Any advice for improvement

kokhongw said:

Typically the risk of hypo < 3.5 mmol are relatively low for Type 2 who are not on insulin or sulfonylurea. It is the overdosage that causes the hypo.

Our liver tends to over compensate by releasing a huge amount of glucose when it sense that our glucose level is low. Hence the dawn phenomenon of elevated glucose level that is frequently observed.

Even on a multi day fast (>72hours), which will exhaust the glycogen store, my glucose level remains stable around 4.5 mmol. The only time that I will experience readings below 4 mmol is when I take strong tea or had a very high carb meal which triggers a reactive hypo.

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It's been 14 months since I was diagnosed with type 2,and I have started to get hypos around the 13th month, 3.6 to 3.8, which makes me hungry and a woozy. I don't even need to test my blood, when this happens I know I need some Snickers mini candy bars or some cake to help me until the next meal.

It happens like once or twice a week these days, while the meds are active -i.e. 4 to 5 hours after meals. I'm on 30mg Diamicron MR (glicalazide) and 1000mg metformin per day, both low doses I think. If I'm not on hypo, my reading is good between 4.6 to 5.3, while the meds are active.

What is a reactive hypo ?

MarcoRiveira said:

It's been 14 months since I was diagnosed with type 2,and I have started to get hypos around the 13th month, 3.6 to 3.8, which makes me hungry and a woozy. I don't even need to test my blood, when this happens I know I need some Snickers mini candy bars or some cake to help me until the next meal.

It happens like once or twice a week these days, while the meds are active -i.e. 4 to 5 hours after meals. I'm on 30mg Diamicron MR (glicalazide) and 1000mg metformin per day, both low doses I think. If I'm not on hypo, my reading is good between 4.6 to 5.3, while the meds are active.

What is a reactive hypo ?

Click to expand...

Gliclazide belongs to the sulfonylurea class of medication used to increase insulin secretion. Hence when you lower your carbs intake there is a higher chance of experiencing a hypo-like symptoms at < 4.0 mmol.

A reactive hypo is one that is not triggered by medication. A high carb meal results in high glucose reading and 3-4 hrs later, the high insulin secretion cause a sharp/sudden drop in glucose reading.
http://www.diabetes.co.uk/reactive-hypoglycemia.html

This is actually a rather common occurrence for those who are pre-diabetic but is often dismissed as just hunger pangs...rather than a clinical condition. It should be recognized as over secretion of insulin and then a conscious efforts should be made to moderate carbs intake. That may be all that is required.