Low Carb Diet and Metformin

Oldvatr

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@Oldvatr atr
No worries. We have definitely had people on the forum reporting that they experience hypos when on met - but from what i have seen, they tend to be on very strict low carb diets.

That is a purely personal observation, and not the product of any kind of study!

I guess the best thing for the OP to do is to test his bg carefully while introducing low carb, and see how it affects him.

And i owe you an apology. In my post above, i misquoted (should have checked the facts before quoting) the reduction of 1.1 mmol/l i mentioned should have been 1.1% as you rightly pointed out. That translates as approx 2.5 ish mmol/l

The video i linked to in my post discusses this at approx 7 mins.

Thank you for pointing out my error. :)
No Probs. I note the OP is not supported for testing, and should talk to their doctor again since going low carb without testing is a concern. Having experienced an 8 mmol/L drop an hour after a low car meal myself, I speak from my experience. Mind you i am taking more than just Metformin.
 

Oldvatr

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Well, perhaps it might be a good idea to monitor your glucose levels if you want to try to discover what's going on?

It's standard practice for most type 2s to be told they don't need to test if on metformin, but many of us still choose do so regardless. That way we can find out what foods are good or bad for our glucose levels, and so can get better control of them. The only way you're going to find out if they're going to go low on a low carb diet is:
(a) buy a meter and use it to test before and after meals,
and (b) adjust your carbohydrate intake depending on what your meter tells you about how your body's responding to what you've eaten

We can only give general advice, and that will often be as a result of what you can tell us about what you eat and what your glucose levels do as a result.

Alternatively you could try just reducing the quantity of some of the higher carb foods you're currently eating by a smaller amount - a reduced carb diet instead of going completely low one.

Robbity
I wholeheartedly agree with the advice offered here. it is the same advice I give myself. I hsve no desire to go ape over counting carbs and trimming meals down to strict limits as set by my DCN, I just want to level out the peaks and troughs to get a stable average set of readings, It is unfortunate that the closer we get to 'normal range', the greater the risk of hypo simply because our automatic pilot is not working properly. A fact of life I'm afraid. This is why your doctor Should support your testing.
 

vintageutopia

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401
Type of diabetes
Type 2
Treatment type
Diet only
Ditto @Chook . I take Metformin only , but I never experience highs/lows. I eat to my meter and choose foods that do not cause a spike (or consequently a fall).

For me, that is key. I expect that if I continued to take Metformin, but increased my carb intake, I would experience more fluctuation in my BS levels.
 
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Oldvatr

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Messages
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Type of diabetes
Type 2
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Ditto @Chook . I take Metformin only , but I never experience highs/lows. I eat to my meter and choose foods that do not cause a spike (or consequently a fall).

For me, that is key. I expect that if I continued to take Metformin, but increased my carb intake, I would experience more fluctuation in my BS levels.
Although you state you are doing LCHF, you say in the body text that you eat to meter, which gives the impression that you are a bit more relaxed about things than some. i share the same approach myself. I think the original question was if Metformin combined with LCHF could give rise to a hypo. from what i have seen so far it seems that it is rare but not unheard of, but would have increasing risk the stricter the LC part of the diet. My advice to anyone attempting an LC diet of any type is to test properly and take a hypo awareness course just in case. i went 8 years without a hypo at all, but am getting some now I am LC and still taking hypoglycaemics. I am learning to reduce my meds dosage to compensate.
 

vintageutopia

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Messages
401
Type of diabetes
Type 2
Treatment type
Diet only
Although you state you are doing LCHF, you say in the body text that you eat to meter, which gives the impression that you are a bit more relaxed about things than some. i share the same approach myself. I think the original question was if Metformin combined with LCHF could give rise to a hypo. from what i have seen so far it seems that it is rare but not unheard of, but would have increasing risk the stricter the LC part of the diet. My advice to anyone attempting an LC diet of any type is to test properly and take a hypo awareness course just in case. i went 8 years without a hypo at all, but am getting some now I am LC and still taking hypoglycaemics. I am learning to reduce my meds dosage to compensate.

I eat between 20-25 net carbs daily, but still need to eat to my meter. There are just some foods that cause me to spike, even though they are within my daily carb limit. I still test when I try a new food or if I am feeling off. I expect it will always be that way, as I want to know what is going on with my body.

That said, for the first four months after my diagnosis, I ate around 100 grams/daily and took Metformin AND Bydureon (injectable hypoglycemic). During that time, I experienced more significant highs and lows than I have while taking Metformin ONLY and eating <25 net carbs per day. It is possible to have lows, as our bodies are unique, however I would attribute it to the shift in diet and a prescribed hypoglycemic for the blood sugars I was having initially. Once the hypoglycemic is adjusted (or eliminated, if possible), I believe a person will experience minimal to no hypos.
 

Oldvatr

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Type of diabetes
Type 2
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I note that you are running to a very strict LC target of <25 gm/day. My DCN advised me to aim for 120-150 gm/day, so I can be more relaxed about things. there is another thread on the forum dedicated to hypo's, and there are quite a few reporting having hypo's: these tend to be diet related, but not LC specifically. There are nondiabetics reporting in it too. Certainly the use of hypoglycemic drugs is usually a factor but not always. Metformin alone is generally recognised as being low risk, I still advise taking the hypo awareness course before doing a LC diet. I nearly lost a non diabetic friend who was doing the Atkins diet, and who went into ketogenic coma by skipping a meal.
 
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vintageutopia

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401
Type of diabetes
Type 2
Treatment type
Diet only
@Oldvatr I was advised to eat within the same carb allotment that was suggested to you. I could easily eat 100-150 grams/day and maintain my BS's, *if* I continued to take hypoglycemic medication. My goal was to eliminate medication and control my diabetes with diet. Considering that I had an A1C of 11%, this was no small task. So, I went in search of a way to do that and stumbled upon this forum and the host of resources available to me.

I was diagnosed with PCOS in my early 20's, so I expect I will always need to take Metformin. I can live with that, though.

Not to question you, but I am surprised that a non-diabetic could induce any sort of a coma from skipping one meal. Can you explain more of what happened?
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
@Oldvatr I was advised to eat within the same carb allotment that was suggested to you. I could easily eat 100-150 grams/day and maintain my BS's, *if* I continued to take hypoglycemic medication. My goal was to eliminate medication and control my diabetes with diet. Considering that I had an A1C of 11%, this was no small task. So, I went in search of a way to do that and stumbled upon this forum and the host of resources available to me.

I was diagnosed with PCOS in my early 20's, so I expect I will always need to take Metformin. I can live with that, though.

Not to question you, but I am surprised that a non-diabetic could induce any sort of a coma from skipping one meal. Can you explain more of what happened?
I was not there, but it happened in a gym, so presumably he was doing a strenuous workout. He never came back to work, and retired due to ill health. He was only in his 50's at the time. We lost contact but I heard he bought a villa in Spain and became an expat.