Hypo levels for the first time

[viviennem]

Advice and comments required, please - for the first time ever my bg levels have gone below 4!

Background: diagnosed Type 2 April 2010, low carb plus (since December) 3 x 500g metformin with meals. Last official (ie, at doctor) fasting bg 6, HbA1c 5.2 - December 16th.

Today's testing and meals:

08:30 7.2 fasting (I'm usually a bit high first thing). Then coffee with semi-skimmed + 1 Splenda
10:30 7.1 pre-breakfast - about 40gm Lizi's Granola - just to see if I could tolerate it.
11:30 coffee as above
12:30 5.5 2 hours post-breakfast
14:30 lunch - omelette (2 eggs) with 2 good-sized mushrooms, cooked in butter
16:30 3.8 2 hours post-lunch. Ate small sweet apple to see if that would help
17:30 3.6 Ate quarter teaspoon of honey + 4 oatcakes with butter
18:30 6.2 That seems to have worked, but now I feel a bit chilled and slightly shaky

I've done no excessive exercise, just normal moving about, driving, a little shopping.

I've taken 2 metformin so far, with the meals, and drunk about a litre of water over the day.

Normally I would have had the omelette for breakfast, and a large-ish salad of lettuce, toms, radish, pepper with either tuna or chicken, and mayonnaise, for lunch. No cereal, and no carbs other than what's in the salad. My lowest-ever level before this was 4.1 after a low-carb supper, but I had been drinking. Now, I've had no alcohol since January 2nd.

Can anyone advise me why my levels went so low? Could it be that I haven't eaten enough? Or was the cereal a quick-release of glucose that didn't last, whereas protein first thing would have stayed with me longer? If so, why didn't the omelette help?

Did I do the right thing in response, and if not, what should I have done?

Supper is going to be beef casserole with mushrooms, leeks and red pepper, and some grated cheese. And my 3rd metformin. I'll test before it, and 2 hours after. Should I have a small carb snack (more oatcakes?) before bed, just in case?

I don't mind admitting it has quite shaken me up. I didn't feel at all hypo when I tested, and I can see no reason why it should have happened. All advice will be gratefully received - thank heaven for the forum!

Vivienne

 

[cugila]

You were 5.5 mmol/l at 1230 hrs.
At 2.30 pm you had a virtually nil carbs Lunch.
At 4.30 pm you tested 3.8 mmol/l.

When did you do the shopping and driving, what times ?

All of that is effectively exercise and stress which will have an effect on your Bg levels.

The usual treatment if hypo is to take some fast acting carbs such as 2 - 3 Glucotabs which should increase the levels within ten to fifteen minutes. The Apple would not have been fast acting enough.
You repeat that treatment until such time that your levels have gone back to near normal then have a small carby snack to stabilise the levels.

There is more information in the Greetings and Introduction section :

viewtopic.php?f=20&t=18529#p168549

 

[viviennem]

Thanks for getting back to me, Ken.

The shopping and driving were from 10:55 - I drove 8 miles to my usual veg shop. Went from there to visit a friend where I had my second coffee. Drove home, about 9 miles, and got back about 13:30. This is my usual routine - country living has its drawbacks! - and wasn't even particularly stressful, as there were no idiots (very few cars in fact) on the road - except myself, of course! :lol: Not much exercise in it either - just a couple of very short walks from the car.

I routinely drive as much as 200 miles in a day - or I did, before last April.

I didn't go much longer than usual between breakfast and lunch - just over 3.5 hours. I time my '2 hours after' test from when I finish eating.

I've no glucose tabs in at the moment - will get some as a matter of urgency on Monday. Honey is all I have in at the moment, though there might be some 80% proof chocolate lurking somewhere. Presumably I should have had the honey immediately, rather than the apple? Were the oatcakes okay as a carb snack? I could easily have had a couple with the omelette, which would have given me 10gms of carb with that meal.

I'll have a look at the link now.

Thanks again

V

 

[cugila]

I have no doubt that the reason you dropped was because of the activity you mention, Bg levels will fluctuate and if the body has little or no fuel they will drop......I have the same problem at times and have to test more often if doing any activity, driving, shopping although you may not think it are exercise and will have an effect on your levels as you have found.

Follow the treatment for a hypo in the link, it is the standard treatment and should work. Chocolate although nice is not fast acting, so save that for later. Try to just have a snack and remember to test levels before you drive.....that is very important.

Honey will work but is not the easiest thing to carry around whereas Glucose Tabs or Dextrose are, they are about 70p per pack. Where I am anyway.

 

[viviennem]

Thanks again. I'm feeling very reassured. I'll get some glucose tabs - the link says a tablespoonful of honey :shock: and I don't think I could get that much down!

Last time I took Dextrose was before A levels in 1967 - what goes around, comes around, as they say.

The good thing to come out of this is that I realise how much I'm going to have to watch my bg as my legs get stronger and I start doing more exercise - best to learn it in my own armchair than half-way up a fellside. Not that that will happen in a hurry!

V

 

[clearviews]

Perhaps you could talk to your doctor about reducing your metformin?
Well done on getting your bg down by the way.

 

[viviennem]

Thanks for that, Clearviews. You might be right about the metformin, particularly as I'm so low carb - aiming for about the same as you, and never more than 60g per day. I've been wondering about it myself - my system seems to have settled down, so I'm not chained to the bathroom any more, but when I need to go I have to go - which is not good if I'm out of the house!