Can Type 2 diabetics get hypoglycaemia?

[Kasia]

Hi there

Please can Type 2 diabetics get hypoglycaemia? I told a GP that I was getting horrendously tired (have had womb cancer and radiotherapy in the past so know about tiredness) and asked her if I could increase my metformin. Thankfully, she agreed to this. I asked what I should do if I'm so tired I'm unable to work. She told me to take a few days off work and that the tiredness isn't hypoglycaemia as "Type 2's don't get hypoglycaemia".

I asked if I could see an endocrinologist. She refused - saying that only people with readings of 15 and over are allowed to see an endocrinologist. The surgery expressly forbids me from testing my BG. Being a rational, scientific person of course I've tested my BG (at my own expense) and have had readings plummetting from 15 to 4. The GP was so intimidating that I didn't dare tell her this.
She told me that "you don't like what I'm saying." Possibly true!!

With luck some more metformin will totally sort the BG but I'd be really interested to hear expert patients' advice about hypos and Type 2. Do Type 2s have them, and if so, what should they do?

I don't think my GP surgery has forgiven me for enthusiastically turning up to the first 'diabetic nurse' appt with a BG metre and a set of readings. They clearly dislike the proactive 'partnership' approach that's encouraged by modern cancer doctors. And I only wanted to be their best patient!

Just as I had to struggle to persuade this kind South West GP practice to diagnose cancer, now I've had to struggle to persuade them to diagnose diabetes. At first they dismissed my extreme fatigue and told me to go out and 'get a life'. Thank goodness I appreciate the black comedy!!!

Very many thanks for any advice you can give
Kasia

 

[tighthead3]

Hello Kasia, I read your post with great interest, as I have had some of the problems you have encountered, especially with the testing issue, I have also had to purchase my own testing meter and test strips, this unfortunately comes down to economics, pure and simple, testing is one of the best ways to ensure your BG levels are under control. I cannot understand your GP saying Type 2 diabetics cannot have hypo's, what a load of rubbish, I have had a hypo, only one because it made me feel so bad, I have done everything in my power to make sure I dont have another. If I were you I would seriously consider changing my GP, as the GP you have doesn't seem to have any idea how diabetes works. All the best for the future.

 

[Kasia]

Thanks very much for the prompt response. Very helpful indeed - you've convinced me that I'm right to be 'proactive' in trying to manage diabetes. All best, Kasia

 

[Sid Bonkers]

Hi Kasia and welcome to the forum.

Your doctor is wrong about so much its hard to know where to start firstly T2's can suffer hypoglycaemia although it is not common but even non diabetics can have hypo events. The tiredness you describe is not generally considered a hypo symptom but more usually associated with hyperglycaemia (high blood glucose (BG) ) and your readings of 15mmol/L are very high. An increase in metformin will help to bring your bg down a little but as the maximum dosage will only reduce bg by 1 to 2mmol/L you will also need to help get those numbers down yourself (be proactive ) and the easiest way to do that is to cut back on the carbohydrates that you eat and generally reduce the portion sizes of your meals, although not knowing your diet it is hard to comment further on this.

You wont find many, if any, diabetics on this forum tell you not to test, testing is the only way to find out what foods do to your blood glucose, all carbohydrates are turned to glucose as they are digested so it is not just sugar that is bad for diabetics, read the link at the bottom of this post to find the information given to the newly diagnosed by the monitors here, it is the key to good control, once you bring those bg levels down and stabilise your levels you will find the the tiredness you describe should reduce and you should also have more energy generally.

Random testing is next to useless so just testing once a day in the morning will just tell you what your bg is at that time and nothing else but by testing before eating and two hours after meals you will see what the food you are eating is doing to your bg, by testing regularly and gradually reducing the amount of carbohydrates in in each meal you will start to see a reduction in your bg levels.

Link to Information For The Newly Diagnosed

 

[Kasia]

Thanks Sid. Sorry so slow replying. Have mugged up the NICE guidelines and yes, they state that self-monitoring blood glucose (SMBG) in Type 2s can be helpful. The guidelines contain a wonderful list of 'pros and cons' for testing.

My favourite is the last 'con' in the NICE guidelines: health care professionals aren't interested in the readings that result from self-monitoring!!

So I asked my PCT what its policy was. A prescribing pharmacist gave a contradictory but revealing reply over the phone but didn't want to send an email. She said:

1. "This PCT follows NICE guidelines."
2. "If Type 2 diabetics are using newer drugs [K: by this I infer Metformin] then they cannot 'go hypo'."
3. "These patients should only test if they have flu; that's the only instance when they could 'go hypo'." [Funny that no medic has bothered to tell me this!]
4. "For Type 2 diabetics using newer drugs SMBG is NOT therapeutic, it is only 'psychological'; it makes the patients 'feel in control'."
5. "Why these patients should want to test is beyond me. They have enough tissue damage without pricking their fingers. And I've pricked my finger and I can tell you that it hurts."

So I thanked the prescribing pharmacist and silently hoped that she never gets Type 2 diabetes with undiagnosed widely fluctuating BG levels that's treated once every 3 months blunt-instrument- NHS-style!

In the world of cancer, Quality of Life (QoL) is considered very important. Inthe world of NHS Type 2 diabetes QoL clearly does not apply!! All the Type 2's will inevitably become insulin-dependent so what the hell's the point of wasting money on improving their quality of life in the interim period.

The false reasoning here is that most of us are perfectly happy to pay for testing strips, are responsible people and have no intention of bankrupting a cash-starved, collapsing NHS.

Good luck everyone!!
Kasia

 

[IanD]

O dear, Kasia. What a dreadful GP & pharmacist you've got. Try to find a sympathetic GP. You could ask various pharmacists which Drs are best for diabetes.

In 10 years I've only once been told (by a locum) that I did not need to test. I get all the test strips I request. I saved the NHS a lot of money by following the low carb diet advice given on this forum in contradiction to the NHS/Diabetes UK high carb "healthy diet." I was told to follow that diet, but that "diabetes is progressive, so you will get worse, medications will be needed, eventually insulin & complications. After 7-8 years on the NHS/DUK diet I was becoming crippled with muscle pain & Dr suggested sending me to hospital for tests. Instead I came here. 3 years on the complications have gone & my general health & control are good. My meter average is below 6, & HbA1c 6.2.

Feel free to ask all the questions you need here. Some of the thousands of members will be able to help from experience.

I test every morning & 2-3 times during the day, & over the weeks I know if my control is drifting up.

Type 2s can have hypos, especially if control is poor. Metformin is considered safe for driving, but if your reads are as low as 4, that IS a hypo. You will feel different with highs & lows. I used to get extremely tired before getting better control.

Whereabouts are you? Have you got a local diabetes support group - we have a useful one in Hounslow. Have you been offered diabetes education, X-PERT or DESMOND?