T2: dropping blood sugar levels

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diatribe

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Relationship to Diabetes
Type 2
Hello everyone,

I was diagnosed about 2.5 years ago, and generally everything has gone well. Weight loss, feeling great etc, plus a better diet and more exercise. The only problems I had at the start were rapid blood sugar drops, this resulted in my doctor taking me off two tablets, so I am am using only Janumet which is a mix of metformin and something else. However, over the last day may blood sugars have started to spike and drop quite alarmingly. The lunch spike was expected, I had little choice so had a carbi lunch. This took it to 230 mg/dl (too high), then later two hours after dinner it fell to 51mg/dl (2.8 m/mol). The spike was expected, due to limited lunch options, however the drop after dinner was more worrying. Today, everything was back to a typical wake up reading of about 100mg/dl, but after eating it went to 64mg/dl, which triggered the red warning (again). The lunch contained eggs and waffles in a restaurant, I allow myself a non-diet/carb meal or two a week, so it should have raised it. In both cases the food I ate prior to the crash was quite different. I think 51 is the lowest I have ever had.

I am wondering if this is in any way related to the cold weather. When I get these drops I find carbs fast, or eat glucose tablets. That seems to help, but I would rather not stay in that situation. If it continues I may seek medical help.

As a general note, for the last two years my blood sugar levels have been pretty boring. Although on meds, they are comparable to that of a normal person. Severe drops only really occurred in the last twelve months when I started doing exercise in the gym. However, I have not been to the gym this week due to the weather conditions.
 
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Inka said:
When you talk about the red warning @diatribe are you referring to a Libre or other CGM? If so, have you confirmed the readings with fingerpricks?
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Thanks for your reply. I have a Contour Next one finger pricker, no other device. Both times (with the low readings) it flashed red. I just took two glucose tablets and about 40 minutes later my sugar level is 139. But I am more concerned that it drops again, it seems rather random right now.
 
diatribe said:
Thanks for your reply. I have a Contour Next one finger pricker, no other device. Both times (with the low readings) it flashed red. I just took two glucose tablets and about 40 minutes later my sugar level is 139. But I am more concerned that it drops again, it seems rather random right now.
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Following as I’m struggling with the same
 
Hi,
I'm just wondering if you have any other conditions that require other medications?
Long story short, I had 10 days in hospital with blood sugar drops that were quite severe, they initially suspected a tumour on my pancreas (insulinoma). My endocrinology consultant thought different and ran cortisol tests, I was initially at 525, 4 weeks later it had dropped to 300 (should be at 650).
They suspect that due to the long term high level of steroids I take for severe and brittle Ashthma, this has caused adrenal insufficiency/failure.
The consultant explained how the adrenal and petruity glands have knock on effects to insulin production.
They also suspected at one point something called reactive hypoglycaemia, which is essentially an insulin over production overload after eating cards (sometimes referred to as dumping syndrome). The way to test that is to take a reading before you eat, eat a carb heavy meal, then test 2 hours after eating.

Until my endocrinology consultant explained how different things can cause issues with blood sugars, I had absolutely no idea.
Just food for thought. I hope things improve for you and feel free to shoot with any questions you may have and I'll do my best to try and help if I can (I'm by no means an expert)
Best wishes,
Matt
 
Sorry to hear about the wobbly glucose levels you’ve been having @diatribe :(

Interesting that you mention weight loss, and starting gym visits. Have your meds been reviewed since these factors have been in place? It could be that the weight loss and exercise has increased the efficiency of your metabolism, and possibly even restored some impaired pancreatic function - so it may be that your Janumet needs adjusting.

Januvia (sitagliptin) works by increasing insulin output, so perhaps your body is now reacting to rises in blood glucose rather too enthusiastically and then dropping your levels too low after a carbier meal? (rather like the reactive hypoglycaemia @mattski mentions)

Might be worth booking an appointment with your Dr to discuss things?
 
mattski said:
Hi,
I'm just wondering if you have any other conditions that require other medications?
Long story short, I had 10 days in hospital with blood sugar drops that were quite severe, they initially suspected a tumour on my pancreas (insulinoma). My endocrinology consultant thought different and ran cortisol tests, I was initially at 525, 4 weeks later it had dropped to 300 (should be at 650).
They suspect that due to the long term high level of steroids I take for severe and brittle Ashthma, this has caused adrenal insufficiency/failure.
The consultant explained how the adrenal and petruity glands have knock on effects to insulin production.
They also suspected at one point something called reactive hypoglycaemia, which is essentially an insulin over production overload after eating cards (sometimes referred to as dumping syndrome). The way to test that is to take a reading before you eat, eat a carb heavy meal, then test 2 hours after eating.

Until my endocrinology consultant explained how different things can cause issues with blood sugars, I had absolutely no idea.
Just food for thought. I hope things improve for you and feel free to shoot with any questions you may have and I'll do my best to try and help if I can (I'm by no means an expert)
Best wishes,
Matt
Click to expand...
I have other medical conditions that I can’t just make T2 the focal point of my life. There are private conditions which I have and I have to look out for them I’m on morphine long term and the major side effect is constipation. I have to build my diet round this and to suggest Keto to me is a red flag. That’s why I left the website before as some can be very forceful and throw the baby out with the bathwater. Tablets I am on have raised my BP and I’ve a kidney result I don’t need only from the last few weeks. Nothing to do with T2 I am in remission and even double checked this morning with my Dr. As we know remission isn’t just one test over a few years.They’re talking of putting me on rimpril but I‘ve been told by anaphylaxis not to take anything ending in pril! I get my second kidney and BP test in 2 weeks. I’ve never had high BP or kidney problems. I’m trying a reduction in anti- inflammatories that are known to cause BP and kidney damage. I spoke to my doc this morning and I’ve started a lower dose and will gauge my pain And try to come off them totally in the next few days And see if it affects my test results. Fingers crossed. My dr warned me that due to age they don’t want my BG falling too low. I hope they solve your BG problems and your‘e well soon.
 
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Keto which is as little as 20g carbs per day is a very different kettle of fish to low carb which can be as much as 130g carbs per day. You can still do low carb and eat the right type of carbs that will help with the effects of the morphine or codeine type of medication.
My other half has Crohn's and never suffered constipation until he has antibiotic treatment for an unusual stump appendicitis but he is advised to keep to a low residue diet so now finds that he has to take Lactulose every day.
I'm afraid multiple conditions are all fighting against each other, treatment for one isn't good for the others.
 
I do SlimmingWorld and eat everything. I don’t measure carbs and it’s worked for me. I measure bread. One portion of whole meal / day and measure dairy. Two portions of milk or one cheese, one milk. ( to prevent bone disease) I have one whole meal bread roll every day. Potatoes and any other carb I want. Not sugar of course.I eat low fat and it all worked for me. I thought my SW consultant would have been more pleased for me that I am in remission TBH. Scottish NHS are working and recommending SW and WW. You get 12 weeks to lose 5% body weight and if you do it you get another 12 weeks. Plus SW give another week free. It’s about finding what works for us as individuals. I’m on more than lactulose, senna and a stool softner , stool softener is amazing. 5 cups of water a day with it but it’s worth it. Loads of stomach meds for ulcer and other condition. Pre cancer. BC It’s like a balancing act tbh.
 
Psi hope everyone survived last nights storm! I was awake till after 4 am
 
Leadinglights said:
Keto which is as little as 20g carbs per day is a very different kettle of fish to low carb which can be as much as 130g carbs per day. You can still do low carb and eat the right type of carbs that will help with the effects of the morphine or codeine type of medication.
My other half has Crohn's and never suffered constipation until he has antibiotic treatment for an unusual stump appendicitis but he is advised to keep to a low residue diet so now finds that he has to take Lactulose every day.
I'm afraid multiple conditions are all fighting against each other, treatment for one isn't good for the others.
Click to expand...
You really have to be on it to know what I mean. I will leave it at that ty Morphine constipation has a different treatment plan than any other constipation. Plus suppositories
 
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I'm sorry to hear that you have additional conditions that make things less straight forward. It's never a one glove fits all as everybody's situation is different and our bodies react differently to medications etc.

I'm no doctor so I find the most helpful thing I can do is share my experiences and try to be as supportive as possible. Half the battles we face are about being heard. I'm sorry to hear that you'd had previously negative experiences here, I've been very fortunate and had some really supportive and beneficial experiences on here which have massively helped improve my knowledge base and helped me to ask the right questions at medical appointments.

So I'm neither a type 1 or 2, I have steroid induced diabetes, I think the neatest classification is 3C?

So I have a host of issues that make my situation complicated, I have heart issues, sleep apnea, hypertension, spinal stenosis, bone spurs and calcified tendons at the knee cap, retinopathy in my eyes, high cholesterol and the type of Asthma I have affects 0.5% of the asthmatic population so its complex and difficult to treat.
Steroids are responsible for a large part of all my conditions but as breathing is a requirement for life, I have little choice.

Ironically, I'm waiting for my results of a synacthen test to officially diagnose the adrenal issue and the consultant has told me that the treatment is steroids every day for life.

The reason I asked about other conditions is because my diabetes has to play second fiddle to the asthma due to its severity but the treatments always impacts the diabetes.

Before the correct categorisation, (previously down as T2) the attitude towards my falling blood sugars were very dismisive , I was denied needles and testing strips, which is what prompted a response to @diatribe as when there is the potential for something else to impact and its nothing to do with lifestyle, attitudes by medical professionals often improve in my experience.

I wish you all the very best for your upcoming test results and keep my fingers crossed that you get the very best possible outcome
 
Jinty2001 said:
I do SlimmingWorld and eat everything. I don’t measure carbs and it’s worked for me. I measure bread. One portion of whole meal / day and measure dairy. Two portions of milk or one cheese, one milk. ( to prevent bone disease) I have one whole meal bread roll every day. Potatoes and any other carb I want. Not sugar of course.I eat low fat and it all worked for me. I thought my SW consultant would have been more pleased for me that I am in remission TBH. Scottish NHS are working and recommending SW and WW. You get 12 weeks to lose 5% body weight and if you do it you get another 12 weeks. Plus SW give another week free. It’s about finding what works for us as individuals. I’m on more than lactulose, senna and a stool softner , stool softener is amazing. 5 cups of water a day with it but it’s worth it. Loads of stomach meds for ulcer and other condition. Pre cancer. BC It’s like a balancing act tbh.
Click to expand...
As you say it is finding what works for you. Sounds as if you have cracked the diet re blood glucose.
 
mattski said:
I'm sorry to hear that you have additional conditions that make things less straight forward. It's never a one glove fits all as everybody's situation is different and our bodies react differently to medications etc.

I'm no doctor so I find the most helpful thing I can do is share my experiences and try to be as supportive as possible. Half the battles we face are about being heard. I'm sorry to hear that you'd had previously negative experiences here, I've been very fortunate and had some really supportive and beneficial experiences on here which have massively helped improve my knowledge base and helped me to ask the right questions at medical appointments.

So I'm neither a type 1 or 2, I have steroid induced diabetes, I think the neatest classification is 3C?

So I have a host of issues that make my situation complicated, I have heart issues, sleep apnea, hypertension, spinal stenosis, bone spurs and calcified tendons at the knee cap, retinopathy in my eyes, high cholesterol and the type of Asthma I have affects 0.5% of the asthmatic population so its complex and difficult to treat.
Steroids are responsible for a large part of all my conditions but as breathing is a requirement for life, I have little choice.

Ironically, I'm waiting for my results of a synacthen test to officially diagnose the adrenal issue and the consultant has told me that the treatment is steroids every day for life.

The reason I asked about other conditions is because my diabetes has to play second fiddle to the asthma due to its severity but the treatments always impacts the diabetes.

Before the correct categorisation, (previously down as T2) the attitude towards my falling blood sugars were very dismisive , I was denied needles and testing strips, which is what prompted a response to @diatribe as when there is the potential for something else to impact and its nothing to do with lifestyle, attitudes by medical professionals often improve in my experience.

I wish you all the very best for your upcoming test results and keep my fingers crossed that you get the very best possible outcome
Click to expand...
Thank you so much for your good wishes . Yes you have it very difficult. I heard that doctors have to weigh up if the treatments side effects are better than the condition they’re treating. I am sorry you’re trapped into a steroid life and that it’s caused your diabetes. I had loads of steroids when I was younger due to asthma that I never knew I had and smoking. I stopped smoking and my steroid use, other than daily symbocort is almost non existent. Thank goodness after hearing your experience. I have spinal/ mobility problems also. I feel trapped in a way into morphine as the condition for getting the treatment from pain management was that I agreed to become addicted. So that I don’t sue them. lol Not in a give me it kind of way but to take the treatment and you do become addicted to it. As long as I get my scripts and there isn’t a shortage everything is fine. No one knows I am on it and it gives me a near normal life. I can walk bent over, but still walking. I have sleep apnoea and it’s in news this morning how it affects people. I don’t feel the machine is the cure all that they’re saying. Often I am disturbed by the machine during the night with the mask slipping.
as for my experience. I am glad I went my own way. I read the menus and the advice on this site and it’s helped me. There is no diabetic diet they said. It’s mostly for me keeping the fat away from my pancreas to let it work. I had infusions of Allendronic acid as I had early osteoporosis,49, due in some part to steroid use. the Allendronic acid infusions were in testing stage and I’ve been put back to osteopena stage. I grew back 14% of bone density which is a lot for a young diagnosis. I am delighted with it and it’s been 12 years now. Another remission.
it’s a balancing act to make priorities for what we need and I do need a balanced diet. Cabbage is my staple food and it’s a good job I like it. Just to add I had rotator cuff surgery to repair my soft tissues in my shoulders 4 years ago. It needs done again but surgeon is leaving it as long as he can this time. My age and his workload probably.
 
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Leadinglights said:
As you say it is finding what works for you. Sounds as if you have cracked the diet re blood glucose.
Click to expand...
Thank you and I hope you find a way to get your BG regulated. I went crazy over the last few months and thought I’d blown it and testing in January I was dreading the result. I even checked with my doc this morning.
“Am I in remission?”
”yes! “
wow!
slimming world has dealt with diabetics for years.
it’s a great way of losing weight and that got my pancreas up and running again. I had chocolates from everywhere over Christmas and ended up buying sweet stuff as well. Then worried after doing the wrong thing , as we do.lol
Best wishes !
 
Just a thought! Have you all tried slow release carbs. Porridge, beans and peanuts and starchy potatoes
 
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Can relate, have over 30 complex conditions including 8 gut/bowel conditions and due to past bariatric surgery suffer with dumping syndrome if I mess up my carb and sugar levels. Glad you have access to an endocrinologist and have found us .
 
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