DO TYPE 2 DIABETICS GET HYPOS?

[Kansenji]

I am a 56 year old male & was diagnosed with type 2 diabetes 18 months ago. I was first put on Insulin, then Metformin. I nearly died of multiple Gastric & Duodenal Ulcers 3 months ago and the suspected culprit was Metformin. I was taken off it & put on the maximum dose of Gliclazide. My Hba1C was 7.3 before I started on medication and is 8.3 now; so I am worse off than before I was first medicated!

What really worries me though, is the attitude of the diabetes nurse at my GP surgery. She was perfectly happy to leave me on the unsuccessful Gliclazide for another 6 months. She also said "Type 2 diabetics DO NOT get HYPOS". This is disconcerting to me, as I have had several Hypoglycemic attacks recently and two in the last two days, both shortly before a meal was due. I have struggled whilst in a semi stupor and with copious amounts of sweat pouring off me, to take blood tests that show that I AM having hypos. This fact does not seem to make any difference to her.

So, DO TYPE 2 DIABETICS GET HYPOS?

If not, then I am not a type 2 diabetic after all; what am I? (no rude answers please) :lol:

 

[sugarless sue]

your nurse needs to go back to school!!

Gliclazide has been prescribed to help
lower your blood sugar.
Take Gliclazide with or shortly before
food.
It is important to have regular meals.
Missing or being late for a meal, or
taking more exercise than usual, may
make your blood sugar go too low
(hypoglycaemia or a ‘hypo’).
Hypos can be recognised by
n Sweating and shaking
n Hunger and headaches
n Blurred vision
n Irritability
n Forgetfulness and confusion
How to treat a hypo
Take three glucose tablets or a
sugary drink, followed by biscuits,
a sandwich, or your next meal, if
it is due.
How

 

[chris_h]

In a word YES. But if you are taking Metformin or a compination of Metformin and Byetta they say you can't. How true this is I don't know yet. See your Dr and tell him/her and purhaps he/she will be able to help you more. Hope you get better soon....Chris

 

[fergus]

Sue is a far kinder person than me and I'm inclined to be a little harsher on your nurse.
Gliclazide is a sulphonylurea and it works by stimulating your pancreas into producing more insulin. Extra insulin is perfectly capable of causing a hypo in a type 2, so you are quite right, and your nurse needs to..........er..........go back to school.

All the best,

fergus

 

[Geoff]

It is a sad fact, but it has been my own experience and that of lots of other peoples, that I have read about on several other diabetic forums, that most, so called Diabetic nurses attached to GP practices, have a scant knowledge of basic diabetic practices. At my own GP's practice, the last time I attended my annual review, the diabetic nurse panicked when she saw my name on the list, she told me that she had to brush up on her diabetic knowledge the night before, because she was afraid that I new more about diabetes than she did!

Don't wast your time talking to your GP, go to the diabetic clinic at your local hospital if you want good care and advice.

 

[sugarless sue]

Metformin doesn't cause hypos but it doesn't mean that you can't feel hypo if you don't eat and your blood sugars fall.

 

[LittleSue]

It's your treatment (and dose) that influences whether you get hypos - NOT what type of diabetes you have.

Pasted from the BNF (drug prescribing book that doctors and nurses use) website:

"6.1.2.1 Sulphonylureas
The sulphonylureas act mainly by augmenting insulin secretion and consequently are effective only when some residual pancreatic beta-cell activity is present; during long-term administration they also have an extrapancreatic action. All may cause hypoglycaemia but this is uncommon and usually indicates excessive dosage. Sulphonylurea-induced hypoglycaemia may persist for many hours and must always be treated in hospital."

Your nurse sounds downright dangerous. She should refer you to a specialist, she can save face by doing this on the basis you've tried a few treatments without success... rather than waiting til you end up in A&E with an "impossible" hypo. She probably doesn't know what to do and the easy way out is to blame the patient and discredit the evidence. She also needs to learn the phrase "I don't know the answer but I will find out". They say things are impossible when they mean "I've never come across that before but I can't admit I'm out of my depth."

When hospital DNs first appeared, many were atrocious. Over the years they seem generally to have improved, or maybe my luck's changed. Sadly the GP nurses are reinventing the wheel. It's depressing how many have closed minds and just trot out the party line despite the evidence. They have very simplistic ideas about such a complex condition. (Sugars high - increase meds. Sugars low - reduce meds. Crashing hypos alternating with raging highs - fine if HbA1c is okay. If patients follow instructions control will be perfect, if control is poor the patient's non-compliant.)

Lost count of the "impossible" things I've done :wink:

Sue

 

[Kansenji]

THANK-YOU to those who have replied to my original thread.

I saw my own GP about my grievances (which I wrote down); he could quite understand why I was unhappy with treatment. He referred me to another GP in the practise who is responsible for all their diabetics. He did acknowledge that the nurse should not have remarked that "Type 2 Diabetics don't get Hypos". Initially I will remain being treated at the local surgery, which is very close by. The "local" hospital is 8 miles away and makes excessive charges (in my opinion) for car parking, so that is a deterrent to attending the clinic there. If I am unhappy with my further care, I will request a referral to the hospital clinic.

It seems like I will be re-starting insulin therapy with possible additional oral medication. The "diabetes" GP suggested that I "might try carefully taking Metformin again at some date in the future". He will be VERY disappointed! :wink: