What to do when BG low?

[SomethingElse]

Hi all,

I’ve heard it’s hard (basically impossible) to have a hypo as T2 with just being on Metformin alone. I’m taking two slow release 500mg a day.

Last night I had dinner and went to a friends house. A bottle of beer and a couple of whiskies later I walked home and my BG was 6.5 as I set off on the 15 minute brisk walk.

On getting home it was down to 3.3. I’ve seen it dip below 4 but that’s the lowest I’ve had in the two weeks I’ve used the Libre 2. I know alcohol lowers BG.

I had a handful of nuts and a babybel and it was back in the 4’s shortly after before bed.

I’m just wondering how seriously I need to treat numbers like that. I appreciate Libre 2 may not always be totally accurate - but do I need to eat something and address it or do I ignore since I can’t hypo (according to others) on metformin alone?

I’m going to a festival this summer and will be walking around a lot and having the odd drink so just want to have an idea as this will happen there I imagine.

Cheers!

 

[pawprint91]

I work with somebody who has hypos and as far as I’m aware they are T2 on metformin alone, but I guess everybody may be different?

Did you check your 3.3 with a finger prick? Sometimes Libre can overpredict (because of how it works) so you might have only been a 4 something in the first place. Did you feel odd (Shaky, weak)? These are symptoms of low blood sugar so if you didn’t have them, chances are perhaps it was the Libre. (I’ve also read that people without diabetes can drop below 4, I believe 3.5 and below is classed as a hypo).

However, if you did check with a meter and did feel off, as far as I know the advice is always to treat a hypo with fast acting carbs - perhaps you could just eat one jelly baby or have a sip of coke to get you back up and make you feel better, so as to avoid sending your levels rocketing. Other T2s will probably be more help here, but I’d suspect hypos for T2 are a bit less “dangerous” in terms of you can’t drop too much without active insulin on board, but I could be wrong.

 

[SomethingElse]

Thanks @pawprint91, interesting.

Yeah, I felt a bit weak and “off”. I’m pretty good at recognising when my BG is getting low. Sometimes I’ll go on a very fast walk and can feel I’m in the low 4’s just by my body. It makes me think the Libre 2 is somewhat accurate.

Doesn’t hurt to keep a packet of sweets around and will do so.

I had a mate who was type 1 and, unfortunately, struggled to stay on top of it. I’ve seen him hypo many times and it’s been full body shakes, totally unaware of where he is and very scary.

I suppose I’m wondering if that could happen to me and if that’s what a hypo looks like for T2s as well (those who have them).

Edit: forgot to add I don’t have a finger prick test. I have a bit of a needle and pin phobia so I’ve avoided so far!

 

[pawprint91]

Glad you are “hypo aware” and can realise when things are dropping!

Sorry to hear about your friend - hypos can be scary for those experiencing them and those around, too! Hypos can have slightly different symptoms for everybody, but as you are aware of them and seem to catch them early, I very much doubt you will be in the same position as your friend.

Have you considered setting the alarm on libre so you can “stop the drop” by eating a sweet when you are in the lows 4s, say? Apologies if you have already!

 

[SomethingElse]

I haven’t set an alarm but will look into it. How does the alarm work if you have to tap it to take the reading anyway? With it being a flash monitor I didn’t think it could automatically monitor?

 

[Lucyr]

I wouldn’t treat it unless feeling particularly unwell, and even then I wouldn’t go for sweets id have something slower like half a cereal bar or a biscuit. As the 3.3 is a libre reading you probably weren’t that low and you won’t have a dangerous hypo on only metformin, so you don’t need to be setting alarms and treating in the 4s to prevent hypos. Non diabetics go below 4 too, it’s only treated in those on certain medications because the active insulin can continue to make them drop.

 

[helli]

@Lucyr in general I agree with you.
However, I recently witnessed my partner experience a hypo due to "bonking" on a bike ride. He definitely needed to treat it with fast acting carbs quickly as he was dangerously shaky for riding a bike.
He measured his BG about 15 minutes after it happened so was starting to feel better but still "not right". At that time, his BG was 2.9. I am pretty sure he was lower than that when he got off his bike to lie down.
I am not suggesting the OP was at this level but I think we need to be aware of bonking when talking about ignoring hypos for people not on insulin.

 

[Lucyr]

@Lucyr in general I agree with you.
However, I recently witnessed my partner experience a hypo due to "bonking" on a bike ride. He definitely needed to treat it with fast acting carbs quickly as he was dangerously shaky for riding a bike.
He measured his BG about 15 minutes after it happened so was starting to feel better but still "not right". At that time, his BG was 2.9. I am pretty sure he was lower than that when he got off his bike to lie down.
I am not suggesting the OP was at this level but I think we need to be aware of bonking when talking about ignoring hypos for people not on insulin.

I did say “I wouldn’t treat it unless feeling particularly unwell”. Given OP wasn’t feeling particularly unwell and it was following alcohol, and their question is about drinking alcohol in future then slow carbs are more appropriate because the alcohol will be processed for a while yet. Being “dangerously shaky whilst riding a bike” is clearly a different situation.

 

[pawprint91]

I haven’t set an alarm but will look into it. How does the alarm work if you have to tap it to take the reading anyway? With it being a flash monitor I didn’t think it could automatically monitor?

There is a setting on the app for alarms on the side bar. The alarm goes off when you are dropping below the level you have set - others on here will be able to give you a better explanation but I think the Libre reads data as long as you do a scan every 8 hours - hence why you get a graph for the day without scanning every minute or even every hour. If your question is specifically in relation to drinking, you could just turn the alarms on when out drinking or at a festival.

@helli my non diabetic partner has also had a similar experience, (as has my also non diabetic friend). With my diabetic knowledge I would always treat these with fast acting carbs these days - it’s very odd/scary seeing non diabetics having hypos isn’t it!

 

[Robin]

I haven’t set an alarm but will look into it. How does the alarm work if you have to tap it to take the reading anyway? With it being a flash monitor I didn’t think it could automatically monitor?

It won’t display the reading on your phone continuously like a true CGM, but the Libre 2 does use a bluetooth connection to send signals to sound an alarm if you’re too low or too high (there are separate alarms for each, so you can have one set, or the other, or both). You get an alarm signal, but then you have to scan as normal in order to display the result and find out the actual figure.

 

[harbottle]

Hi all,

I’ve heard it’s hard (basically impossible) to have a hypo as T2 with just being on Metformin alone. I’m taking two slow release 500mg a day.

Last night I had dinner and went to a friends house. A bottle of beer and a couple of whiskies later I walked home and my BG was 6.5 as I set off on the 15 minute brisk walk.

On getting home it was down to 3.3. I’ve seen it dip below 4 but that’s the lowest I’ve had in the two weeks I’ve used the Libre 2. I know alcohol lowers BG.

I had a handful of nuts and a babybel and it was back in the 4’s shortly after before bed.

I’m just wondering how seriously I need to treat numbers like that. I appreciate Libre 2 may not always be totally accurate - but do I need to eat something and address it or do I ignore since I can’t hypo (according to others) on metformin alone?

I’m going to a festival this summer and will be walking around a lot and having the odd drink so just want to have an idea as this will happen there I imagine.

Cheers!

Yeah, this happens to me all the time, especially if I have a beer (Last night!) and go for a walk.
It also happens if I eat something high in carbs and go for a walk.
It usually goes back up once I sit down and relax. I don't worry about it.

Nuts and Babybel won't help, though.

 

[everydayupsanddowns]

I’m just wondering how seriously I need to treat numbers like that. I appreciate Libre 2 may not always be totally accurate - but do I need to eat something and address it or do I ignore since I can’t hypo (according to others) on metformin alone?

Sorry to hear about the low glucose symptoms you experienced @SomethingElse, i can understand why you are worried abour them happening again.

Non-Ds do drift below 4.0 from time to time, there are various sensor traces posted on the internet to confirm this.

It is unlikely (though as you can read in this thread not impossible) that you would go low enough to have a really debilitating hypo with confusion or loss of consciousness - but I don’t think I would ignore the symptoms.

I suggest carrying a small amount of fast acting but fairly unpleasant carbohydrates (eg glucose tablets) so that you could have just one or two were you to see your levels dropping, or experience and of the warning signs of impending hypoglycaemia. I find glucose tabs chalky and pretty grim to eat, so I’d be far less likely to be tempted to eat one unless I actually needed to!