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Metformin and hypos?

Discussion in 'Type 2 Diabetes' started by suzybee, Oct 13, 2011.

  1. viviennem

    viviennem Type 2 · Well-Known Member

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    Chocoholicnomore, I know what your DN means and I could have made it clearer in my last post - sorry!

    When you've been running high blood sugars for some time, you can get the "false hypo" symptoms when your blood sugars come down quickly (as yours have done), even if you're still in 'non-hypo' range - that is, over 4.0mmol/l. You were under 4 - but for a non-diabetic, the pre-meal target is between 3.5 and 5.5, so you weren't desperately low even though you were under 4.

    For us diabetics, better to treat when under 4, particularly if you feel hypo-ish, than risk going lower.

    I would tell her you have 'cut your carbs' because it is helping you to lose weight, and has also improved your blood glucose levels. Tell her how much weight you've lost, and show her the results from your own testing. Tell her that you feel well on your new eating plan (if you do?), and that this is the only 'hypo' episode you've had (if it is).

    She'll ask if you're eating high fat, probably. You can say that you're watching your fat intake and that you know that polyunsaturated fats are best. Even I can say that without telling lies - I just don't explain any further!

    Ask her to discuss your diet with you, and to explain why you shouldn't be trying to reduce your blood glucose levels by cutting carbs. I'll be interested to read the answer to that one! Probably along the lines of needing carbs to keep your blood glucose levels stable. Well, everyone is different, but my BGs are very stable on minimum carbs, so don't worry too much.

    With any luck you've got an open-minded DN who is willing to talk things through with you sensibly. I'm lucky in that our practice nurse, who does the diabetes checks, agrees with me about low carb even if she's not allowed to say so, so we don't argue.

    If your DN tells you that you must base every meal around carbs, ask her how many grams of carb she recommends you should be aiming for each day. Don't argue with her - there's no need for a confrontation, and you'll only get upset. Just find out exactly what she wants you to do, write it down, and take it home to think about.

    This is what I did when I saw the NHS dietitian. I knew I wasn't going to do as she recommended, so I just smiled, said yes, and have done as I think best ever since I left that meeting.

    You could let us know what advice she gives you, and we'll have a discussion. If you get everyone's views from Grazer's to mine, including others, you'll have something to think about. :lol:

    You are doing very well in coping with your diabetes, and you mustn't get downhearted. There is an awful lot to learn - I should think all of us learn something new all the time, no matter how clued up we think we are - I know I do! :wink:

    I agree with Grazer about your insurers - always tell them. I phoned my car insurers and they really weren't bothered once I'd told them I was Type 2 on Metformin. It has made no difference to my premiums. Make a note of the time and date of the phone call, and who you spoke to, and then there can be no doubt that they know. There's a section on the DVLA website about diabetes and driving that's worth checking.

    Keep up the good work!

    Viv 8)
     
  2. Sue o2

    Sue o2 Type 2 · Well-Known Member

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    I am on metformin only now fter having the gliclazide stopped a few months ago because of daily hypos, but i do still have low sugar readings below 4.0 for instance yesterday at 4 oclock dont know why i tested as i had no feelings of being low but i tested and i was at 3.4, ive noticed that my danger period for going low is usually between after lunch and before my evening meal so ive now decided to eat a pear (as well as my lunch) at lunch time and see if i get to dinner time without having to have extra food which i really dont want.

    Sue
     
  3. chocoholicnomore

    chocoholicnomore Type 2 · Well-Known Member

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    Thanks for all your advice.

    Grazer- I phoned my insurance company today. They have noted it on my file but it doesn't affect my premiums. I checked the DVLA website and they only need to be notified if anything on the list applies, which it doesn't.Thanks for your advice. I am glad I did it and, as you say, it keeps everything right and doesn't give them a get out clause.

    Viviennem-Thanks for your explanation and advice. It certainly seems to make more sense. However, I am still unsure where to go from here regards eating. I have been eating a little more today and haven't been as strict with my carbs but my BG levels are higher. It was 7.3 2 hours after lunch. Usually it's about 5. something. I am worried about increasing carbs and bg levels in case DN increases my meds but if I stay as strict as I was will I risk another hypo or do you think it's probably just a one of due to drastic change in eating habits. Also, I still want to lose weight and the low carbing has loads of success stories posted in this forum. I am due to start X-pert course a week today and I have dietician appointment on 02/11/11. I thought I knew what I was aiming for before yesterday but now I am still confused. I had intended going to appointments with an open mind but am worried now about conflicting advice e.g. was DN right to tell me that I should be aiming for 8s and 9s even 10s? My hb1 was over 9 on diagnosis. I wanted to get it down as much as possible. Am I aiming for too much too soon? Sorry for asking even more questions but you seem to be really knowledgeable and always give good advice. I know everybody reacts differently but, on the whole, what do you think I should do?
     
  4. Grazer

    Grazer · Well-Known Member

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    I'm no expert on this, but as far as I know the Hypos we can get aren't seriously harmful as they can be for someone on insulin or similar meds. Yes, we can go low, as can a non-diabetic, but we're not gonna get seriously ill. My daughter is not diabetic, but often gets low blood sugars in the "Hypo" regions. She comes over weepy and feeling weird, but nowadays just knows it's time to eat something. If it were me, I'd stick to whatever diet works for the BGs, and if you suffer from low sugars now and again, so what? Don't mean that in an uncaring way, but you can just buy some Glucotabs if you want from the chemist and chew on one of them if you feel bad. Or maybe half a one - don't want the opposite and start getting big spikes.
     
  5. chocoholicnomore

    chocoholicnomore Type 2 · Well-Known Member

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    Thanks Grazer. That's a reassuring answer and makes sense.
    Maybe I over reacted a bit. I thought a hypo was serious and could lead to hospitalisation, or worse a coma, if not caught in time. I suppose I thought this because I also thought only insulin injecting diabetics could get hypos and it is well known that this is serious. A colleague at work lost his son (he was only in his 20s)to a diabetic coma just a few months ago.
    I think I also panicked because I had been driving for about 1/2 hour while feeling like this. I didn't know it was a hypo. I just blamed my jittery, agitated feeling on the bad weather and driving conditions at the time. It was only once I got home and tested BG that I realised it must have been symptoms of a hypo. At least I'll know if it happens again.
    Think I'll go back to low carbs and buy glucose tabs.
    Thanks again for all your help.
     
  6. viviennem

    viviennem Type 2 · Well-Known Member

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    I am very overweight, Chocoholicnomore - I started this time at over 21 stone!

    However, I have decided that I am NOT going to obsess about my weight this time - I'm eating for my blood glucose levels and for me, that means low carb. I also know, from experience, that if I keep on with my low-carb lifestyle the weight will come off, and it has - 4 stone in the last 18 months.

    The weight loss is undoubtedly good for my health, but keeping my blood glucose within the Type 2 target range is also very good for my health, and just at the moment that's the most important thing, so I'm working towards that and not beating myself up if I don't lose weight. It will go in time - it really is slow and steady from here on.

    I came to low carb after almost 40 years of unsuccessful weight loss dieting. I know it works for me; it doesn't for everyone. If you're happy low-carbing, stick with it. As the weight comes off you'll be able to add more, low GI carbs into your diet, which should keep your DN happy. :wink: It's your diabetes, and it's up to you to manage it.

    Tell her you're controlling your carb intake and aiming to eat low GI carbs - she'll be impressed!

    Let us know how you go on with her - and don't worry too much. Worry is unproductive and leads to chocolate! :lol:

    Viv 8)
     
  7. chocoholicnomore

    chocoholicnomore Type 2 · Well-Known Member

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    Thanks Viv

    Some really good advice there.

    Well done for your massive achievement with the weight loss. You must be really proud of yourself and feel all the benefits of it.

    I know what it's like yo yo dieting. I have been to virtually every weight loss club and, just before diagnosis, was at my heaviest ever weight. I could write a book on all the slimming plans and know them inside out but just don't have the will power to stick with it! :oops:

    I think this time is different because it's my health at stake if I don't stick to it. (Before, if I gave up it just meant buying a bigger size of clothing)

    Will let you know how I get on with DN.

    Thanks again for your help

    Marina
     
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