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Need some help, a bit confused

M

MichaelTimothy

Member
Messages
19
Location
Cairo, Egypt
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I have been doing really well for the last month, after being diagnosed with hypertension and T2. My daily averages have been around 118/65 BP, and blood glucose by pin prick at between 95 and 75 mg/dl - 5.3 to 4.2 mmol/l.

But this morning I had a nasty turn. My waking stats at 4am were 123/65 BP, and BG was 5.0. All good.

At 7am, having missed my normal morning workout, I went downstairs, ate my usual 2 walnuts and 2 olives, and took my metformin 500. But I missed breakfast, being intensely busy prepping for a lunch party later today. I ate nothing until around 9.30 when I had a nasty turn: cold sweat, nausea, head spinning,almost passing out. I thought I was having a hypo incident, never having experienced one before, and did a pin prick: I was 7.8 mmol/l, and my systolic BP was below 100.

I have now eaten and exercised, and at 10 am I am 114 BP, and 5.4 mmol/l. Pretty much back to normal. But I am puzzled as to what provoked this. The only thing I can come up with is that metformin on an empty stomach depresses BP? And raises blood sugar? It seems counter-intuitive to me, but perhaps someone could offer me some help in understanding this?
 
Hi Michael, I'm no expert here but I do know that it is not recommended to take metformin on an empty stomach, so could have caused the nausea? I ALWAYS take mine after my breakfast but on the days I miss breakfast I take it with the first meal of the day
 
MichaelTimothy said:
I am taking candesartan 4 mg, which is a pretty minimal dose. It is doing the job pretty well, and I have never had any kind of incident that I might link to it.
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As hypertension and T2 are often linked, changes that impact one often impact both so you could have had a low BP moment due to the meds that might have caused your "wobble" and your body might then have pumped out extra glucose to rectify hence the higher than usual bloods. I never took any meds for hypertension but my low carb diet fixed it. Talk to your doc about removing all the meds for a while and see what happens? Low carb is a powerful tool.
 

The only thing different I do to my usual routine, was to take the metformin on an empty stomach. But what could have driven my BG from 5.0 to 7.8 without taking into account any other factor other than not eating? I would have expected logically, that my BG would go down?
 
Yes it does seem surprising? Did you test just the once?
 

Thank you for that: yes I was beginning to suspect that it was a low BP moment perhaps caused by physical exertion without food at the root of it? And I agree with you 100% about low carbs! The only carbs that I eat are slow carbs that are intrinsic to vegetables that are otherwise very healthful.
 
coby said:
Yes it does seem surprising? Did you test just the once?
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No. I tested again some 45 minutes later after a 5 minute workout and some food (cheese, yoghurt, cucumber and tomato), and the blood was 114 -sorry 6.4, still higher than usual by far. Then I tested another time about an hour after that and I was at 5.4 which is in my normal range.
 
Glad you re-tested as some strips can be at fault and that second was certainly better, if a tad higher than you were expecting. x
 

Hi @MichaelTimothy,

Imho, I don't think it was the metformin on an empty stomach -- when I was still on metformin and took the tablet without food (and I did this quite often) the worst which happened was a bit of nausea, though usually I was just fine.

My guess would be that it was the prepping for the lunch party (a bit like exercise for our body, and add into this a bit of stress). Personally, when I spent something like an hour or more in the kitchen (like cooking a bit more complex meal, including slicing, dicing, frying, doing dishes, etc), I always see significantly higher blood sugar levels. It actually does a better job at raising them than vigorous exercise. When you also consider the time of day (we are more insulin resistant in the morning) and the empty stomach (glucose dump from the liver for energy), I believe this would pretty much explain all of the rise.
 

How confident are you that your hands were clean? I'm wondering if your blood sugar was in fact on the low side and the meter reading was in error?
 
You have mentioned in your post what you ate this morning however you don’t mention drinking. I’m just wondering if your symptoms were due to low blood pressure? Your systolic dropped from 125 to 100, with working hard too maybe you were dehydrated?
 

That is certainly a possibility, although in general I am very careful about keeping hydrated. I live in a hot climate, and I drink between 2 to 3 litres a day of water, and no alcohol. But after reading the very kind comments and suggestions I have received, I am inclined to think that this episode was probably initiated by a BP rather than a sugar problem. I probably should have eaten before rushing around exerting myself.
 
I am on a low carb group and several people, over the years have had falls when continuing to take tablets for high blood pressure - one was quite serious, falling down a staircase, so it might be a very good idea to tell your GP about the incident and maybe suggest that adjusting the blood pressure medication could be prudent.
 

What is your normal BG after you have breakfast?
I have found that mine usually go up prior to my normal main meal, irrespective of me fasting or not.
I usually skip breakfast but will have a light low carb lunch. This keeps my BG around the 5.5 average. But come 6pm my BG starts to go up and can easily hit 6-7mmo/l, even if I have fasted until then. I tend to have my main meal around 7pm. I’ve put it down to my body getting ready for the ‘hunt’ for food.

You also said that you were ‘intensely busy’, which tallies with your body being, ‘on the hunt for food’, hence bumping you glucose reserves into your bloodstream so that you had the energy to succeed.

I do suspect that the hypo’ symptoms were more likely the meds on an empty stomach.
I normally get them if I dip below 3.2 but not always. I have had symptoms when around 5 mmo/l …
 

you skipped breakfast (and maybe liquids). So it’s not just meds on en empty stomach but the lack of food itself that was different.

it seems a liver dump is what pushed the bgl up. Why it dumped could be because of the lack of food or the wobble the spike in bp caused.
 
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