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How to deal with high reading 2-3 hours after a meal

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icecoffee

Member
Messages
6
I always have a very high reading 2 hours after every meals and even don't want to test after 3 hours as there is almost a chance it is still high above 8. For years I've been struggling to just manage to keep the figure below 7 after 4 hours. For example, yesterday I had 6.5 in the morning, 45-50 cabs roughly for breakfast at 6.30am, 14.5 at 8.30am, 9.4 at 9.30am and 6.0 at 10.35am. I was horrified but I know it is the normal case for me for so many years. However because my HbA1c is mostly below 7, last time was 6.6, the doctor and nurse are happy with my control so I just try not to be bothered.

Another problem is when the figure falls to acceptable around 7 about 3.5-4 hours after breakfast and lunch it won't stay there. I must have a snack or I will have a hypo (3's). The BS level would drop rapidly. There once it was 4s from 9s an hour ago. Now I am worried about hypo very day around the time. Very frastrated. On the other hand, it expains why the HbA1c is not too bad.

I am on Metformin, 850mg in morning, 850mg at lunch and 500mg+Gliclazide 60mg at dinner. No snacks before bad. Have a hypo a few times during night but not too many. On a low cab diet, around 150g a day. Very skinny (47kg, 1.64m) so not sure whether can do lower cabs.

People here are doing so well on managing their conditions. Please could I have your advice on how to get the reading down to nomal or acceptable (7.5? 7?) 2 hours after a meal and keep it not to fall or not to fall quickly? Please help. Many thanks.
 
High icecoffee and welcome.

That's a difficult one! I would say the first thing you need to do is get to the bottom of the hypo problem. Gliclazide can certainly stimulate enough insulin production to cause hypo's so look at that as a cause. I take it when you do drop low you do get all the classic hypo problems? It sounds like your insulin response is overly reactive for some reason.

Your doctor and nurse should be bothered if you are suffering recurrent hypos regardless of what hBA1c you have and should be doing stuff to try and resolve it for you like maybe changing your medication to see if that makes a difference. I would go back and explain the hypo problem in detail and specifically ask if they think it could be being caused by the Gliclazide. Mention a medication called Januvia to them. That works well at lowering levels without stimulating insulin. Once you get to a point where you can get stable but low non hypoing fasting levels you can then work how to tweak each meal based on how many carbs you are tolerant of. At the moment as you've found it is very difficult for you to judge carbs because of how reactive you are.

Keep in touch and let us all know how you are getting on.
 
Hello icecoffee,

You certainly did the right thing in joining this site because there are many in your position either in part or who completely mirror your symptoms. You have posted as a Type 2 (I think) so you should not worry too much about having a hypo without being aware because it is uncommon at least from my understanding having been a member here for over a year. In fact I could have been the author of your first para, at least in part, because I have to wait for three hours for my levels to drop especially after lunch and then they happily come down to 5/6 before my dinner. I am sure you will do constantly as well if not better after discussing this with your doctor. I await your update because I am expecting extra meds to be suggested early August and your situation could be of help to me also. If you are stressing about hypos it could perhaps be affecting your levels so carry jelly babies, etc., with you and this should reassure you.
 
hi

Hi Icecoffee

Perhaps you need to split your gliclazide dosage if it is the immediate release form. If it is the extended release form, it is more usual to take it with breakfast so that it covers the meals throughout the day. if you take that form at night it will be stimulating the release of insulin when you are asleep and don't need it. As xyzzy says, I would go back to your doc and have a chat about the gliclazide and your hypos.

Take care

Doug
 
Hi Xyzzy, BaliRob and Osidge Doug

I was so moved by your kind replies. Thanks a lot for your useful advices! I will arrange to see the doctor and discuss issues about hypo, medication, Januvia and how to take them more effectively. It feels good that there are people other than doctors/nurses I can talk to for helps as sometimes I feel tired to fight the condition on my own. I will let you know when I make any progress.

All the best wishes.
 
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