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Type 2 Going low

gary 196

gary 196

Member
Messages
10
Location
Belfast
Type of diabetes
Treatment type
Tablets (oral)
Recently been on low carb hba1 down from 78 to 54 I am on metformin and gliclicide I find testing before driving home from work sugars are quite low 3.5 being the lowest as I am not on insulin is this a problem I feel fine no symptoms of hypo practice nurse says it’s to low and I should eat more carbs it sort of defeats trying to get sugars down.
 
Rather than eating more carbs I'd be asking why they haven't suggested reducing your medication?
Obviously your dietary changes are having a significant impact on your blood sugars so maybe doses should be reduced?
 
Hi @gary 196, An interesting question. Based on my experience as a diabetic and nor as professional advice or opinion.:
3.5. mmol/l is defined as hypoglycaemia (see Home page - Blood sugar levels).
Driving at hypoglycaemic levels is considered dangerous. You are prescribed glicazide which is an oral hypoglycaemic agent and your GP is supposed to provide you with a certificate or filled out form (I can only speak for Australia where i live) to say that you are diabetic and fit to drive, provided your BSL is above 5 mmol/l.
My concern for you is that if you attempt to drive at a BSL of 3.5 mmol/l you could have an accident which harms you, someone else, or their pet or causes damage to cars, property etc. Ask a lawyer how much you gain to lose financially and personally.
You should listen to your nurse. Too low is bad as she has inferred. Be wise, see your GP, sort out your carbs and BSL with your nurse, be a good boy and get your license sorted.
 
kitedoc said:
Hi @gary 196, An interesting question. Based on my experience as a diabetic and nor as professional advice or opinion.:
3.5. mmol/l is defined as hypoglycaemia (see Home page - Blood sugar levels).
Driving at hypoglycaemic levels is considered dangerous. You are prescribed glicazide which is an oral hypoglycaemic agent and your GP is supposed to provide you with a certificate or filled out form (I can only speak for Australia where i live) to say that you are diabetic and fit to drive, provided your BSL is above 5 mmol/l.
My concern for you is that if you attempt to drive at a BSL of 3.5 mmol/l you could have an accident which harms you, someone else, or their pet or causes damage to cars, property etc. Ask a lawyer how much you gain to lose financially and personally.
You should listen to your nurse. Too low is bad as she has inferred. Be wise, see your GP, sort out your carbs and BSL with your nurse, be a good boy and get your license sorted.
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Hi kitedoc, over here in the UK, we have to inform our driving licence authorities if we are on certain glucose lowering drugs, ie insulin and some others. They then issue a 3 year driving licence which gets reviewed. I think the only time a Dr would get involved is if they knew a person was driving around in hypo land or unfit to drive and then they too would alert DVLA or in other extenuating circumstances. Generally though, the law here is not to drive if under 4, if over 4 but under 5, to take a snack and then to test every 2 hours. If glicazide is one of the listed meds (I'm not sure) then the poster would not be allowed to drive under 4.
 
gary 196 said:
Recently been on low carb hba1 down from 78 to 54 I am on metformin and gliclicide I find testing before driving home from work sugars are quite low 3.5 being the lowest as I am not on insulin is this a problem I feel fine no symptoms of hypo practice nurse says it’s to low and I should eat more carbs it sort of defeats trying to get sugars down.
Click to expand...

It is so annoying when you get told to 'eat more carbs', my DN said that advice was now obsolete and the first option would be to adjust the medication. Of course, if she means eat more carbs when you are at 3.5, and wish to drive then that's understandable.
 
I am also on Gliclazide and have been informed that were I to have a car accident when hypo without being able to demonstrate that I had taken my BG prior to driving and been within target, then my car insurance would be invalidated.
Before changing your dose of medication on the basis of a single low BG, you really need a pattern of blood sugars across the day as you can still be having significant highs which would increase in frequency / intensity on lower meds. Your hba1c of 54 also shows you are having average blood sugars of 8.7, which is certainly higher than you need them to be.
Having used Libre, I wouldnt reccomend getting one of those to establish your daily highs and lows - they are gret for showing trends but in my experience too inacurate when it comes to absolute figures - what I would suggest is
a) doing 2 weeks of multiple finger prick tests a day - I would do 6-8 at different times of day - to get a pattern of when younare getting highs / lows
b) if you get a low in the mid 3s again then eat a small amount of a more carby food ( say 1/2 apple / banana,or a digestive biscuit, or a couple of squares of chocolate) and keep testing over the next hour or two to see if it comes back up
C) before making any further dietary change or medication adjustment, take a graph of your readings and discuss them with a medic.
 
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KK123 said:
Hi kitedoc, over here in the UK, we have to inform our driving licence authorities if we are on certain glucose lowering drugs, ie insulin and some others. They then issue a 3 year driving licence which gets reviewed. I think the only time a Dr would get involved is if they knew a person was driving around in hypo land or unfit to drive and then they too would alert DVLA or in other extenuating circumstances. Generally though, the law here is not to drive if under 4, if over 4 but under 5, to take a snack and then to test every 2 hours. If glicazide is one of the listed meds (I'm not sure) then the poster would not be allowed to drive under 4.
Click to expand...
With Glic, you have to initially inform the DVLA that you are on the medication and are aware of the need to test before driving. You then have to additionally inform them if you have a hypo requiring asisstance. The licence is not time issued as a time limited one unless you are experiencing serious hypos. Driving while hypo without evidence of appropriate BG testing to ensure your safety to drive, could be seen as a motoring offence and would invalidate motor insurance in the event of an accident ( whoevers fault the accident was)
 
Jim Lahey said:
Eat more carbs so you can take more drugs. Diabetes 101.

:banghead:
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Just stop taking drugs so you can get higher blood sugars. Diabetes 101a.

Get good data on what happening, then make decisions. Safe diabetes management 101
 
Boo1979 said:
Just stop taking drugs so you can get higher blood sugars. Diabetes 101a.

Get good data on what happening, then make decisions. Safe diabetes management 101
Click to expand...

:D

Touché. I’ll take that one on the chin, but honestly, we know that’s not what happened. He was told to eat more carbs. The sensible decision would have been to formulate a strategy to safely reduce the medications instead. In my opinion :)

EDIT: I imagine that a hypoglycaemic is going to cause a lot of instability in a person eating low-carb but who clearly still has a level of insulin resistance. It would probably be better to try switching solely to Metformin. Perhaps even a higher dose of Metformin. Certainly eating more carbs isn’t going to get Gary’s HbA1c lower.
 
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OK. Sorry to thread jump but. Stupid question time.

I drive for a living and I am normally somewhere between 4.3 to 4.8 by end of the working day.

Normally around 5 first thing. May touch 6 after dinner then down to mid 4's.

Pre diabetic, no meds and currently in keto. Feeling better than I have for years.

Driving under 5 is illegal? Er?
 
Only if you’re taking hypoglycaemic drugs, as I understand it.

They are capable of causing hypoglycaemia.
 
Spl@ said:
OK. Sorry to thread jump but. Stupid question time.

I drive for a living and I am normally somewhere between 4.3 to 4.8 by end of the working day.

Normally around 5 first thing. May touch 6 after dinner then down to mid 4's.

Pre diabetic, no meds and currently in keto. Feeling better than I have for years.

Driving under 5 is illegal? Er?
Click to expand...
As Jim said, the rules on BG & driving, only apply to diabetics being treated with medication that can lower BG
 
gary 196 said:
Recently been on low carb hba1 down from 78 to 54 I am on metformin and gliclicide I find testing before driving home from work sugars are quite low 3.5 being the lowest as I am not on insulin is this a problem I feel fine no symptoms of hypo practice nurse says it’s to low and I should eat more carbs it sort of defeats trying to get sugars down.
Click to expand...

Hi, first of all well done getting your Hba1c levels down.
Second, get a GPs appointment, show your GP, your readings and what you are eating and the success of getting your Hba1c levels down due to a low carb diet.
He should then decide to either advise you to cut the dosage of Glicizide, because it is the drug that is driving your blood sugars down. Or raise the carb intake to offset the low readings. He may even decide to take you off the drug altogether.
But, ultimately it is your choice and whatever you decide on his advice, tell your GP.

Only your GP can change your dosage or alter your prescription.
Most dsns in my experience, or not clinicians or diagnostic trained.

As for driving, I was informed by my endocrinologist and GP, not drive at all, because of the number of Hypoglycaemic episodes I was having, and at my last review, I was told that if I wanted to reapply for my license I would have to go the DVLA, and because my condition is not recognised by them in their list, only Hypoglycaemia! It would prove difficult to get the approval necessary.

Best wishes
 
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