Type 2 Hypo help please

[dogslife]

Hi there folks. Would appreciate advice please asap.. Am T2 and take gliclazide with breakfast then SR metformin and gliclazide with evening meal.Have just had a hypo out of the blue. Had a good lunch about 31/2 hrs beforehand so didn't expect sugar levels to be low. Suddenly went very hungry/ thirsty started to shake , sweating and felt like legs were turning to jelly!Took bloods and were 3.5. Ate some chocolate followed by toasted cheese shortly afterwards for my evening meal and bloods now up to 6.5. My question is do I still take my metformin and gliclazide as I normally do after my meal or will I be risking my bloods dropping too low again? Or should I eat something else then just take the metformin tonight and resume my normal meds tomorrow? Please advise. Many thanks. dogslife.

 

[Lamont D]

I would inform your GP that your meds are affecting you.
Glicizide is known to lower blood glucose levels down towards hypo levels, your dose may be too high.

Hope this helps.

 

[dogslife]

I would inform your GP that your meds are affecting you.
Glicizide is known to lower blood glucose levels down towards hypo levels, your dose may be too high.

Hope this helps.

Thanks for your quick response, I will let my GP know as you suggest. In the meantime I just need advice re what I should do tonight. Thanks again.

 

[dogslife]

I would inform your GP that your meds are affecting you.
Glicizide is known to lower blood glucose levels down towards hypo levels, your dose may be too high.

Hope this helps.

Thanks for your quick response, I will let my GP know as you suggest. In the meantime I just need advice re what I should do tonight. Thanks again.

I would inform your GP that your meds are affecting you.
Glicizide is known to lower blood glucose levels down towards hypo levels, your dose may be too high.

Hope this helps.

https://en.wikipedia.org/wiki/Gliclazide

Gliclazide can cause Hypoglycemia, Metformin doesn't. We members can't give advice, we only can express our personal opinion or experience.
What I would do, is definitely eating something, NOT taking the Gliclazide and it would not harm not having Metformin either because Metformin does build up a very stable plasma level and does not react directly to more or less drug.

You may contact NHSChoices today and contact your GP or diabetic nurse tomorrow.

Thanks for your thoughts. They are much appreciated.

 

[TorqPenderloin]

Maybe I'm getting a little too used to artificial insulin, but a reading of 3.5 doesn't worry me too much these days. It could be nothing more than meter inaccuracy.


Below 3.0 is definitely a pause for concern though.

Just my personal opinion. I'd still talk to the doc about it though.

 

[Daibell]

Hi. If anything it will be the Gliclazide causing low blood sugar. Do discuss reducing the dose with your GP and keep measuring.

 

[dogslife]

Maybe I'm getting a little too used to artificial insulin, but a reading of 3.5 doesn't worry me too much these days. It could be nothing more than meter inaccuracy.


Below 3.0 is definitely a pause for concern though.

Just my personal opinion. I'd still talk to the doc about it though.

Thanks for the reassurance. It was my hypo symptoms that made me check my levels not the other way around so on this occasion I'm pretty sure it wasn't a false reading. I still feel pretty weak/ ache today even though my level was back up to 7+ before breakfast. I've been on the same dose of gliclizide for a while but have lost weight and cut down on carbs so may need the dose adjusting. Thanks again.

 

[dogslife]

Hi. If anything it will be the Gliclazide causing low blood sugar. Do discuss reducing the dose with your GP and keep measuring.

Thanks for your response. I have been on 80 mg of gliclizide for a while but have lost some weight and cut down on carbs recently so maybe you are right. I have an appointment on Monday with a practice nurse so will mention it then. Still feeling pretty weak and ache today! Thanks again.

 

[dogslife]

Maybe I'm getting a little too used to artificial insulin, but a reading of 3.5 doesn't worry me too much these days. It could be nothing more than meter inaccuracy.


Below 3.0 is definitely a pause for concern though.

Just my personal opinion. I'd still talk to the doc about it though.

 

[Oldvatr]

It is the change in diet combining with a strong dose of Gliclazide. I too am on 80 mg same timings as you and when i started LC diet, I got the symptoms of hypo regularly, even within 1 hour of a meal where my pre-meal reading was 10.4 and my 1hr PP was 2.1.

I stopped my evening Gliclazides (2) and generally my bgl was ok without them. Occasionally I will take 1 or 2 Gliclazides if my post prandials are high, otherwise I omit them totally.

IMy GP and I reached agreement last week, and although he will still prescribe the original dose of Gliclazide, it is up to me whether I take any. So far this week I have only had 1 of the 14 in my medi-wallet. My average bgl this week is 6.3, which I am happy with, and hypo's = zero.

 

[Neohdiver]

Thanks for your response. I have been on 80 mg of gliclizide for a while but have lost some weight and cut down on carbs recently so maybe you are right. I have an appointment on Monday with a practice nurse so will mention it then. Still feeling pretty weak and ache today! Thanks again.

Lower carbs + glicizide is likely the culprit. Your new carb level may be to low for the insulin level the glicizide causes. Make sure you talk to your doctor about your diet, as well. A number of people drop glicizide (no longer need it - or find the hypos too risky/frequent), or dramatically reduce it, once the lower their carb level.

 

[dogslife]

It is the change in diet combining with a strong dose of Gliclazide. I too am on 80 mg same timings as you and when i started LC diet, I got the symptoms of hypo regularly, even within 1 hour of a meal where my pre-meal reading was 10.4 and my 1hr PP was 2.1.

I stopped my evening Gliclazides (2) and generally my bgl was ok without them. Occasionally I will take 1 or 2 Gliclazides if my post prandials are high, otherwise I omit them totally.

IMy GP and I reached agreement last week, and although he will still prescribe the original dose of Gliclazide, it is up to me whether I take any. So far this week I have only had 1 of the 14 in my medi-wallet. My average bgl this week is 6.3, which I am happy with, and hypo's = zero.

Thank you for your comments. Omitted my evening gliclozide on the evening of my hypo and just took my metformin but only after another snack. My pre breakfast test the next morning was 7+, higher than usual, and I felt pretty unwell all day. Yesterday I took the breakfast gliclozide as normal , my metformin with my evening meal then my gliclozide an hour later after eating a banana. This morning my pre breakfast test was down to 6.5. and I feel OK. I will discuss what you suggest at my appointment on Monday. It certainly makes sense to me. Thanks again.

 

[dogslife]

Lower carbs + glicizide is likely the culprit. Your new carb level may be to low for the insulin level the glicizide causes. Make sure you talk to your doctor about your diet, as well. A number of people drop glicizide (no longer need it - or find the hypos too risky/frequent), or dramatically reduce it, once the lower their carb level.

Thank you for your support. What you say makes sense to me and I will definitely talk to my GP about it.

 

[uart]

Hi dogslife. What everyone has said, it's the low carb combined with gliclazide. I had the same thing, used to sometimes get mild hypo's with gliclazide.

Gliclazide stimulates your pancreas to make more insulin, but it operates pretty much independent of what you've eaten. So whereas a non diabetic would just naturally produce less insulin if they ate less carbs, or the insulin dependent diabetic would just inject less insulin if they ate less carbs, it's a little more difficult on glicizide. It's slow acting, but it will pretty try to keep your pancreas making insulin most of the time.

Because of the above, weight loss is often difficult with gliclazide, I know that I couldn't lose any weight while I was on it. If you can low carb (or LCHF) and reduce your gliclazide dosage then trust me that is a GOOD thing.

 

[dogslife]

Hi dogslife. What everyone has said, it's the low carb combined with gliclazide. I had the same thing, used to sometimes get mild hypo's with gliclazide.

Gliclazide stimulates your pancreas to make more insulin, but it operates pretty much independent of what you've eaten. So whereas a non diabetic would just naturally produce less insulin if they ate less carbs, or the insulin dependent diabetic would just inject less insulin if they ate less carbs, it's a little more difficult on glicizide. It's slow acting, but it will pretty try to keep your pancreas making insulin most of the time.

Because of the above, weight loss is often difficult with gliclazide, I know that I couldn't lose any weight while I was on it. If you can low carb (or LCHF) and reduce your gliclazide dosage then trust me that is a GOOD thing.

Thanks for your reply. I'm pretty sure my weight gain was due to gliclazide in the first place. I was advised to lose weight and have recently lost about 7-9 pounds by cutting down on portion size and carbs as well as walking more often. At the same time I had my statins dose increased and additional blood pressure medication prescribed. These have been temporarily withdrawn by my GP as I was getting raised / irratic pulse and raised blood sugars. I am monitoring both at home daily and have another appointment in 9 days time when she may rethink my medication. I am due to start aqua aerobic classes next week as part of my Lifestyle programme. The fact is I felt fine before all of these changes, even though my diabetic review showed these scores to be above target. I have an interim appointment for a blood pressure check with a nurse today so will mention the gliclazide dose to her. Thanks again for bothering. Much appreciated.

 

[dogslife]

Just a quick update. I have since seen my GP. I have recorded my fasting daily blood sugars for the past 2 weeks which were OK and my recent HbA1c has reduced from 58 in November to 50 due to my change of diet so she has reduced my Gliclazide dose and I will continue to monitor / record daily, particularly as I have signed up for 2 additional exercise classes starting next week. Hopefully this will help to keep my levels under control on the lower dose. Thanks again to all who replied to my request for help.

 

[Lamont D]

It's all your own work, we just pushed you in the right direction.

Well done!