Low Carb diet low numbers in the morning

[BobEssex]

Hi Peeps. Am 61, type 2 taking 3x500 Metformin, 5mg Linagliptin, statins plus Adalats (supports my Reynauds disease). My Metformin was increased from 2 to 3 tabs in the spring this year as my HbA1c (normally in the region of 7.2 to 7.5) increased to over 8.5.

Rather than increase to meds further, I’ve revisited my food plan and have reduced my carbs significantly. I was already careful so didn’t eat a huge amount to start with. My next blood test is not due for another month.

Numbers during the day are 4.5 to 6.7 – and very close 2 hours after meals so on the surface looks promising. The issue is low numbers in the morning. Have had 3.3 and 1.9 – taken about 5 to 6 a.m. over the last week.

So my quandary. Do I increase the carbs or reduce my evening meds (2xMeformin, Liniglipton, statins). Ideally the later as that’s what I’m trying to achieve however, I don’t want to screw my next HbA1c. Seems ironic that I’m adding carbs to fit the meds.

Anybody else experienced this on a low carb food plan?

 

[Robkww]

Seems like your new diet has had an effect. Suggest you relay this information to your medical team for advice on any interim change of medication.

 

[BobEssex]

Seems like your new diet has had an effect. Suggest you relay this information to your medical team for advice on any interim change of medication.

Diabetic nurse on medical leave. My GP has just retired. My new GP (lovely lady) looked very vague when I discussed this in the first place. Was rather hoping someone here may have had similar issues and did get advice. Cheers

 

[Bluetit1802]

Hi Peeps. Am 61, type 2 taking 3x500 Metformin, 5mg Linagliptin, statins plus Adalats (supports my Reynauds disease). My Metformin was increased from 2 to 3 tabs in the spring this year as my HbA1c (normally in the region of 7.2 to 7.5) increased to over 8.5.

Rather than increase to meds further, I’ve revisited my food plan and have reduced my carbs significantly. I was already careful so didn’t eat a huge amount to start with. My next blood test is not due for another month.

Numbers during the day are 4.5 to 6.7 – and very close 2 hours after meals so on the surface looks promising. The issue is low numbers in the morning. Have had 3.3 and 1.9 – taken about 5 to 6 a.m. over the last week.

So my quandary. Do I increase the carbs or reduce my evening meds (2xMeformin, Liniglipton, statins). Ideally the later as that’s what I’m trying to achieve however, I don’t want to screw my next HbA1c. Seems ironic that I’m adding carbs to fit the meds.

Anybody else experienced this on a low carb food plan?

Linagliptin works by encouraging the pancreas to produce extra insulin, and it also reduces the amount of glucagon produced in the pancreas. Glucogen triggers the liver to produce glucose in times of fasting overnight, between meals etc. (Liver dump) When someone has normal glucose levels, as you seem to have from what you say, you actually need the liver to produce this glucose to stop you going too low into hypo territory overnight and between meals. This situation is made worse because the Linagliptin is also making the pancreas produce extra insulin - which again can make your levels to low. It seems like a double whammy to me.. Your 1.9 was very low. I hope you had a quick remedy to hand.

If you change anything, it needs to be the Linagliptin, but you must speak to a doctor about this - we can't advise you either way. Make an appointment quickly, hopefully with a GP that understands how Linaglitin works.

I do not agree with adding carbs to fit the medicine.

https://patient.info/medicine/linagliptin-tablets-for-diabetes-trajenta (about a third of the way down)

 

[BobEssex]

Linagliptin works by encouraging the pancreas to produce extra insulin, and it also reduces the amount of glucagon produced in the pancreas. Glucogen triggers the liver to produce glucose in times of fasting overnight, between meals etc. (Liver dump) When someone has normal glucose levels, as you seem to have from what you say, you actually need the liver to produce this glucose to stop you going too low into hypo territory overnight and between meals. This situation is made worse because the Linagliptin is also making the pancreas produce extra insulin - which again can make your levels to low. It seems like a double whammy to me.. Your 1.9 was very low. I hope you had a quick remedy to hand.

If you change anything, it needs to be the Linagliptin, but you must speak to a doctor about this - we can't advise you either way. Make an appointment quickly, hopefully with a GP that understands how Linaglitin works.

I do not agree with adding carbs to fit the medicine.

https://patient.info/medicine/linagliptin-tablets-for-diabetes-trajenta (about a third of the way down)

Many thanks for your input. Very educational, Did not appreciate exactly how the Linagliptin effects both liver and pancreas.

Curiously, have had a call from a health expert today.
Eat a sandwich before bedtime (I havnt eaten a sandwich for years, so am not starting now)
Dont worry about the 1.9. Really!
Keep taking the meds until your next test is due - 4 weeks - agreed, sort of.

May well go for a blood test slightly earlier methinks. In the meantime will add a slice of toast in the evening.
My morning double espresso fixed the 1.9 and gave me chance to cook some rice.

Thanks for your time and input. Will post my bloods next month. Am so curious.
Cheers

 

[Bluetit1802]

Many thanks for your input. Very educational, Did not appreciate exactly how the Linagliptin effects both liver and pancreas.

Curiously, have had a call from a health expert today.
Eat a sandwich before bedtime (I havnt eaten a sandwich for years, so am not starting now)
Dont worry about the 1.9. Really!
Keep taking the meds until your next test is due - 4 weeks - agreed, sort of.

May well go for a blood test slightly earlier methinks. In the meantime will add a slice of toast in the evening.
My morning double espresso fixed the 1.9 and gave me chance to cook some rice.

Thanks for your time and input. Will post my bloods next month. Am so curious.
Cheers

Good idea to have the toast. If I were you I would keep something at the side of your bed in case you do hypo during the night (hopefully you won't). I'm not an expert on these things, but even a biscuit might help, or a jelly baby. Just keep testing, especially before you drive (if you do drive).

Keep posting, and asking questions, and we would love to know how you go on.

 

[BobEssex]

Good idea to have the toast. If I were you I would keep something at the side of your bed in case you do hypo during the night (hopefully you won't). I'm not an expert on these things, but even a biscuit might help, or a jelly baby. Just keep testing, especially before you drive (if you do drive).

Keep posting, and asking questions, and we would love to know how you go on.

Am off to buy some biscuits. Cheers

 

[ickihun]

This is the only time I like an hypo, when it tells me I can reduce my insulin units.
An achievement worth big praise to you.
Well done!

 

[Lamont D]

Many thanks for your input. Very educational, Did not appreciate exactly how the Linagliptin effects both liver and pancreas.

Curiously, have had a call from a health expert today.
Eat a sandwich before bedtime (I havnt eaten a sandwich for years, so am not starting now)
Dont worry about the 1.9. Really!
Keep taking the meds until your next test is due - 4 weeks - agreed, sort of.

May well go for a blood test slightly earlier methinks. In the meantime will add a slice of toast in the evening.
My morning double espresso fixed the 1.9 and gave me chance to cook some rice.

Thanks for your time and input. Will post my bloods next month. Am so curious.
Cheers

As usual @Bluetit1802 is right, it is the sitagliptin that is causing the low blood glucose levels. I would advise you phone your surgery and tell them that you are getting hypos all the time and you have current low readings.
They should respond by advising you to either lower your dosage or stop altogether.

The drug works to kick your pancreas to your first insulin response. And help rid you of the glucose from your meal. Which helps with insulin resistance and lowers your hba1c levels.

You should not have to keep taking action for hypos if you are T2.

Best wishes

 

[Bluetit1802]

Am off to buy some biscuits. Cheers

I said one, not a whole packet!!!!

 

[Lamont D]

I said one, not a whole packet!!!!

You're just not, no fun these days!