptoms. Maybe it’s not that but some sort of intolerance to Metformin and the 2nd tablet tipped the balance.
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Those are my thoughts too, so it would be really useful to know what your HbA1c result was at diagnosis. Anything above 47 gets you a full diabetes diagnosis but I would expect you to be considerably higher, possibly 3 figures to get false hypos at 7/8. Even if your levels were incredibly high to start with getting regular false hypos at 7 or 8 would be unusual as your body should have adjusted after a few days.

If you were not on a low carb diet, then I might suspect it could be Reactive Hypoglycaemia where a high carb meal sends your levels very high because the pancreas is slow to release insulin and then releases too much too late so you then come plummeting down from a very high level which can feel horrid and certainly trigger hypo response, but if you are not eating high carb foods or meals and hour or two before these evenets that I would rule that out. If you are eating low carb then there should be nothing to trigger a big spike. Are you testing before and 2 hours after meals and if so, what sort of readings are you getting?

Can I ask if you are female and if so, have you considered the menopause as causing these symptoms or perhaps a thyroid problem?
 
I didn't want to write a really long post but In Feb 23 my HbA1C was 44, in May it was 43 and now in Aug 48. The Dr did say that historic HbA1Cs before Feb were in the pre-diabetic range but I was told my bloods were satisfactory. Never was I told to go on a diet or eating plan.
My eating went of out control around May, emotional eating due to issues and that's why I think I've now moved into the diabetic ranfe. Not her fault, she's learning, she advised me to go on a course, when I applied I was told it was a prediabetic course and i aasnt eligible. I coukd have been on that in Feb and in a better place now. She's just relaying the Dr's plan. I'm angry and worried that for months I've been symptomatic of pre-T2 for ages and nothing was said. My feet and ankles are very swollen around since Feb time and i dont know if its just a coincidence. My Mum is T2 and has neuropathy, eyesight issues due to her inability to control her sugars.
I bought a kinetic testing kit and prior to met my random sugars sat around 13-16. Thank you @Leadinglights, I'll check out the link

I've 2 weeks to wait till I see the diabetic dietician so fingers crossed, I'll know more. Thanks for getting reading and getting this far! Xx
 
I haven't been testing before and after meals. I will now, thanks @rebrascora, I am 10 years post menopausal and I have Hashimoto's Thyroiditis but the Dr says my bloods are in range. I'm considering asking for a referral to a endocrinology as I feel rubbish most days.
What range be post blood sugars be? I don't have a clue. I've been spending too much time overthinking. Time to start learning, and you lovely community have been so supportive I've learned more today than in the last 4 months x
 
Your latest HbA1c of 48 earlier this month is literally right on the diabetes threshold, so I really would not expect you to experience false hypos at all at this level. That said, the readings of 13-16 unless those readings were taken within a couple of hours of eating foods which contained a moderate portion of food. I think you need to start a system of strategic testing, immediately before and then 2 hours after meals, alongside a food diary so that you can note the increase due to each meal ie how much the meal caused your levels to rise as well as keeping a not in that diary of when you felt unwell in case it correlates to particular foods or perhaps even to when you take the Metformin. It is unlikely but not impossible that these may be a reaction to the medication and sometimes it isn't just the medication itself but the binding and coating agents used in the pill manufacture which can upset some people's system.

I wonder if it might be helpful for you to apply to Abbott laboratories for a free 14day trial of their Freestyle Libre 2 system, to give you an indication if these symptoms occur when your BG levels spike very high and then drop rapidly (false hypos). This monitors your levels 24/7 and provides a graph to show what is happening. All you need is a diabetes diagnosis and a suitable phone which the LibreLink app will work on to qualify for the free trial and they are £50 to buy, so having a free trial with no commitment to buy afterwards is a big bonus to help you get better info about what is happening for a couple of weeks and you can log your meals and when you have these episodes on the app if you like or pen and paper if you prefer.

That said, I believe Hashimoto's is an autoimmune condition and here on the forum we are well aware that autoimmune conditions tend to congregate in certain patients and wreak havoc and I am half wondering if you might actually be in the early stages of developing Type 1 which is autoimmune rather than Type 2 which is metabolic. Not that that would cause you to have hypos as it is the injected insulin we use which causes them if we miscalculate or our bodies respond differently to the insulin we have injected to how we might expect them to.

Anyway, those are all just thoughts which are floating around in my head from reading your few posts. A period of strategic testing should shine a bit more light on the situation and a Libre would likely give you much more insight although Libre does have it's limitations which we can talk you through if you decide to try that option.
 
Welcome to the forum @Misery70

The sweats you describe aren’t common effects of Metformin itself, so it may be something else entirely, or the triggered by rapid fluctuation of BG (though with your relatively modest HbA1c this seems less likely).

Hope you get to the bottom of it, and that your symptoms recede over the coming days. They sound pretty unpleasant and debilitating :(
 
Misery70 said:
Thank you, Nayshiftin and geodesy. I've looked up false hypos and that makes sense now. I feel better knowing that I've obviously went low carb, and taking smaller portions too quickly. This has altered my set point blood sugars. It makes sense now. Now to start planning meals, the dietician appt can't come quick enough.
I appreciate your time in answering. Thanks again.
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Have you seen the Freshwell site there is a free app too it really helps .
 
Misery70 said:
I've downloaded the app, its really good. I'm going to tell my practice nurse about it, so she can let others know. Thank you.
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Leadinglights told me about it too I just love the app . Needs a few tweaks like all things but great. if the ingredients don’t add up check the site as pdf seem better
 
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