Hi, I am asking a question for my hubbie. He is T2 and has been stable for 7 years on diet and Metformin. Last year he started to get hypos so gradually stopped the Metformin but he is still getting hypos ? His Dr tested C Peptide and insulin last time and said all was normal. But I am still concerned. His lowest has been 2.8 a couple of hours after eating but the more normal hypo is around 3.5. he is on cortisone so has started taking extra cortisone to try and raise his BGL... but this is all sounding a little odd to me ?? He eats about 80g carbs a day which he has done for about 5 or 6 years.. Thanks, Jen.
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Hypos
- Thread starter JennyP
- Start Date
mentat
Well-Known Member
I assume your husband doesn't inject insulin, if he is then everything is different.
Do the hypos occur around periods of exercise? Exercise tends to lower blood sugar.
One likely cause is that his sugar spikes after eating and then his body's insulin response overreacts to the situation, making him "crash". Does his sugar go quite high before he goes hypo? If so, then you should try to avoid the sugar spikes, either by eating low-GI or having frequent smaller meals.
However, some people who are not diabetic develop hypoglycaemia (often triggered by exercise); maybe this has happened to him. It can happen if the body's glucagon response is impaired.
If his hypos are always a couple of hours after eating I would guess it's a crash after a sugar spike, but I can't be sure.
Do the hypos occur around periods of exercise? Exercise tends to lower blood sugar.
One likely cause is that his sugar spikes after eating and then his body's insulin response overreacts to the situation, making him "crash". Does his sugar go quite high before he goes hypo? If so, then you should try to avoid the sugar spikes, either by eating low-GI or having frequent smaller meals.
However, some people who are not diabetic develop hypoglycaemia (often triggered by exercise); maybe this has happened to him. It can happen if the body's glucagon response is impaired.
If his hypos are always a couple of hours after eating I would guess it's a crash after a sugar spike, but I can't be sure.
No, he is not on Insulin. He does exercise with weights every second day or so but that has not changed in 6 years... He eats low carb most of the time. Lunch is often a bit more carby ( say 30g) and I am not sure if he tests an hour after eating to measure a peak level.. so I may tell him to do that. I don't think his BGL goes high through the day though. His HbA1c is dropping. Is the C Peptide test usually accurate ? His Dr is a GP and I am a bit worried he may need to see an Endo as something is being missed. Thanks for your reply. Jen
He tested yesterday an hour after lunch his BGL was 15... dropped to 7 after two hours. So yesterday was a good day as he did not get a hypo.. This is with extra cortisone taken to push up his levels.. Lunch was tuna on rice crackers - about 30g carbs - his normal lunch for last 6 years..
mentat
Well-Known Member
15 is quite high for a spike, especially with such a low carb meal. I don't like the extra cortisone. My guess is that the hypos are due to the very high sugars causing the pancreas to produce an excess of insulin which then leads to a crash.
If that is true (and I'm no doctor), then the cortisone could be exacerbating the problem.
You may also want to try reducing the spikes, either by eating more frequent, smaller meals, or adding more fat and greens to the meal to try to reduce the GI.
If that is true (and I'm no doctor), then the cortisone could be exacerbating the problem.
You may also want to try reducing the spikes, either by eating more frequent, smaller meals, or adding more fat and greens to the meal to try to reduce the GI.
Sid Bonkers
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Something is clearly not right here as no one on Metformin should experience regular hypos, so it is something that needs to be explored urgently before any serious damage is caused.
Your husband should NOT increase his steroid as this could have dangerous consequences assuming you are talking about Prednisolone. Never ever increase your medication without consulting a doctor or at the very least a pharmacist.
If he is taking Pred then it would be normal for his bg to rise, certainly not drop to hypo levels, when I was diagnosed my bg was 29 mmol/L with an hba1c of 12.6%, I was taking 10g prednisolone a day at the time and had been a long term steroid user which almost certainly caused my diabetes, I never had hypos until I started taking insulin after diagnosis.
Please get your husband to his doctor ASAP and until you can get an appointment reduce his Pred to the prescribed amount.
Hope you get things sorted out quickly
Your husband should NOT increase his steroid as this could have dangerous consequences assuming you are talking about Prednisolone. Never ever increase your medication without consulting a doctor or at the very least a pharmacist.
If he is taking Pred then it would be normal for his bg to rise, certainly not drop to hypo levels, when I was diagnosed my bg was 29 mmol/L with an hba1c of 12.6%, I was taking 10g prednisolone a day at the time and had been a long term steroid user which almost certainly caused my diabetes, I never had hypos until I started taking insulin after diagnosis.
Please get your husband to his doctor ASAP and until you can get an appointment reduce his Pred to the prescribed amount.
Hope you get things sorted out quickly
Thanks for your replies. I agree it is odd. He is not on metformin now. Has never been on Insulin. BGL have been improving so much in last year or so, that the meds are not needed now. But now the BGL is going too low ? His diet has not changed. He has been on Pred all this time - low dose and his Dr a GP approved him to take more ( 10 - 15mg a day ) to level out the hypos but I thought it sounded odd too? Years ago when I was being tested for BGL problems the Endo was thinking Insulinomas - so now I think that too - but surely a GP would know this ? GP did test his C Peptide and fasting Insulin levels and both were OK. Is this test for Insulinomas ? I had a 5 hour GTT for my testing. I would like him to see an Endo but he says he is alright.. and the extra Pred helps.. :?
mentat
Well-Known Member
Hypos are dangerous, and many people who get frequent hypos start to lose the warning signs. If he has one while driving etc. he could have an accident.
If he is having hypos and not on any diabetic medication, there may be a serious underlying problem. I think simply taking extra steroids to increase blood sugars is a destructive band-aid solution. Steroids have nasty side-effects!
I read a lot of stories on the internet about people finding that specific diet changes send their autoimmune conditions into remission (e.g. many people find excluding all nightshades such as tomatoes, eggplant, potatoes, and peppers from their diet eliminates the symptoms of joint inflammation). Maybe you'd be interested in looking into this as a way to reduce dependence on steroids.
If he is having hypos and not on any diabetic medication, there may be a serious underlying problem. I think simply taking extra steroids to increase blood sugars is a destructive band-aid solution. Steroids have nasty side-effects!
I read a lot of stories on the internet about people finding that specific diet changes send their autoimmune conditions into remission (e.g. many people find excluding all nightshades such as tomatoes, eggplant, potatoes, and peppers from their diet eliminates the symptoms of joint inflammation). Maybe you'd be interested in looking into this as a way to reduce dependence on steroids.
Yes, he only does local driving now and always tests before driving or even walking outside.
He is on steroids for adrenal insufficiency so can never come off them or he would die. I explain the steroids to people as being like Insulin to a Type 1 Diabetic. If you don't take them you die but you have to take the correct amount. Unfortunately for AI there is no finger prick test so there is more guesswork involved. So the Dr increased the steroids in case his hypos were being caused by low cortisol. It is puzzling as he has been stable on all the medications for 7 years and now this. His steroid dose at the moment is more than people with AI normally need. I can't wonder if this is not normal.
That is scary that he may be getting used to low BGL and not recognise a hypo. He is extra careful at the moment and tests quite often and eats often but I worry what would happen if I am not here or a hypo happens at night.
He is on steroids for adrenal insufficiency so can never come off them or he would die. I explain the steroids to people as being like Insulin to a Type 1 Diabetic. If you don't take them you die but you have to take the correct amount. Unfortunately for AI there is no finger prick test so there is more guesswork involved. So the Dr increased the steroids in case his hypos were being caused by low cortisol. It is puzzling as he has been stable on all the medications for 7 years and now this. His steroid dose at the moment is more than people with AI normally need. I can't wonder if this is not normal.
That is scary that he may be getting used to low BGL and not recognise a hypo. He is extra careful at the moment and tests quite often and eats often but I worry what would happen if I am not here or a hypo happens at night.
mentat
Well-Known Member
That's sad to hear.
I have another random suggestion - maybe he should try fasting, perhaps one day a week? I'm a type 1 diabetic and I find having days where my sugars don't go up and down, and where I don't need to worry about how much I eat, very liberating. Fasting seems to kick-start repair processes in the body. If his hypos are caused by sugar spikes after eating, then on a fasting day he may be free of hypos. It might also make him happier to eat more often on non-fast days.
If it appears that he never gets hypos on fast days that may help you figure out how to address the hypos.
I have another random suggestion - maybe he should try fasting, perhaps one day a week? I'm a type 1 diabetic and I find having days where my sugars don't go up and down, and where I don't need to worry about how much I eat, very liberating. Fasting seems to kick-start repair processes in the body. If his hypos are caused by sugar spikes after eating, then on a fasting day he may be free of hypos. It might also make him happier to eat more often on non-fast days.
If it appears that he never gets hypos on fast days that may help you figure out how to address the hypos.
You are right - he is starting to lose the warning signal for hypos. He tested 2 hours after lunch and it was 4.0 and he had no symptoms. So he ate some nuts ... and tested an hour later and it was 3.7. So now he has had some chocolate... He has a sinus infection at the moment . Would that be affecting the levels ? I am feeling a bit concerned but he shrugs it off. Jen..
