Metformin and hypos?

[Emilyingram123]

i have been diagnosed for just under a year now and in that time I have managed to get my Hba1c from 74 to 39!! Which is great. I did this through exercise / healthy diet and cutting out all of the carbs.

I started on 3 x 500mg of Metformin a day and decreased to two after my last blood test, however I’ve noticed I quite often get hypos. Yesterday I had eaten as normal but I was sat in the library and it hit me out of nowhere. I’ve had a few quiet horrible low blood sugars (lowest at 3.4 recorded), however I didn’t think Metformin was meant to cause hypos. Do I still need them now my HBA1c is at a “normal” level?

If anyone has any advice it would be much appreciated

Emily

 

[rom35]

Hi, I hear first time that metformin without hard excercise or physical work can do hypo - 3.4 is not so terrible low as 3.9 is the limit and there is +-0.8 possible difference of glucometer according to the norm. If you are able to manage your BG without medicaments, I see no point to take them. Anyway, why your doc prescribed it to you with HbA1C = 39 ????

 

[Emilyingram123]

Hi, I hear first time that metformin without hard excercise or physical work can do hypo - 3.4 is not so terrible low as 3.9 is the limit and there is +-0.8 possible difference of glucometer according to the norm. If you are able to manage your BG without medicaments, I see no point to take them. Anyway, why your doc prescribed it to you with HbA1C = 39 ????

Hi, I hear first time that metformin without hard excercise or physical work can do hypo - 3.4 is not so terrible low as 3.9 is the limit and there is +-0.8 possible difference of glucometer according to the norm. If you are able to manage your BG without medicaments, I see no point to take them. Anyway, why your doc prescribed it to you with HbA1C = 39 ????

i was diagnosed with a HBA1C at 74 so I’ve brought it down to 39.

Thanks anyway for the advice
I will ask my nurse next week

Emily

 

[HICHAM_T2]

I think it's rarely causes metformin in the hypo
Maybe just coincided with some wine

 

[Daibell]

There is a variant of diabetes called Reactive Hyperglycaemia that can cause unexpected BS movements. Have look at that forum on this website. It's unlikely to be the Metformin causing the problem.

 

[ickihun]

I've had hypos on metformin only in the past. Not regularly but it does happen.

A few type2s report the odd hypo feeling on metformin.
Which is why I don't believe in no test strips on metformin only.

 

[JohnEGreen]

My lowest in recent times was 2.4 but have had several in the low 3's

 

[britishpub]

I often get readings in the low 3’s but none of them was a hypo. I feel fine when my BG is that low.

 

[daisyduck]

Metformin is not supposed to cause hypos. I did have one funny turn though. I'd been very low carb all day and did some strenuous exercise.. power walking and running. ( I was out so couldn't measure my BG at the time ) I stopped for a minute then walked slowly home. I was feeling better by then and BG was 4.2, so if it had been a hypo my liver had kicked in and given me a boost.
I stopped taking metformin after 11 weeks of feeling awful on it.

 

[lindijanice]

Hey @Emilyingram123, Great job on getting your levels down so well - keep going! I would agree with others that Metformin is not supposed to give hypos, but we are all different in our reactions to meds. Perhaps you could give it a go without it for a week or two and see if you are any better....maybe keep a food diary too to make sure that you are consuming enough food. The suggestion of the reactive hypoglycemia is maybe something to check out further if you continue to experience these episodes of hypos or false hypos, whatever they are.....hope you get it sorted out soon/L

 

[dpob]

Anyone getting hypos and regular very low readings should talk to their GP or diabetic nurse immediately. Hypos are extremely dangerous as one could slip into a coma and some have been known not to come out. Anyway, with a HbA1C as low as 39 there is absolutely no need for 3 metaformin tablets.
I also started with a high HbA1C and I also was prescribed 3 * 500mg metformins along with diamicron tablets. Similar to most people here, I cut out the processed foods and take-aways etc., but mainly I stopped eating carbohydrates apart from fruit and vegetables. I managed to lose 6 stone approx. 40 kilos in eighteen months. My last reading was 37.5. I have been taking only one metformin usually in the evenings and some days I manage with none at all.
My doctor gradually cut down the dose as my readings were getting lower over the months.
However a person should also use their own common sense. Personally I still test regularly but at this stage I know by how I am feeling whether my sugar is higher or lower and I would imagine it is the same for most people. We wouldn't continue taking a high dose of cold and flu medicine if the cold or flu was petering out. Same for diabetes. Because these tablets actually increase the insulin in our blood to lower the sugar levels, it makes it harder to lose the weight.
So keep up the good work. You're doing great but through trial and error and not just from what I have learned over time on this brilliant resource, there is no need for so many tablets when our HbA1C and blood sugar readings are getting lower.
But please take on board that hypos are dangerous. Stay above 4. Nothing wrong with readings of 5 or 6....

 

[rachaelc]

I've had hypos on metformin only in the past. Not regularly but it does happen.

A few type2s report the odd hypo feeling on metformin.
Which is why I don't believe in no test strips on metformin only.

I also have had hypos on metformin. I always seem to react to new meds at first, have been on several different ones. I recently went onto sustained release version, had hypos for about 2wks, then settled down. I'm much more stable on s.r metformin.

 

[kokhongw]

Hypo's can and do occur for T2D, even if we are not on medication...

This is 3 mmol 3 hours after lunch...at 1 1/2 hour it was 165mg/dl ~ 9 mmols

I believe one of the key reason for this is that we have greatly increased/improved our insulin sensitivity thru our diet/fat loss but have yet to restore the 1st phase insulin response. Hence due to the lack of a robust 1st phase insulin response, we end up with a large second phase response that drives our glucose levels too low...

The solution is still to eat meals that do not provoke huge glucose/insulin response.

Also what most of us fails to understand is that it is not the low glucose level alone that trigger a hypo event, it is the speed of the drop and the absence of ketones. If there is adequate level of ketones 2-3 mmol, then the low level of glucose 3 mmol does not trigger a hypo event as our brain would still be adequately fueled to maintain clarity and functionality.

 

[Zilsniggy]

Perhaps you could give it a go without it for a week or two and see if you are any better....maybe keep a food diary too to make sure that you are consuming enough food.

Please be careful and don't reduce medication without medical advice. Metformin can take 4-6 weeks to reach a therapeutic level in the body. Likewise it can take that kind of time for sugars to stabilise after you stop taking it, so a week or two may not be long enough to show the effects.

 

[lindijanice]

Hey @Zilsniggy I agree with you re letting your Doc or DN know what you are doing. Also for the effects to show do take longer than a week or two, thanks for the correction! Cheers/L

 

[Zilsniggy]

ey @Zilsniggy I agree with you re letting your Doc or DN know what you are doing. Also for the effects to show do take longer than a week or two, thanks for the correction! Cheers/L

We are all different. Just don't want anyone trying this without medical input, which can be dangerous. Some people might get control quickly after stopping metformin, some not.

 

[ickihun]

We are all different. Just don't want anyone trying this without medical input, which can be dangerous. Some people might get control quickly after stopping metformin, some not.

Me.. not.
Ive rocketed in 2wks. Should I expect to go even higher? Or do they settle down again without me increasing my insulin units?
DN told me she didn't mind if I needed more insulin. (I'm getting very expensive, at this rate thou). Hopefully only temporary til op.

 

[ringi]

Hypos are extremely dangerous

Not the sort people get when only taking Metformin, in fact, there have been very few cases of comas from hypos with any drug other than insulin. Clearly, there is a risk with driving etc but there has never been any proof of Metformin leading to car accidents from hypos.

Because these tablets actually increase the insulin in our blood to lower the sugar levels, it makes it harder to lose the weight.

Metformin never increases the insulin in our blood, hence one of the reasons it is used so often.

 

[ringi]

First we must be careful how we define a hypos.

I define it as very low BG that our body is not able to correct unless we eat some carbs. E.g. if I go out running, get a low BG, but it recovers with me laying on the ground (without eating carbs) it was not a hypo. (Just look at what lots of poeole are like at the end of a 26 mile run, and we don't call it a hypo!)​

Lots of people get low BG, but as they do not have diabetes they don’t have a meter, therefore don’t know why they are feeling a “bit off” for a short time.

Wine can reduce the livers ability to respond quickly when our BG goes low regardless of Metformin usage.

If someone has recently gone low carb, their body may not yet be used to using fat – I don’t think this is your issue.

As I understand it Metformin mostly reduces your BG most in the morning, given how low your A1c is, it would be reasonable to measure your fasting BG every day for two weeks, then (after talking to your GP) reduce the Metformin dose, and measure your fasting BG every day over the next few weeks. Also, see if your “hypos” are getting better – however, this is hard to judge as you have no objective way to measure how you feel.

 

[Zilsniggy]

Me.. not.
Ive rocketed in 2wks. Should I expect to go even higher? Or do they settle down again without me increasing my insulin units?
DN told me she didn't mind if I needed more insulin. (I'm getting very expensive, at this rate thou). Hopefully only temporary til op.

It could take 4-6 weeks, as I've mentioned above.......I'd go for a month and see what happens. Depends how high your sugars are actually going without the metformin.