Scared of carbs

Bewildered

Well-Known Member
Messages
128
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I have been trying to low carb for a while now. I was diagnosed in January with type 2, have lost 4 stone but still have a bmi of 27.
I have generally improved my fasting blood glucose to below 7, and my last hba1c was 'normal', I take metformin 2g.
My worry is that I have regular hypos; 3.3, 3.8, and often I catch at a 4 / 4.1.
I have eggs for breakfast, just recently added one ryvita, salad and protein for lunch, veg and protein at dinner. I have started to add a small portion of potato at dinner. I have also tried rice (after 2 hrs my bg was under 7). Sometimes I have a homemade soup and another ryvita.
So my carbs are low and mostly in veg.
I know I need to do something differently to prevent the hypos but I am now scared of carbs!!!!
Should I eat more regularly? Should I add more carbs? Do I start to cut down the metformin?
On the plus side, having a hypo has meant I get to eat naughty... (Read with sarcasm )
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
When you say you get hypos, what do you mean?

Do you get the hypo symptoms (these vary between people, but in me they include reduced brain function, shaking, no concentration or decision making, wobbly feelings, white face and ravening hunger)
or do you mean that your meter is reading in the 3s?

The reason I ask is that non-diabetics (with normal HbA1cs, and normal fasting readings) often have blood glucose in the 3s. In such a normal person their own body will regulate blood glucose to maintain it at a level above hypo, and symptom free. The reason 3s are considered to be hypos for diabetics is because type 1 diabetics and type 2s on insulin or heavy-hitting drugs like gliclazide can lower the bg to hypo levels in ways that the body cannot compensate for.

Metformin is considered to 'not cause hypos', although I have never seen any evidence that it prevents hypos. You may want to discuss with your nurse/doc coming off the drug, since you don't seem to need it any more (I am firmly against unnecessary medication, but not all health care professionals seem to agree with me ;) ) Or reducing the dose, at least. Your blood glucose seems excellently under control!

If metformin is working on your body in the usual way, it will be reducing your blood glucose by about 1.5 mmol/l (at a 2mg dose), probably not any more. So you may find your readings rise a little if you stop it. On the other hand, the body has a number of excellent self regulating systems, and it may already be compensating for that - in which case there is no point at all in you continuing with a drug that your body is over-ruling.
 
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Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
When you say you get hypos, what do you mean?

Do you get the hypo symptoms (these vary between people, but in me they include reduced brain function, shaking, no concentration or decision making, wobbly feelings, white face and ravening hunger)
or do you mean that your meter is reading in the 3s?

The reason I ask is that non-diabetics (with normal HbA1cs, and normal fasting readings) often have blood glucose in the 3s. In such a normal person their own body will regulate blood glucose to maintain it at a level above hypo, and symptom free. The reason 3s are considered to be hypos for diabetics is because type 1 diabetics and type 2s on insulin or heavy-hitting drugs like gliclazide can lower the bg to hypo levels in ways that the body cannot compensate for.

Metformin is considered to 'not cause hypos', although I have never seen any evidence that it prevents hypos. You may want to discuss with your nurse/doc coming off the drug, since you don't seem to need it any more (I am firmly against unnecessary medication, but not all health care professionals seem to agree with me ;) ) Or reducing the dose, at least. Your blood glucose seems excellently under control!

If metformin is working on your body in the usual way, it will be reducing your blood glucose by about 1.5 mmol/l (at a 2mg dose), probably not any more. So you may find your readings rise a little if you stop it. On the other hand, the body has a number of excellent self regulating systems, and it may already be compensating for that - in which case there is no point at all in you continuing with a drug that your body is over-ruling.
 

Chook

Expert
Messages
5,095
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
People who think they know everything.
I find I am less likely to get hypo symptoms if I can keep my carbs down to under 20-25 spread out over the day. I worked this out when I was regularly fasting for 18 to 24 hours at a time, twice a week and never had a hypo whereas on the other days when I was eating I was regularly going very low but only after meals that had more than 8g of carbs in. But we are all different.

I am on Metformin and I have definitely had hypos. Actually it was embarrassing. I have to tell my employer when my medication changes and when I was put on Metformin I proudly passed on what the DN nurse had told me that Metformin would prevent hypos. I was then moved to a job where I was working 12 hour nights alone in a residental house with five LD individuals. About three weeks in to the job I regularly started having mild hypo symptoms (at about 4.2 to 4.4) and one night it dipped lower and I hypoed at 3.7. That was when I just kind of gave up and started eating all kinds of unsuitable stuff to ensure my bg stayed high.
 
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Bewildered

Well-Known Member
Messages
128
Type of diabetes
Type 1
Treatment type
Insulin

Hi, thank you. I get the sensations of a hypo as well as the meter reading, I get shaky, feel sick, bit difficult to concentrate, head is a bit floaty.
I have the DP also, I go to bed with a lower bg than I wake with, so clearly I can 'kick out' at night, just not so much during the day.
My DN told me to eat 'healthy carbs' and porridge and had a rant at me because I had put 1 lb on since the previous weigh in two weeks earlier (despite an overall weight loss of 3 stone at that point!), so I don't have much faith in her I am afraid. Although my GP supported me doing the Newcastle Plan, so maybe he is the better bet (although he thought I was nuts!).
I think about the metformin as a buffer but would like to be off it. Both of my grandmothers and my mum are diabetic, my mum is on insulin.
 

Klangley

Well-Known Member
Messages
153
Type of diabetes
Type 2
Treatment type
Diet only
First 4 stone since January, that is hugely impressive! I can only dream of that sort of progress, well done.

I am hugely inexperienced in all this but it strikes me as really strange your DN has not discussed taking you off or reducing your Metformin, especially as your HbA1c was described as normal.

One thing I have picked up in the last couple of months is that some of the advice coming out of the good old NHS is pretty mixed and some (perhaps most) DN's are openly hostile to Low Carb. You are probably totally pissing him or her off by demonstrating great progress on the evil low carb regime......don't you understand Diabetes is progressive, can have people improving! Doctors it seems are slightly more open minded.

As a slight aside, god help the doctor or nurse who has a rant at me about anything :)
 
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LinsT

Well-Known Member
Messages
494
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Funnily enough I had this exact same problem for the first time today. Driving home from work I started feeling really quite ill - shaky, light headed, headachey. Checked my BG when I got in and it was 3.5 - checked again and got 3.7. I appreciate this is a false hypo (I'm on metformin only) but false or not it felt very uncomfortable and not good while driving.
I had eaten a good low carb breakfast and lunch, but I hadn't eaten much fat or any snacks. So, to try stop this happening again I'm planning to take some cheese chunks and peanuts to work tomorrow to have some little snacks between meals to try keep things a little more constant. I'm certainly not planning to increase carb content as I'm positive this will just swing my levels too far up again.
 
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Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi, I have been trying to low carb for a while now. I was diagnosed in January with type 2, have lost 4 stone but still have a bmi of 27.
I have generally improved my fasting blood glucose to below 7, and my last hba1c was 'normal', I take metformin 2g.
My worry is that I have regular hypos; 3.3, 3.8, and often I catch at a 4 / 4.1.
I have eggs for breakfast, just recently added one ryvita, salad and protein for lunch, veg and protein at dinner. I have started to add a small portion of potato at dinner. I have also tried rice (after 2 hrs my bg was under 7). Sometimes I have a homemade soup and another ryvita.
So my carbs are low and mostly in veg.
I know I need to do something differently to prevent the hypos but I am now scared of carbs!!!!
Should I eat more regularly? Should I add more carbs? Do I start to cut down the metformin?
On the plus side, having a hypo has meant I get to eat naughty... (Read with sarcasm )
How long after you have eaten, do you get the hypo? 1 hour, two hours, three, more?
Is it every time you go without food for a while?
Do you spike after an hour or before?
Any other symptoms, other than diabetic symptoms?
Can you give us your average fasting blood or your last hba1c?
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
I find I am less likely to get hypo symptoms if I can keep my carbs down to under 20-25 spread out over the day. I worked this out when I was regularly fasting for 18 to 24 hours at a time, twice a week and never had a hypo whereas on the other days when I was eating I was regularly going very low but only after meals that had more than 8g of carbs in. But we are all different.

I am on Metformin and I have definitely had hypos. Actually it was embarrassing. I have to tell my employer when my medication changes and when I was put on Metformin I proudly passed on what the DN nurse had told me that Metformin would prevent hypos. I was then moved to a job where I was working 12 hour nights alone in a residental house with five LD individuals. About three weeks in to the job I regularly started having mild hypo symptoms (at about 4.2 to 4.4) and one night it dipped lower and I hypoed at 3.7. That was when I just kind of gave up and started eating all kinds of unsuitable stuff to ensure my bg stayed high.
The fact that you have just come off meds to drop your blood glucose levels and you low carb can give you good readings that you quoted, I believe your body is adjusting again to your low carb lifestyle. If the lows, as they are not quite in hypo levels for a T2 diabetic, keep happening or go into the threes, make sure you treat them and speak to your GP as I might be missing something. Is the lows after exercise? Or only after eating relatively low carbs?
 

Bewildered

Well-Known Member
Messages
128
Type of diabetes
Type 1
Treatment type
Insulin
How long after you have eaten, do you get the hypo? 1 hour, two hours, three, more?
Is it every time you go without food for a while?
Do you spike after an hour or before?
Any other symptoms, other than diabetic symptoms?
Can you give us your average fasting blood or your last hba1c?

Hi, thank you for your post,

My first HbA1c in April this year was 88 ( I had been taking Metformin for four months), in July it was 42 (mostly low carb but 6 weeks at a bad attempt of Newcastle diet and a holiday where it was more difficult to manage meals). My meter tells me my average is 6.1 at the moment, bearing in mind I test an hour after, two hours after, when I feel it might be low and fasting.

My first hypo was when I was prescribed Gliclizide as well as the Metformin, so I came off this after about a week. I was at work and couldn't string a sentence together.

Then I started to have 3's when I went 5 hours between meals. (I aim for 7am, midday, 6pm as this fits in with work and travel to/from work).

I had a dinner the other evening, can't recall exactly what I had but it is usually veg, meat and potatoes. One hour later I had a reading of 8, then two hours later I felt awful so checked and had 3.3.

Sometimes I have a reading in the 3's and I can not fathom why.

Last night I had a reading of 8, one hour after dinner ( bean chilli and dumplings), then I exercised so I had two rich tea biscuits and a cup of tea before hand - after 20 mins my reading was 3.6. I had a packet of peanut M&Ms, (only thing to hand), a cup of tea with milk, two biscuits and an hour later had a reading of 7.3.

Not sure about spiking, the highest reading I have had an hour after a meal is 12, but this would be down to bread, I have avoided pasta, tried rice, couscous, potatoes and had the odd cake and chocolate bar. The cake and chocolate obviously raise my levels but usually back within an acceptable range after 2-3 hours.

Don't think I have any other symptoms.
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi,
I appreciate the reply and you are going hypo because of the carbs you are eating.
How long have you stopped taking the glicizide?

The reason I'm asking these questions as it does sound familiar to me.
But you may not have the other symptoms that what I believe it could be!

Your first post about being afraid of carbs, that is how I feel.
Eating more carbs will make it worse, I believe.

There are a few things that make a person go hypo if diagnosed as T2, one is meds, one is not eating for long periods and the other off the top of my head is Hypoglycaemia.
There are many forms of Hypoglycaemia. And only tests can get you diagnosed.

Have a read of the links below, but don't rule out at all the other possibilities or even more that have not been mentioned.

I don't want to rule any possibility out!
 
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Bewildered

Well-Known Member
Messages
128
Type of diabetes
Type 1
Treatment type
Insulin
Hi,
I appreciate the reply and you are going hypo because of the carbs you are eating.
How long have you stopped taking the glicizide?

The reason I'm asking these questions as it does sound familiar to me.
But you may not have the other symptoms that what I believe it could be!

Your first post about being afraid of carbs, that is how I feel.
Eating more carbs will make it worse, I believe.

There are a few things that make a person go hypo if diagnosed as T2, one is meds, one is not eating for long periods and the other off the top of my head is Hypoglycaemia.
There are many forms of Hypoglycaemia. And only tests can get you diagnosed.

Have a read of the links below, but don't rule out at all the other possibilities or even more that have not been mentioned.

I don't want to rule any possibility out!

Thank you for this, I had a quick read through. I stopped the gliclizide in March and only took it fow a very short time.
I think I referred to be scared of carbs because I am worried that I need more carbs to prevent the low blood glucose but I am scared that increasing carbs will make the diabetes worse.
From the list of causes, I have an under active thyroid, being treated and feels okay at the moment. I had nausea, but that was a side effect of medication now worn off. And for years before I was diagnosed type 2, I have had shakes, nausea etc when going for too long between meals, but not noticed this after a 'carb binge'.

So, if I have understood you correctly, are you suggesting that the carbs I eat lead to an overproduction of insulin, so if I up my intake then the frequency of low levels may increase?

Gosh, the more I learn the more I realise I don't know!
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Thank you for this, I had a quick read through. I stopped the gliclizide in March and only took it fow a very short time.
I think I referred to be scared of carbs because I am worried that I need more carbs to prevent the low blood glucose but I am scared that increasing carbs will make the diabetes worse.
From the list of causes, I have an under active thyroid, being treated and feels okay at the moment. I had nausea, but that was a side effect of medication now worn off. And for years before I was diagnosed type 2, I have had shakes, nausea etc when going for too long between meals, but not noticed this after a 'carb binge'.

So, if I have understood you correctly, are you suggesting that the carbs I eat lead to an overproduction of insulin, so if I up my intake then the frequency of low levels may increase?

Gosh, the more I learn the more I realise I don't know!

Yes, that's what I am saying!
The carbs turn into glucose quicker than any other type of food including sugar, which is also the same thing, because it turns to glucose into your blood. The liver and pancreas produce insulin among other hormones to turn the glucose without the science bit into energy. The unused insulin turns into visceral fat. So the more carbs and sugars you have the more insulin you have. If you low carb, you use the excess insulin and the amount of glucose you need to give you energy.
So the lower the carb intake the lower the amount of insulin and glucose.

Insulin resistance is another way of saying your body's had enough and can't cope with certain types of Foods and drinks.

Your thyroid problems are akin to your blood glucose levels. And it will be of benefit to low carb, there have been quite a few who have done well on this lifestyle.

What I would suggest is, to try and not eat carbs for a few days, just protein and above ground veg and record your fasting pre meal and one hour and two after eating.
Just to see what is happening!
You did say that you go low if you don't eat for a while after carb heavy meal.
Then don't leave it too long between eating, eat little and often, low carb!

If you haven't read my links below. And you could be T2 and RH, along with your thyroid problems.
 
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