Blood Sugar is always low.

[Pancreas_Betrayed_me]

I've been diagnosed with diabetes type 2 for around 3 months now, I also have anxiety (unfortunate combo)
when I was diagnosed I was told to take 3 pills of 500 grams metformin per day because my blood sugar was really high, thanks to diet and exercise, nowadays I take only 1, my blood sugar usually stays around 70-80 (mg/dl) , sometimes 65+ very rarely 90+, never had any problems with my blood sugar I didn't even had to check it that regularly because it was really constant, I thought this was great until 6 days ago, when I woke up in the middle of the night with sweat and a racing heartbeat, I thought it was just a panic attack again, it has happened before so I just took .50 mg of clonazepam, but I decided to check my blood sugar while waiting to find a whooping 55 (mg/dl) I thought it was a mistake so I did again, 57 this time, so i decided to eat some red apple slices with peanut butter and 15 minutes later my blood sugar was at around 60, so I decided to eat more, with a slice of whole grain bread this time, 30 minutes later I was finally at 78 (mg/dl) and I went to sleep, wake up 5 hours later and took my blood sugar to find a 65 (mg/dl), at breakfast and my numbers looked normal for the rest of the day.

2 days later I had a similar experience, and I've been quite anxious since then, I've been trying to no avail to keep my blood sugar at more 80+, it doesn't matter what I eat my blood sugar will rise and will quickly fall again, the most ridiculous example of this the 4th of October where once again my blood sugar was really low at a 57 (mg/dl) this was in the middle of the day however and I had no symptoms I decided to eat a measly red apple and a protein bar to get a 182 (mg/dl) 15 minutes later (which is probably the highest I ever seen since my diagnosis) , but just 10 minutes later I was back at 80 (mg/dl)

Now this may sounds great but I am honestly in constant fear of getting hypoglycemia, I check my blood sugar before sleeping to find a 71, I feel the need to eat carbs but it usually just makes me feel worst at night or I can't sleep at all, doing exercise has also become worrisome, before I used to don't mind seeing a 65+ but nowadays it just makes me anxious.
as far as I can tell this has been always the case and I just never noticed until now

My glucose tolerance test (3 months ago) for example was 180 (mg/dl) at 1 hour but 2 hours later it was 88 (mg/dl)


Has anyone experience something similar? what could be causing this? could this by fault of the antidepressant medication? I started taking Escitalopram 7 days ago and never experienced anything like this before.
I've honestly never been more on edge in my life.

 

[xfieldok]

I googled Escitalopram diabetes.

It does say it can make diabetes management more difficult.

 

[Geordie_P]

A quick convert as this site leans towards Brit measurements has
57 as 3.2,
182 as 10.1,
80 as 4.4
and 71 as 3.9

The low readings are a bit odd, but I wouldn't panic yet: if you're only on metformin I don't think you can go into a dangerous hypo. I myself, when losing weight and keeping my sugars down, would often get readings in the 3's and 4's without any adverse effect. Hopefully someone with more direct experience will jump in soon. Good luck with it.

Also, I like your JoJo avatar!

 

[Pancreas_Betrayed_me]

A quick convert as this site leans towards Brit measurements has
57 as 3.2,
182 as 10.1,
80 as 4.4
and 71 as 3.9

The low readings are a bit odd, but I wouldn't panic yet: if you're only on metformin I don't think you can go into a dangerous hypo. I myself, when losing weight and keeping my sugars down, would often get readings in the 3's and 4's without any adverse effect. Hopefully someone with more direct experience will jump in soon. Good luck with it.

Also, I like your JoJo avatar!

It's is really okay to be so low? every single website in the internet says that below 70 is dangerous, but I never feel anything strange when being around 60 until recently, I honestly can't differentiate symptoms from anxiety and hypoglycemia so it's hard to tell.

 

[Geordie_P]

Well I definitely want someone with more experience to correct me if I'm wrong, but as far as I know, hypos on Metformin aren't really a thing because your liver will compensate and it's hard for you to have a serious hypo: it's more of an issue when you're on insulin or gliclazide. Certainly I was going to work in the mornings with bloods in the high threes or low fours without any ill-effect. That said, the Escitalopram might change things.

 

[Dandelade]

It's is really okay to be so low? every single website in the internet says that below 70 is dangerous, but I never feel anything strange when being around 60 until recently, I honestly can't differentiate symptoms from anxiety and hypoglycemia so it's hard to tell.

Hi there, I’ve had a few episodes in the 3s as well and my liver kicks in raising it back up. I was really concerned as well but it is ok as an odd episode. If you’re not on medication that could keep it there or go lower your body should respond. I’d be worried if it wasn’t going back up or perhaps if it was happening all the time? My understanding is that the levels are to be worried if you’re on insulin or sometimes glicazide which will keep it too low. Reactive hypoglycaemia is a thing if it happens all the time after food.

I’m sure others will respond with more experience than me to reassure you too or give you more information.

 

[In Response]

In the UK, if you are not on insulin, paramedics do not consider someone hypo unless their levels are below 3.
It is only dangerous at this level if you take insulin.

 

[Pancreas_Betrayed_me]

In the UK, if you are not on insulin, paramedics do not consider someone hypo unless their levels are below 3.
It is only dangerous at this level if you take insulin.

well that's actually reassuring, but being 3.1 it's pretty close regardless.

 

[Pancreas_Betrayed_me]

Hi there, I’ve had a few episodes in the 3s as well and my liver kicks in raising it back up. I was really concerned as well but it is ok as an odd episode. If you’re not on medication that could keep it there or go lower your body should respond. I’d be worried if it wasn’t going back up or perhaps if it was happening all the time? My understanding is that the levels are to be worried if you’re on insulin or sometimes glicazide which will keep it too low. Reactive hypoglycaemia is a thing if it happens all the time after food.

I’m sure others will respond with more experience than me to reassure you too or give you more information.

I'm not sure if goes up in his own because every time i cached my blood sugar too low i ate carbs to raise it up.
it happened around 4 times in 1 week or so.

 

[Ronancastled]

I've been diagnosed with diabetes type 2 for around 3 months now

My glucose tolerance test (3 months ago) for example was 180 (mg/dl) at 1 hour but 2 hours later it was 88 (mg/dl)

So you were diagnosed with a 2 hour reading of 88mg/dl on the 75g OGTT.
Good news, you're not diabetic

 

[Pancreas_Betrayed_me]

So you were diagnosed with a 2 hour reading of 88mg/dl on the 75g OGTT.
Good news, you're not diabetic

and a 10.2 in the hemoglobin A1c

 

[catinahat]

Diabetes of any flavour causes high sugar levels, the difference between T2 and T1 is that in T1 the pancreas stops producing insulin, in T2 our insulin production is usually fine but our bodies stop responding to it (insulin resistance ). All warnings you read about the dangers of letting your blood sugar go too low are aimed at people taking medication that can force your blood sugar level down to dangerous levels. Metformin helps with the insulin resistance, it can not force down levels in the same way that insulin does.
People who don't have diabetes will quite regularly have low sugar levels depending on what and when they have eaten. The only difference is they don't test and are unaware what their levels are.
I do think that with your anxiety issues and your excellent glucose levels (jealous by the way) maybe you should put away your glucose meter for a while

 

[Hertfordshiremum]

I'm not sure if goes up in his own because every time i cached my blood sugar too low i ate carbs to raise it up.
it happened around 4 times in 1 week or so.

Maybe ask your doctor about dropping the one metformin tablet a day? Sounds like you are controlling your diabetes by exercise and diet? My diabetic nurse told me metformin inhibits the release of glucose from the liver (I was having a lot of hypos a few years back) just googled it and seems to be a few links suggesting this. As you have started a new medication I would be ringing up and discussing this.

 

[Ronancastled]

and a 10.2 in the hemoglobin A1c

Which means your average BG in the preceding 3 months was 13.6mmol/L or 245mg/dl.
Yet you hit 10(180) @ 1 hour on the OGTT & 4.9(88) @ the 2 hour.

Something not right.
Did you have a repeat to your HbA1c test ?

 

[Pancreas_Betrayed_me]

Maybe ask your doctor about dropping the one metformin tablet a day? Sounds like you are controlling your diabetes by exercise and diet? My diabetic nurse told me metformin inhibits the release of glucose from the liver (I was having a lot of hypos a few years back) just googled it and seems to be a few links suggesting this. As you have started a new medication I would be ringing up and discussing this.

I already stopped taking it since today, going to talk to the medic regardless, looks like Escitalopram does indeed lower blood sugar in occasions.

Diabetes of any flavour causes high sugar levels, the difference between T2 and T1 is that in T1 the pancreas stops producing insulin, in T2 our insulin production is usually fine but our bodies stop responding to it (insulin resistance ). All warnings you read about the dangers of letting your blood sugar go too low are aimed at people taking medication that can force your blood sugar level down to dangerous levels. Metformin helps with the insulin resistance, it can not force down levels in the same way that insulin does.
People who don't have diabetes will quite regularly have low sugar levels depending on what and when they have eaten. The only difference is they don't test and are unaware what their levels are.
I do think that with your anxiety issues and your excellent glucose levels (jealous by the way) maybe you should put away your glucose meter for a while

Thanks for all this info I really appreciate it.

 

[EllieM]

and a 10.2 in the hemoglobin A1c

That corresponds to 88mmol/mol which is definitely in the diabetic range.

looks like Escitalopram does indeed lower blood sugar in occasions.

Googling Escitalopram and hypoglycemia gives some interesting results, but mainly for women over 60....

But in your position I'd definitely have a discussion with your doctor.

 

[NicoleC1971]

Sounds as if your pancreas is working well in that it reacts quickly to what you eat which is what you want. Those who have elevated glucose spikes after a meal have high levels of insulin too and eventually this leads to the diagnosis.
So I am also wondering it the diagnosis was not right and that you are taking metformin you don't need.
If you can afford it how about getting a flash monitoring device such as FreeStyleLibre or Dexcom then you can see how 'in range' you are and show results to your team with a view to reducing the meds or dropping them?
The other factor is that symptoms of a mild hypo are very very similar to anxiety. I can sleep through a 3.5 but feel anxious and jittery going to a 4.0 especially if the rate of descent if rapid. The monitoring device might give ;you some useful information on that aspect of it and you may find that eating actually triggers a further insulin surge such that you are in a hypo - recover- hypo loop and that your initial diagnosis is off.
Btw I would not suggest doing this monitoring for any longer than the 10 days or 2 weeks that a sensor lasts because it may trigger further anxiety to be traded against the gain of useful health information.

 

[Pancreas_Betrayed_me]

Which means your average BG in the preceding 3 months was 13.6mmol/L or 245mg/dl.
Yet you hit 10(180) @ 1 hour on the OGTT & 4.9(88) @ the 2 hour.

Something not right.
Did you have a repeat to your HbA1c test ?

I will have another this month.
For further confusion I got diagnosed while having a panic attack, someone took my blood sugar and it was 300 mg/dl (16.65 mmol/L), but next day when I went to get a simple blood test I was back in the normal range, so I didn't know I was diabetic right away.

 

[JoKalsbeek]

I've been diagnosed with diabetes type 2 for around 3 months now, I also have anxiety (unfortunate combo)
when I was diagnosed I was told to take 3 pills of 500 grams metformin per day because my blood sugar was really high, thanks to diet and exercise, nowadays I take only 1, my blood sugar usually stays around 70-80 (mg/dl) , sometimes 65+ very rarely 90+, never had any problems with my blood sugar I didn't even had to check it that regularly because it was really constant, I thought this was great until 6 days ago, when I woke up in the middle of the night with sweat and a racing heartbeat, I thought it was just a panic attack again, it has happened before so I just took .50 mg of clonazepam, but I decided to check my blood sugar while waiting to find a whooping 55 (mg/dl) I thought it was a mistake so I did again, 57 this time, so i decided to eat some red apple slices with peanut butter and 15 minutes later my blood sugar was at around 60, so I decided to eat more, with a slice of whole grain bread this time, 30 minutes later I was finally at 78 (mg/dl) and I went to sleep, wake up 5 hours later and took my blood sugar to find a 65 (mg/dl), at breakfast and my numbers looked normal for the rest of the day.

2 days later I had a similar experience, and I've been quite anxious since then, I've been trying to no avail to keep my blood sugar at more 80+, it doesn't matter what I eat my blood sugar will rise and will quickly fall again, the most ridiculous example of this the 4th of October where once again my blood sugar was really low at a 57 (mg/dl) this was in the middle of the day however and I had no symptoms I decided to eat a measly red apple and a protein bar to get a 182 (mg/dl) 15 minutes later (which is probably the highest I ever seen since my diagnosis) , but just 10 minutes later I was back at 80 (mg/dl)

Now this may sounds great but I am honestly in constant fear of getting hypoglycemia, I check my blood sugar before sleeping to find a 71, I feel the need to eat carbs but it usually just makes me feel worst at night or I can't sleep at all, doing exercise has also become worrisome, before I used to don't mind seeing a 65+ but nowadays it just makes me anxious.
as far as I can tell this has been always the case and I just never noticed until now

My glucose tolerance test (3 months ago) for example was 180 (mg/dl) at 1 hour but 2 hours later it was 88 (mg/dl)


Has anyone experience something similar? what could be causing this? could this by fault of the antidepressant medication? I started taking Escitalopram 7 days ago and never experienced anything like this before.
I've honestly never been more on edge in my life.

I live with generalised and social anxiety, so I do get the whole panic attack thing; it and a proper hypo can be very similar. But you're not on glucose lowering meds, save for the pram, so your liver should kick in if you go too low. It may be time to ditch the last metformin (it makes your liver dump less glucose), as you don't seem to need it. That should help create a bit of a buffer, assuming you can't do without the pram. That'll get your liver to do its job again. If you remain uncomfortably low, you could up your carbs in slight increments until you find your happy place. Not something I'd usually suggest, but when there's other conditions involved with meds you can't get around, and your control is really tight, we have to be somewhat flexible, right? (Maybe add in 10 grams a day, and see whether you feel better? Nothing too much in a go.)

 

[bulkbiker]

I decided to eat a measly red apple and a protein bar to get a 182 (mg/dl) 15 minutes later (which is probably the highest I ever seen since my diagnosis) , but just 10 minutes later I was back at 80 (mg/dl)

That sounds to me like a classic case of polluted finger with maybe some apple juice caught up in the blood sample.. possible?