Type 2 hypo

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BeadieJay

BeadieJay

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Relationship to Diabetes
Type 2
Hi, I'm new here, though have had Type 2 since June 2004. For ages I didn't really control my diabetes, the pills seemed to keep my numbers steady so I stopped watching what I ate, but have finally changed my ways and getting things back under control.

I'm currently taking Metformin, Sitagliptin and Gliclazide, but am hoping to come off Sitagliptin and Gliclazide at the very least. I'm trying to control things by diet and have lost about a stone (getting weighed again tomorrow, so not totally sure) since July, averaging a loss of about 2lb per week. My HbA1c in March was 7.7% and last week it was down to 6.7%, so am absolutely thrilled at that 🙂

Because I'm trying to lose weight as well as controlling the diabetes, I'm struggling with finding the right foods to do both things - I don't want to go on a diet, I want to change my eating habits and lifestyle, so that it will be easy to keep to for the rest of my life.

A few weeks ago I went to London and didn't eat between 1:30pm when I had a sandwich, and 10:30 pm when I had a snack (biscuit) - all that time in between I didn't feel hungry, and certainly didn't feel like I was going hypo.

So, today I woke up not feeling very well and had a slight fever. I had some dry toast and coffee for breakfast at about 8:00 and went back to bed at 10:15. I woke again 2 hours later feeling absolutely awful - sweating buckets, shaky, very definitely hypo feeling, so I took my blood and was shocked to see that it was 2.7 - I've never been that low ever - I usually consider myself going hypo if I go below 5 🙄 as that's usually when I feel the symptoms. I think the lowest I've been before today was a 3.8

My GP says that he only considers it to be a hypo if I pass out 😱 Well I consider 2.7 to definitely be a hypo, but my question is - and I'm sorry I've taken so long to get to the point - I didn't think that Type 2's actually had hypos, I didn't realise that I'd ever be able to get quite that low, so what should I have done differently - I could barely eat my breakfast, and definitely couldn't have eaten anything else before going back to bed. I had some dextrose tablets after taking my bsg and managed to eat a sandwich, but it was hard work eating....although am now feeling more or less back to normal.

This hypo really scared me, it was so unexpected especially as I've gone so long without eating before now without any problems. I am seeing my GP on Friday, but would appreciate some comments from other Type 2s.

Thank you 🙂
 
Hi there beanie and welcome, i think that if your on certain medication as a type 2 you can suffer hypos especially gliclazide, your doctor sounds very strange saying he does not consider it a hypo until you pass out how scary😱.Anything below 4.0 is a hypo.Hope the appoint met goes ok on Friday x
 
Steff is correct, anythign below 4 is a hypo, however you feel. It should be treated with fast acting glucose- like glucose tablets and folllowed by a carb snack, so sounds like you treated perfectly.
The gliclazide is the most likely culprit for the hypo, so thats the med that might need reviewing. good luck at the appointment
 
Hi BeadieJay, welcome to the forum 🙂 Your doctor is talking nonesense - a hypo is anything below 4! Well, there is some debate about whether 3.5-4.0 is 'low' and below 3.5 is hypo, since that is below the level a non-diabetic person would be unlikely to drop. It sounds like the changes in your diet and lifestyle (and on this occasion an almost total lack of food!) means that your medication needs are changing. Your doctor should recognise this and arrange to reduce your doses appropriately, so don't be fobbed off if you find that the lows are happening more frequently. The Gliglazide can cause hypos and possibly the sitagliptin too, since I believe they work by stimulating production of insulin. People often have to reduce or be taken off these when their levels start falling too low due to other factors like weight loss and improved diet.
 
My Dad was type 2 and he did have hypos - although nothing lower than 3 if I remember correctly. If he woke up late he would get them sometimes so my Mum started giving him a carton of fruit juice to sip on during the night.(not sure if thats a good idea or not - they had NO control of his D)
And of course you dont have to pass out to be hypo - some doctors are a waste of space 😡
 
Why on earth do they have you on Sitagliptin AND Gliclazide! No wonder you're getting hypos. they both work by making your body produce more insulin and are known to cause hypos, especially the Gliclazide. Metformin is supposed to help your body make better use of the insulin it already produces and is much less likely to be responsible for the hypos. As the others have said, the optimum readings we all hope to see are between 4 and 7, and not more than 10 after meals or exercise. Anything below 4 I'm told is a hypo and below 3.5 is a serious hypo. If you're consistently getting below that level you need to keep nagging your doctor to look at your medications again. Keep us posted on your progress and I hope you get it all sorted out soon.
 
A very big welcome to the forum!

I completely agree with what everyone else has said.

About losing weight. I decided to set my diet to lose around 1lb per week (I'm currently a little below that at 0.9lb/week, but am quite happy with how it's going so far). I decided on that level of weight loss for the same reason as you (I'm guessing) so that when the target is reached, I won't have to change my lifestyle too much. In theory, the weight should then stay off without too much difficulty.

Andy 🙂
 
Your Dr really needs to review your meds. Gliclazide can cause hypos (it says so on the Patient Information Leaflet) then the Sitagliptin is trying to boost the insulin production on the pancreas - so the 2 together in the wrong quantities could cause a severe hypo.

If your Dr seriously believes you haven't had a hypo unless you pass out then I think you should change Drs. As others have said anything below 4 is a hypo and I can't imagine anyone thinking 2.7 isn't. Maybe there is another Dr at the practice or you could ask for a referral to a community Diabetes Specialist Nurse who could help you fine tune the meds.
 
Thank you all so much for your replies, I'm so glad I posted on here 🙂 Thank you especially for the info about hypos. I feel like I'm starting over again in terms of learning about diabetes, even tho I've had it for 6 years, and I definitely appreciate the support you've all shown me so far.

AlisonM said:
Why on earth do they have you on Sitagliptin AND Gliclazide!
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There was a very good reason for being on both those meds and the Metformin - because until very recently I was totally out of control with my diabetes, my HbA1cs were getting higher and higher and I wanted to eat the same things I always had, so my doctor put me on these meds in an effort to bring my HbA1cs down....which they did. And then one day I realised how stupid I was being and that I didn't want to be B.A.D. (an acronym I use to remind myself everytime I'm tempted to eat a Mars Bar that I don't want to be a Blind, Amputee on Dialysis!).

To be fair to my doctor, he's been a huge help, in fact, more so than my previous GP in the same surgery who just prescribed those drugs rather than telling me bluntly that I was going to kill myself if I didn't do something fairly soon - but maybe he would have said that "after" I made the realisation for myself, maybe I just wouldn't have listened to him because I didn't want to hear it :(

I think my GP will definitely take me off one of the meds when I see him on Friday - this is what I've been working towards; it was just such a shock to have a hypo when I've never gone so low before in similar circumstances, but then my blood sugar's haven't been so well controlled in such a long time and I stupidly didn't think about the consequences - I won't make that mistake again, that hypo was seriously terrifying. 😱

Andy HB said:
About losing weight. I decided to set my diet to lose around 1lb per week (I'm currently a little below that at 0.9lb/week, but am quite happy with how it's going so far). I decided on that level of weight loss for the same reason as you (I'm guessing) so that when the target is reached, I won't have to change my lifestyle too much. In theory, the weight should then stay off without too much difficulty.
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That's exactly what I'm trying to achieve. I'm eating smaller portions, and although I'm trying to get my bs levels down, I still allow myself the occasional treat. I figured that if I went on a specific diet, that I'd just put all the weight back on when I stopped dieting, and I really don't want to do that!! Good luck with your continued weight loss 🙂

Thank you again for all the replies - I'll let you know how I get on on Friday.
 
AlisonM said:
Why on earth do they have you on Sitagliptin AND Gliclazide! No wonder you're getting hypos. .
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It's not a problem to be on both these meds if you need them. Sitagliptin is less likely to cause hypos because is produces insulin in the presence of glucose after eating.

Good for you if you've made the changes so you don't need all the meds.
 
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