Metformin...what if?

Hi timewarp.
Welcome.
Are you T1 or T2 ?

A daily dose of 1500mg of Metformin is not a high dose and will take time to have any effect and will also be affected by your Diet.
It also has many side effects as well. Fortunately you are not obliged to have them all. :lol:

As your bg levels are very low for a Diabetic I am not surprised you are feeling the way you do.
Are you eating enough at the moment ?

Your target Bg levels are as follows:
Fasting (waking) .................between 4 - 7 mmol/l.
2 hrs after meals.................no more than 8.5 mmol/l.

Ask what you need and we will try to answer your questions.
Ken.

Hi Timewarp

Im not sure re the dry mouth - might just be unrelated to diabetes, or a side effect of other medicaiton as I wouldnt expect it with bg numbers you note, although maybe being at 8 is still too high for your body? I didnt get thirst until mines hit the 20's at diagnosis but now get it if I hit double figures.
As for the shakiness and confusion it may be that your bg is too low for 'you' at present at times. Many type 2's seem to function ok in the 4's but anything under 4 is def deemed hypo (low blood sugar) for type 1's and needs to be treated by eating fast acting sugar followed by a slow release sugar (ie lucozade followed by toast). I dont think its as prescriptive for type 2's and there is some debate as to whether they do 'truly' have hypos. I assume they/you must because I know that before I was diabetic i had low blood sugar on lots of occasions though of course my body could compensate then.

Symptoms of hypo number many, shaking/confusion/light headed/hunger to name a few. So, it might be when you are at 3.1 this is too low and making you feel bad. Esp if before diagnosis your body was 'used' to running at higher levels. It wont like it and you might get 'false hypo' effects which is when your meter states things are ok but your body says not. As your body gets used to it, it wont react the same.

As for waking at 8, there is something called Dawn Phenomenon which even when you go to bed on good numbers, your body prepares for the day by dumping glucose from your liver, plus other hormones are released in your body to make sure you have enough energy to get up in the morning.
Some type 2's swear by a no carb snack before bed (cheese, cold meat, nuts etc) and make sure they eat breakfast in the morning. I wont ask re diet etc at present, though it will help to stablise bg if you look at this more closely.

Hope this helps for now. Please keep posting - we have squillions of brilliant type 2's on this forum who'll get you sorted in no time!

Even a NON - Diabetic can Hypo.
Reactive hypoglycaemia
Reactive hypoglycaemia is possibly the most common reason for hypoglycaemia in non-diabetics but is often overdiagnosed.
This form of hypoglycaemia is probably caused by an overproduction of insulin from the pancreas after a large meal with a lot of carbohydrates. The insulin can still be detected even after several hours, although the level should be back to normal at this time.
This condition is probably most common in overweight people and those with Type 2 diabetes, where the large demand for insulin can sometimes cause too much insulin to be produced in the pancreas.
There is some evidence to suggest that reactive hypoglycaemia can precede Type 2 diabetes.

As a T2 on Byetta and Gliclazide I have had a few as well, mainly when I first started hitting numbers of 4 and below.

Ken.

Hi Ken
Anyone can hypo, not just through reactive hypoglycaemia. In the old days, I got hypo symptoms a few times from crash dieting( I've had weight issues all my life)
Most people can function perfectly well down to 3 The odd thing here is 4 at bedtime and 8 on waking, that's pretty extreme for Dawn Phenomenon. Unless someone's eating at bedtime, or drinking something sugary, There's not a lot that can be done about DP It's a bit of a mystery, why some people get it so strongly.

I was diagnosed type 2 a month ago as well as well.

Prescribed Metmorfin 1000mg and then 2000mg for as long as i require it.

On diagnosis my blood glucose was 16 and then every monday when i check 1st thing in the morning it is around 6 0r 7.

It was 7.4 this morning for some reason.

Was told to test once a week and dont want to use too many strips on the NHS.

Dont use any other medication.

Nice to read about people with similar story.

All the best.

Davey

timewarp said:

Forgot to mention...BP is 146/106..
Seems high on diastolic.

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High on both.Read this.

What blood pressure readings mean

Less than 120 over 80 (120/80): Your blood pressure reading is ideal and healthy. Follow a healthy lifestyle to keep it at this level.

Between 120 over 80 and 140 over 90 (120/80-140/90): You have a normal blood pressure reading but it is a little higher than it should be, and you should try to lower it. Make healthy changes to your lifestyle.

140 over 90 (140/90) or higher (over a number of weeks): You may have high blood pressure (hypertension). Change your lifestyle - see your doctor or nurse and take any medicines they may give you.
Ken.

Could my symptoms occur because I am fluctuating from say 12-13 down to 3/4 over a few hours?

Most definitely. Extremes of Bg levels are bound to give you all sorts of symptoms.

The Metformin only reduces blood sugar slightly what happens next if it doesn't control it enough. Is Metformin the only drug to help?

There are a number of other drugs which can be prescribed, taking into account your Warfarin. It is a progressive step usually.

The Nurse didn't think that Metformin would react with Warfarin, it seems it does. I do self test on Warfarin for my INR twice a week so I get a good picture of this.

I can find no evidence anywhere that supports that theory ? What makes you think it does ? Have you discussed this with your GP ?

Even before diagnosis I know I was between 3.5 to 4.2 before bed. I get extreme tiredness at 11, 2, 5 and 7? what might this indicate? This has been happening for some time then 6 weeks ago I got the thirst, urine issues etc.

This is all classic symptoms of uncontrolled Diabetes. Read this.
http://www.nhs.uk/Pathways/diabetes/Pages/Symptoms.aspx

I am just over 40 and slightly overweight.

So the thirst, heavy urination tiredness are indicative of being high rather than low?

Answer as above.

Hope that helps.
Ken.

cugila said:

Reactive hypoglycaemia
Reactive hypoglycaemia is possibly the most common reason for hypoglycaemia in non-diabetics but is often overdiagnosed.

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IMNSHO it is actually UNDERdiagnosed.

It can be a first sign that your pancreas is on its way out (I had it for about 50 years) and usually responds well to avoiding highs, thus not overstressing the control circuit. Keeping the carbs down and grazing rather than having large carby meals is often a good plan.

Hi again tw.

I used to eat like you years ago, shifts and extremely long hours. Not a good idea.

As your BG is all over the place you will feel tired etc at odd times until you can get some control. This all takes time. Just persevere and you will get there.

I find it is far better to have a light Breakfast, light Lunch then a reasonable evening Meal. You can have small snacks in between so you don't get hungry.

I stated to somebody else, if you want control and a better life - then it is a lifestyle change. It will work and isn't that difficult. Since I gained control of the numbers I am far healthier and much livelier throughout the day and Evenings. Before I was falling asleep anywhere.

Your Diet may have to be adjusted, but that will be YOUR choice.

Ken.

timewarp said:

Thanks...

Had main meal tonight and two hours after I was 5.2.
That's not bad at all.
According to what I have read I should be about 8 at bedtime.
Don't know where you have read that. My Bg is usually in the 6 range. does depend on what you are eating.

Perhaps this indicates I don't eat enough? should I have a snack at bedtime?
If you are 8 at bedtimes I don't think you need any more Carbs at all.

Anyone on Metformin...does it make you overheat appear feverish?
I take Metformin and have never had that feeling other than when Bg is out of control.I am unsure what 'transient' means in the context of Metformin causing diarrohea

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Transient - means lasting a short time only.

Have a protein based snack before you go to bed,cheese ,ham something like that.This may stop your liver dumping glucose into your system because you are going too low and stop you getting theses morning highs.

timewarp said.

Diabetes.co.uk information.
"What is a good blood glucose level?

A normal pre-prandial (before meal) blood glucose level will be between 4 and 7 mmol/l.
Correct.
After eating (post-prandial) levels should be less than 10 mmol/l when tested 90 minutes after a meal.
Not correct. These levels were changed in February 2009. The guideline figure given by NICE is actually no more than 8.5 mmol/l after 2 Hrs. This isn't the first time some of the info on here has been out of date.
When going to bed for the night, levels should be about 8mmol/l."
Correct. If you want to be that high.

Very few carbs! Check up what kind of carb content crackers have,IIRC cream crackers are about 0.7 per cracker so a couple with cheese and ham would be OK .Check out Collins Gem carb counter for carbs values .It's just to stop the liver dumping because it thinks you do not have enough glucose in your blood stream for the energies of the day.