Concerned about Hypoglycemia

Beardie83

Newbie
Messages
3
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi everyone, :)

Thank you for taking the time to read my post. I’d be very grateful if you please could share some guidance.

A bit of background: I’ve recently been diagnosed with Type 2 diabetes. After my second HbA1c result came back at 6.8%, I was prescribed Metformin. When I received my initial result, I invested a lot of time researching and implementing a low-carb, low-fat diet while maintaining a high protein intake. I was already strength training regularly, and my cardio consisted mainly of slow-paced dog walks twice daily, I am overweight due to a lax and unhealthy diet that included a high amount of carbs. Since then, I’ve added daily brisk treadmill walking on an incline for 20–30 minutes, combined with strength training.

To better understand my blood sugar responses to food and exercise, I purchased both a finger-prick blood glucose monitor and a CGM. I checked my blood sugar by cross-referencing the CGM reading with a finger prick test, using whichever reading was higher.

My concern now is that my recent readings have me worried that starting Metformin could put me at risk of hypoglycaemia.

While I’m asleep, my readings tend to range from 5.4 to 5.8, and upon waking (before eating), my readings have been between 6.6 and 7.4, with lower readings over the past few days. I understand this could be due to the dawn phenomenon.

Based on my research, I’ve implemented a few suggestions, such as limiting carbs a few hours before bed and doing evening cardio. I’ve also tried doing cardio within 30 minutes of waking, which seems to bring my readings down to between 5.6 and 6.1 more quickly. During the day, my fasting readings have been between 5.3 and 5.8.

Ninety minutes after eating, my readings have been between 6.2 and 6.6 before returning to the fasting range.

If I start taking Metformin as prescribed, starting with one 500mg tablet with breakfast and gradually increasing over the next three weeks—will this significantly lower my levels and, given my current revised exercise routine and low carb diet? How much typically would my levels drop when taking the medication?

Unfortunately, my experience with the diabetic nurse felt quite impersonal and rushed. After my first test, I was simply handed a pack of booklets, and after my second, I was informed over the phone and told I could collect my prescription from the pharmacy, without any discussion of alternative options. When I enquired about my diet control and remission programmes, I was told that I’d need to have my eye and foot checks before being considered for such a programme and to read the information in the booklets provided. I have another appointment with the same nurse in two weeks, but I was hoping to get some guidance beforehand. To be honest, I’m hesitant to book an earlier appointment with the nurse, as I’m unsure how well received it would be, based on my experience so far.

I feel I’m managing my diabetes well with my diet and exercise and am committed to maintaining these changes long term. I’m not opposed to taking the medication; I’m just a bit concerned.

I’d really appreciate any advice or insights, especially from anyone who’s managed similar concerns. It’s all still new to me, and I want to make sure I’m doing the best for my health in the long term. Thank you in advance for any help you can offer.

Regards

B
 
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Beardie83

Newbie
Messages
3
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I am unable to upload my Libre daily graph as I am a newbie, hopefully I will be able to provide shortly
 

JoKalsbeek

Expert
Messages
6,276
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Hi everyone, :)

Thank you for taking the time to read my post. I’d be very grateful if you please could share some guidance.

A bit of background: I’ve recently been diagnosed with Type 2 diabetes. After my second HbA1c result came back at 6.8%, I was prescribed Metformin. When I received my initial result, I invested a lot of time researching and implementing a low-carb, low-fat diet while maintaining a high protein intake. I was already strength training regularly, and my cardio consisted mainly of slow-paced dog walks twice daily, I am overweight due to a lax and unhealthy diet that included a high amount of carbs. Since then, I’ve added daily brisk treadmill walking on an incline for 20–30 minutes, combined with strength training.

To better understand my blood sugar responses to food and exercise, I purchased both a finger-prick blood glucose monitor and a CGM. I checked my blood sugar by cross-referencing the CGM reading with a finger prick test, using whichever reading was higher.

My concern now is that my recent readings have me worried that starting Metformin could put me at risk of hypoglycaemia.

While I’m asleep, my readings tend to range from 5.4 to 5.8, and upon waking (before eating), my readings have been between 6.6 and 7.4, with lower readings over the past few days. I understand this could be due to the dawn phenomenon.

Based on my research, I’ve implemented a few suggestions, such as limiting carbs a few hours before bed and doing evening cardio. I’ve also tried doing cardio within 30 minutes of waking, which seems to bring my readings down to between 5.6 and 6.1 more quickly. During the day, my fasting readings have been between 5.3 and 5.8.

Ninety minutes after eating, my readings have been between 6.2 and 6.6 before returning to the fasting range.

If I start taking Metformin as prescribed, starting with one 500mg tablet with breakfast and gradually increasing over the next three weeks—will this significantly lower my levels and, given my current revised exercise routine and low carb diet? How much typically would my levels drop when taking the medication?

Unfortunately, my experience with the diabetic nurse felt quite impersonal and rushed. After my first test, I was simply handed a pack of booklets, and after my second, I was informed over the phone and told I could collect my prescription from the pharmacy, without any discussion of alternative options. When I enquired about my diet control and remission programmes, I was told that I’d need to have my eye and foot checks before being considered for such a programme and to read the information in the booklets provided. I have another appointment with the same nurse in two weeks, but I was hoping to get some guidance beforehand. To be honest, I’m hesitant to book an earlier appointment with the nurse, as I’m unsure how well received it would be, based on my experience so far.

I feel I’m managing my diabetes well with my diet and exercise and am committed to maintaining these changes long term. I’m not opposed to taking the medication; I’m just a bit concerned.

I’d really appreciate any advice or insights, especially from anyone who’s managed similar concerns. It’s all still new to me, and I want to make sure I’m doing the best for my health in the long term. Thank you in advance for any help you can offer.

Regards

B
Hi @Beardie83 , and welcome,

Metformin basically tells your liver not to dump as much glucose as it normally would, and it makes you a smidge more sensitive to your own insulin. Basically this means it should not cause you hypo's. Lots of other medications could, but metformin is quite safe in that regard.

Most of us are basically thrown into the deep end, alas... So use the time you have before your next appointment to do a bunch of research, and get to know your own body's response to foods. Best advice I can give you, really... Get to know yourself and your needs, with the help of that little glucose meter.

Good luck,
Jo
 

IanBish

Well-Known Member
Messages
942
Type of diabetes
Type 2
Treatment type
Diet only
Hi @Beardie83 and welcome to the forum.

Unless I've missed something, those values seem to be quite acceptable. As @JoKalsbeek says, Metformin would not by itself cause low blood sugar.

You're doing the right things checking your blood sugar to see how you react to various foods and exercise.
 
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Lamont D

Oracle
Messages
17,304
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi there.
In my experience, the readings you have given are definitely not hypoglycaemic levels.
Normal BG range is between 3.5, and 6 mmols.

Well done on getting your BG levels down nearer to normal levels.

A quick hint about low fat.
The fat is taken out and replaced by industrial sugars and sweetners, which are far worse for a diabetic.
Good saturated fats are a good source of nutrition.
Do read up on these pitfalls.

Best wishes.