hypo management and more

[geoffry]

Hi, I am now on metformin and gliclazide but have had a few hypos, 2.6, 3.8, 3.2 etc. They have always responded to coke in that I then take my BM 15 mins later as I was told to, and the levels are then above 6 or 7. However when I then take a cereal bar or have lunch etc if it is just before a meal, and retest a bit later, my BM has gone upto 10-11. Do I always need that second thing to keep the BMs up or is it just sufficient to take coke or lucozade? My BMs have been more stable and having these higher readings post hypo managment is frustrating. I am still new to all this so would appreciate advice. (incidentally my c peptide was in normal range but my GAD was positive so the GP has said whilst I am producing some insulin and therefore am ok on oral meds, I will need to go onto insulin probably withing a couple of years but is adament I shouldn't go on it yet - is that the experience of others?) Thank you. This forum has been invaluable the last few weeks.

 

[smidge]

Hey Geoffry!

Given that your GAD test was positive, you are probably LADA or Type 1.5 and will progress to Type 1 within a couple of years. You will need insulin. In the initial stages, they usually try oral meds - I don't know why! As insulin is inevitable and can actually help to preserve the remaining pancreatic beta cells, I would have thought it would be better to begin insulin straight away. Anyway, that's not what they do. I went onto insulin within the year and it was the best thing I ever did. It's not a breeze, and it has it's down sides, but for me, it was the best course of action. The trouble with LADA is that you tend to peak pretty high after food and tend to be very sensitive to carb. Make sure you test after meals and if your BG starts to rise, get onto insulin. In the meantime, it will be the Gliclazide that is causing your hypos rather than the Metformin. Glic makes your pancreas produce more insulin - it will only work for a short time, because eventually, your pancreas won't be capable of producing insulin. The metformin makes your cells more receptive to insulin, but will only lower your BGs by a point or so.

You don't need to take too much carb to correct a mild hypo. 1 or 2 jelly babies will do it. They have about 6g carb each and work pretty quickly. LADAs are generally pretty sensitive to carb and the advice to take 10g quick acting followed by 15g slow acting carb sends my BGs really high. So I don't do it! Try a jelly baby and test 15 minutes later to see what effect it's had. You'll soon get the hang of it. Keep testing until your BG is steady.

Keep asking questions. There are several of us LADAs on the forum at various stages of the condition, so ther is usually someone around to help. We don't have our own area, but the Type 2 area has people on the same meds as you and the Type 1 area has people with autoimmune forms of diabetes, although mostly insulin users. Have a read of both because they are both really usefull to LADAs!

Take care

Smidge

 

[geoffry]

Hi Smidge, a huge thank you for your reply - both helpful and encouraging. I have been looking at both the posts for type 1 and 2 and wasn't really sure where I fitted in so it is good to know there are others in a similar position. Also encouraging to hear that despite knowing you would need to go onto insulin, your GP still put you on oral meds first. It does seem strange that despite knowing that orals won't work for long, they still want to start with them.
I have now bought the jelly babies so will give it a go. I think I am sensitive to carbs but my readings are still quite unpredicatble at the mo and sometimes I am and sometimes I'm not! My challenge is that having always been very slim, I lost more weight when they put me on metformin cos of the side effects so I am now under 10 stone and can't afford to lose more weight so juggling food and reducing carbs is a challenge, especially as I am already a little limited with food having had my colon removed several yrs ago, which I suspect affects my food intake, transit time and blood sugars as well.
Anyway, thank you for your help... I'll get there, just feels like a long journey and as for Christmas - if it wasn't for the kids I think I would want to cancel it this year!!