Possible hypo

[optimistic_ginger]

Hi, I wonder if I can pick the collective brain...

I am on exenatide and metformin. I started on exenatide last summer and love it, I took it less often over Christmas and new year because it makes me feel so full and I wanted to enjoy seasonal treats, then the GP surgery messed up in early January so I didn't get my new pen when I needed it so had to go a couple of days without any at all. Anyway, I'm back on it now and apart from having to slog through the initial side effects again it's fine. I think I've lost about a stone in weight since I started taking it.

My diet has been a bit up and down in the last few weeks, as I've struggled to drop the sweets and chocolates and deal with a stressful time (starting a new job next week after nearly a year of unemployment and illness), so have my BMs.

I think I had a hypo today, my BM was 11.4 out of bed, I don't know why, I hardly ate anything yesterday and nothing that I shouldn't have, then I had my injection and a bowl of fruity porridge (not ideal I know), then about half an hour later I got a nasty headache and felt dreadful, so I lay down and had a rest. 2 hours post breakfast my BM was 4.7, rising to 6.6 about 45 minutes later and then 11.7 after a light lunch of a goats cheese bagel and a small pile of crisps. My face felt weird even when my BM was within normal and I still have a headache and don't quite feel myself. I did drop my BM to 3.8 a couple of weeks ago, and felt ill with it, but prior to Christmas I'd had no hypos at all (I know 3.8 isn't officially a hypo, and I'm just guessing that I had one today, but they make me feel ill). According to the literature exenatide without a sulphonylurea shouldn't cause hypos.

I don't really know what's going on, my BMs are so erratic, I don't know why I'm getting hypos all of a sudden. Could it be related to weight loss? If my BMs weren't regularly still in double figures I would think that my control had improved due to my weight loss and I was overmedicated, but that doesn't appear to be the case.

Have I been feeling grotty all day because of a hypo? Is the fact that my BM shot up so fast a sign that I was hypo? Is that how it works?

(Sorry if this is TMI, but I just had a period for the first time in over 3 years (I have the mirena coil in), could that be related?)

I'm confused and upset, I like the exenatide, but now I'm scared, of hypos and also of having to stop taking it... Any experience or helpful suggestions would be so very welcome! Thanks guys.

 

[pavlovsdog]

Hi, I wonder if I can pick the collective brain...

I am on exenatide and metformin. I started on exenatide last summer and love it, I took it less often over Christmas and new year because it makes me feel so full and I wanted to enjoy seasonal treats, then the GP surgery messed up in early January so I didn't get my new pen when I needed it so had to go a couple of days without any at all. Anyway, I'm back on it now and apart from having to slog through the initial side effects again it's fine. I think I've lost about a stone in weight since I started taking it.

My diet has been a bit up and down in the last few weeks, as I've struggled to drop the sweets and chocolates and deal with a stressful time (starting a new job next week after nearly a year of unemployment and illness), so have my BMs.

I think I had a hypo today, my BM was 11.4 out of bed, I don't know why, I hardly ate anything yesterday and nothing that I shouldn't have, then I had my injection and a bowl of fruity porridge (not ideal I know), then about half an hour later I got a nasty headache and felt dreadful, so I lay down and had a rest. 2 hours post breakfast my BM was 4.7, rising to 6.6 about 45 minutes later and then 11.7 after a light lunch of a goats cheese bagel and a small pile of crisps. My face felt weird even when my BM was within normal and I still have a headache and don't quite feel myself. I did drop my BM to 3.8 a couple of weeks ago, and felt ill with it, but prior to Christmas I'd had no hypos at all (I know 3.8 isn't officially a hypo, and I'm just guessing that I had one today, but they make me feel ill). According to the literature exenatide without a sulphonylurea shouldn't cause hypos.

I don't really know what's going on, my BMs are so erratic, I don't know why I'm getting hypos all of a sudden. Could it be related to weight loss? If my BMs weren't regularly still in double figures I would think that my control had improved due to my weight loss and I was overmedicated, but that doesn't appear to be the case.

Have I been feeling grotty all day because of a hypo? Is the fact that my BM shot up so fast a sign that I was hypo? Is that how it works?

(Sorry if this is TMI, but I just had a period for the first time in over 3 years (I have the mirena coil in), could that be related?)

I'm confused and upset, I like the exenatide, but now I'm scared, of hypos and also of having to stop taking it... Any experience or helpful suggestions would be so very welcome! Thanks guys.

Hi, I'm still learning about all this myself, so I'm no expert but I'm sure others will be along with suggestions. I don't know what Exenatide is I'm afraid, so I can't comment on that. I have been on Metformin in the past, and it is possible to have hypos with it, despite what HPCs say.

A number of things stick out for me though:
It sound like you are not eating enough or regularly, it's really important to get into a good routine with your food intake. Also, are you drinking enough fluids? You should be drinking 2-3 litres a day.
It might be an idea if you get these symptoms again, to take your Bg to check if you are having a hypo - headaches and feeling unwell are common symptoms. If you are then you need to eat
Your weight loss could impact on medication, as the dosage might need adjusting, so you should check this out with your GP or DSN
You could have had a 'false hypo' so it might be worth reading up about this, and also 'dawn phenomenon'.
I find I become unwell when my BG falls into the low 4's, everyone is a bit different, so it's important to get to know your own reactions and warning signs
You might also want to read a bit more about different diet options, there's loads of info on this forum, I have gone low carb high fat, which has had a massive effect on my Bg's.
I also had the Mirena coil several years ago, and it made me ill, so it might be worth having a chat with your HCP about that too.

Hope this helps, I apologise if I've repeated stuff you already know! Keep in touch with the forum and have a good look round, there's loads of useful information on many of the things you're experiencing. Good luck, and let us know how you get on.

 

[donnellysdogs]

Anything under 4 is classified as being on the floor. I.e hypo. I know nothing about exenatide though.

However you do seem to be getting some large swings in your bg levels and this is not particularly good...

Trying to bump up so others may be able to help...

 

[pavlovsdog]

Hope others see this and contribute

 

[optimistic_ginger]

Thanks guys, my bms have gone crazy today! Exenatide might be better known as byetta, the twice daily injection which is basically sitagliptin but better.
I had my first meal at lunch time, a thick tuna sandwich, lots of tuna, lots of mayo, one slice of wholemeal bread and a handful of crisps. I took my injection a few minutes before I ate, forgot to check my bm before. Then this happened:
30 min after eating 5.7
1 hr after eating 3.7
1hr 15 min after eating 6.2
1 hr 17 min after eating 6.9

Looks like maybe I'm getting precipitous drops shortly after eating. That's going to make my sugars erratic isn't it? I need to see my gp I think...

 

[pavlovsdog]

Thanks guys, my bms have gone crazy today! Exenatide might be better known as byetta, the twice daily injection which is basically sitagliptin but better.
I had my first meal at lunch time, a thick tuna sandwich, lots of tuna, lots of mayo, one slice of wholemeal bread and a handful of crisps. I took my injection a few minutes before I ate, forgot to check my bm before. Then this happened:
30 min after eating 5.7
1 hr after eating 3.7
1hr 15 min after eating 6.2
1 hr 17 min after eating 6.9

Looks like maybe I'm getting precipitous drops shortly after eating. That's going to make my sugars erratic isn't it? I need to see my gp I think...

Hi,
I think you should also try to eat breakfast as it's probably not helping if you wait til lunchtime. I'm only making an educated guess, but I wonder if your bg's were on the low side immediately after eating because you hadn't eaten til then and also had your injection which would lower your bg quickly? They usually suggest testing just two hours after eating and your last test shows a raise in your bg within the normal range, though it might have been a bit higher after 2 hours. I would probably also ditch the crisps, as they are very carb laden which would raise your bg on the higher side, perhaps replace it with some nuts or berries, or sliced raw veggies (not root veg though!). Defo see your GP anyway, just to be sure. I'm assuming you follow the recommended dietary approach of the 'healthy plate', If you haven't been referred to a dietician it might be worth asking to have a chat with one about you diet too

 

[pavlovsdog]

PS: was the tuna tinned? If so, and you're eating this as part of a healthy diet, you don't get the same benefits as fresh tuna due to the canning process which virtually destroys all the goodness of the fish :halo:

 

[cyclist]

I'm reading bagel, sandwich and crisps and it reads like your BG will be all over the place

How long after waking did you test your fasting?
The number seems high for a morning reading if you were good the day before