Hypo

[Deborah 85]

Your GP should have warned you about Gliclazide. Mine didn't either.

To be honest, it’s not the GP that I see, it’s just the nurse. I still don’t really know what I’m supposed to be looking out for.

 

[Deborah 85]

This is for starters: https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

There is a lot more info on the main website, so spend some hours surfing and reading, both on the website and in the forums. You can also use the search bar on the top right for questions about specific things, like gliclazide. Stupid search bar doesn't do shorter words or phrases, so searching for 'false hypo' won't get you very far, but google might help.

Not sure if you've had @daisy1 's useful welcoming post, but it will appear on this thread.

Thanks that’s really helpful!

 

[Deborah 85]

As a T1, I rarely post in T2 threads, because the conditions are different, but I have to say here if you got to the point where you were shaking uncontrollably, it means your body was going into what's called autonomic response and you seriously needed to eat some sugar at that point.

You can reach a stage where the body has i identified that your bg was way too low, so it started pumping out adrenalin to tell the liver to release stored glucose to get you back to a zone it's happier with.

Low bg on its own won't make you shake, you could slip away quietly into an early grave with a low bg if it weren't for the autonomic response. The low bg induces the adrenalin release, and it's the adrenalin which makes you shake.

A washed out feeling may continue for a while even after you've, hopefully, eaten some glucose - adrenalin kicks around the system for a while.

It's all well and good the other posters saying you should just try and ride these periods through, but if you're getting to the stage of shaking, you absolutely need about 10g of fast acting glucose.

Once you're better, then you've got time to figure out in the longer term whether your meds need adjusted, not when you're on the verge of fitting.

Thank you, that’s very helpful. as I said, I didn’t know how for sure to get my bg up so I just had some chocolate but I have found that’s not the best thing I should have had? I don’t know if the shaking was just because I was scared as I didn’t know what happening and I knew I didn’t feel good. Or if it was a symptom.

 

[Bluetit1802]

I have updated my profile.
I still don’t know if it was a hypo or if it was just a fake one.

Thanks for updating your profile.

I can't help you with the hypo question. I have never had one, although I do go to the low 4s at times, but feel absolutely fine when I do, and I'm not on any medication.

 

[Deborah 85]

Thanks for updating your profile.

I can't help you with the hypo question. I have never had one, although I do go to the low 4s at times, but feel absolutely fine when I do, and I'm not on any medication.

That’s the second time I have been as low as 4.7 but the last time I didn’t feel any different, this time I was shaking so I’m unsure myself why this was different

 

[Bluetit1802]

That’s the second time I have been as low as 4.7 but the last time I didn’t feel any different, this time I was shaking so I’m unsure myself why this was different

4.7 isn't low, but the problem with Gliclazide is it could have been going up from a much lower level once your adrenaline and liver kicked in, or could have been on the way down to a much lower level, which is why you need to keep a meter with you at all times, always always test before you drive, and test every 10 or 15 minutes if you get physical symptoms to make sure you are not dropping lower. Also, keep some jelly babies or glucose tablets with you at all times, and have spare ones in your car.

What are your levels like in normal circumstances during the day, such as before meals and 2 hours after eating, plus morning fasting and bedtimes? If these are nice and normal due to your eating plan it may be worth speaking to your nurse about reducing the gliclazide.

 

[Peaches20]

You need to carry some glucotabs which are fast acting glucose tablets and can be purchased from places like Boots. Gliclazide can make your blood sugar drop very low. Mine was constantly falling around 3.9, luckily my GP took me off it when I showed him my BG logs. As someone said earlier you need to carry your meter with you and if your reading is low then please don’t drive.

 

[Deborah 85]

4.7 isn't low, but the problem with Gliclazide is it could have been going up from a much lower level once your adrenaline and liver kicked in, or could have been on the way down to a much lower level, which is why you need to keep a meter with you at all times, always always test before you drive, and test every 10 or 15 minutes if you get physical symptoms to make sure you are not dropping lower. Also, keep some jelly babies or glucose tablets with you at all times, and have spare ones in your car.

What are your levels like in normal circumstances during the day, such as before meals and 2 hours after eating, plus morning fasting and bedtimes? If these are nice and normal due to your eating plan it may be worth speaking to your nurse about reducing the gliclazide.

The nurse has told me that I only need to test the now three times a day. Once in the morning when I get up before breakfast and then before dinner and before bed. Normally they are sitting at around 7 when I wake up and then around 6 when I get home after dinner and then around 6/7 when I’m going to bed. Is that still really high?
I don’t really think I understand what morning fasting is and when im supposed to do it? I know the morning but like when? I’ve only started today testing two hours after eating as I didn’t know that’s what I was supposed to be doing.

 

[Deborah 85]

You need to carry some glucotabs which are fast acting glucose tablets and can be purchased from places like Boots. Gliclazide can make your blood sugar drop very low. Mine was constantly falling around 3.9, luckily my GP took me off it when I showed him my BG logs. As someone said earlier you need to carry your meter with you and if your reading is low then please don’t drive.

The nurse said she would revisit the dosage if I kept going low but she said 4.9 was low and would send me into a hypo?

 

[Peaches20]

From my understanding a hypo is anything below 4.0 as I was told by my GP. Prior to my GP appt I told the nurse I was getting hypos, she asked “how do you know you’re getting a hypo?” I described the symptoms: shaking, wobbly feeling, difficulty with speech. She dismissed it as a false hypo and issued me with a meter and sent me on my way. It wasn’t till I started testing that I had evidence of hypos. Perhaps someone else on the forum can confirm if a reading of 4.9 is a hypo?

 

[daisy1]

@Deborah 85
Hello Deborah and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[slip]

I now understand why your nurse said 4.9 is 'hypo' (or low) - it isn't but with the meds you're on it could quite easily head that way. Also did I pick up that you've changed your diet to low(ish) carb recently? (and I assume recently started taking the gliclzide?) - if your nurse based the dose on your previous carb intake or assumed you were eating a 'normal' amount of it then it is likely your BGs have come down relatively fast, hence the false-hypos - I'd heed the other posts about having glucotabs or jelly babies (or what ever fast acting glucose) at hand - but don't over do them!, as your body get use to the lower end of normal you'll get less of these episodes at the 4 or 5 mark, abut then you'll start to get into real hypo territory. Hopefully by then you'll be off the meds anyway, keep your nurse informed.

She should have warned you about driving and testing at the very least, if you are on any glucose lower meds (metformin isn't) you should inform the DVLA (I suspect you'll only be on them for a short term, very short I'd imagine! so by the time dvla get into gear it'll be in the past anyway).

 

[Koalajane]

I was put on 40mg gliclazide on diagnosis due to the steroids raising my sugars. After 6 months my hba1c went to 37 so I was taken off it. My hba1c is now 40 on the LCHF diet and still on steroids. I think you need your dose lowered.