New Diabetic Type 2 - Hypo Sugar Ranges?

[StuOnTwo]

Hey apologies but I was diagnosed in October last year and still trying to figure things out and adjust to this condition. I have a question about hypo's:

I see on this site that the range after eating should be 4.0 to 8.5 but I have noticed that I seem to start Hypo'ing around the 4.6 mark... shaking, sweating and sometimes I slightly like... confused feeling? Is this normal? I thought that a Hypo would be at levels of sugar nearer 4.0 and below ?

Thanks

Stu

 

[Oldvatr]

Hey apologies but I was diagnosed in October last year and still trying to figure things out and adjust to this condition. I have a question about hypo's:

I see on this site that the range after eating should be 4.0 to 8.5 but I have noticed that I seem to start Hypo'ing around the 4.6 mark... shaking, sweating and sometimes I slightly like... confused feeling? Is this normal? I thought that a Hypo would be at levels of sugar nearer 4.0 and below ?

Thanks

Stu

What meter are you using? If it is an SD Codefree or an Accuchek meter then it will be displaying results using a different calibration that is 12% higher than the figures usually quoted in the Newbie Starter info. If this is the case, then multiply the reading by 0,88 to get the usual figure. So 4,6 on your meter would convert to around 4,0. In addition, each meter has an allowed variation of up to +/- 0.88 mmol, so this could take the reading lower into the range you expect for hypo.

If you are getting the symptoms of hypo as you describe then trust your body, and treat it as a hypo, Meters give a guide only, but the reality must be how you feel.

Edit to add: As I type, I am myself recovering from a hypo. My NEO meter read 3,6, by SD Codefree read 4.9. My body said FEED ME!

 

[Totto]

It's probably a false hypo, as your body is used to higher BG levels and when BG normalise it feels like a hypo. Get used to it. It will pass.

 

[Winnie53]

@StuOnTwo this article by Jenny Ruhl explains false hypos... http://diabetesupdate.blogspot.com/2007/07/type-2s-understanding-false-hypos.html

If you are on any diabetes medications, this article will explain when you should and shouldn't be concerned about hypos.

She updates her excellent book Blood Sugar 101 every 4 years. The most recent revised edition was published this year. I learned a lot from her when I was re-diagnosed with type 2 diabetes early last year, and have her revised edition on my book pile to read as I write this.

 

[Jaylee]

Hey apologies but I was diagnosed in October last year and still trying to figure things out and adjust to this condition. I have a question about hypo's:

I see on this site that the range after eating should be 4.0 to 8.5 but I have noticed that I seem to start Hypo'ing around the 4.6 mark... shaking, sweating and sometimes I slightly like... confused feeling? Is this normal? I thought that a Hypo would be at levels of sugar nearer 4.0 and below ?

Thanks

Stu

Hi,

What diabetes medication are you prescribed...?

 

[StuOnTwo]

I am on metformin.

 

[Winnie53]

Might be worth a call to see if your medication needs to be adjusted.

"Neither Metformin, Byetta, Januvia, Precose, Avandia nor Actos provoke hypos nor can you experience a true hypo if you cut way back on your carbs. What you are likely to encounter if you use these drugs or carb restriction to bring your blood sugar down to normal levels, is a "false hypo.""

http://diabetesupdate.blogspot.com/2007/07/type-2s-understanding-false-hypos.html

 

[Oldvatr]

Might be worth a call to see if your medication needs to be adjusted.

"Neither Metformin, Byetta, Januvia, Precose, Avandia nor Actos provoke hypos nor can you experience a true hypo if you cut way back on your carbs. What you are likely to encounter if you use these drugs or carb restriction to bring your blood sugar down to normal levels, is a "false hypo.""

http://diabetesupdate.blogspot.com/2007/07/type-2s-understanding-false-hypos.html

What you state here is what is generally considered correct, especially by the medical profession. However, there are reports on this forum and also on the Atkins forum that would show that it is not always so certain. I have myself had hypo's when taking certain herbal supplements as indeed I did yesterday which was directly due to such an event.

The OP implied in their opening post that this was not an isolated event, and seems to have recurred thus prompting the question.

 

[britishpub]

when taking certain herbal supplements

 

[Winnie53]

@Oldvatr apologies for creating confusion. Thank you for prompting me to clarify.

A "false hypo" is very uncomfortable, but generally not life threatening. That's the difference between a "false hypo" and the type of hypos that diabetics who use insulin or a few of the diabetic drugs experience - (my type 1 diabetic friend died five years ago from a hypo; she passed out, hit her head, and died; she was the hub of my circle of friends; she is deeply missed).

I suffered from hypoglycemia for many years throughout the early 80's and it was absolutely miserable. With time I learned to head the hypos off with a snack.

To speak more clearly, the original poster (OP) needs to increase carbs or reduce his/her medication to stop these "false hypos", but needs to do so in consultation with his/her healthcare provider.

 

[Oldvatr]

@Oldvatr apologies for creating confusion. Thank you for prompting me to clarify.

A "false hypo" is very uncomfortable, but generally not life threatening. That's the difference between a "false hypo" and the type of hypos that diabetics who use insulin or a few of the diabetic drugs experience - (my type 1 diabetic friend died five years ago from a hypo; she passed out, hit her head, and died; she was the hub of my circle of friends; she is deeply missed).

I suffered from hypoglycemia for many years throughout the early 80's and it was absolutely miserable. With time I learned to head the hypos off with a snack.

To speak more clearly, the original poster (OP) needs to increase carbs or reduce his/her medication to stop these "false hypos", but needs to do so in consultation with his/her healthcare provider.

When I did the maths on the meter readings, then I could not at that time rule out clinical hypo, since it was just possible from the figures. The OP has not answered my question of what meter they are using, so we can probably assume it is not one of the two I identified as being plasma calibrated. So False hypo is probably where we are today. Anyway, such a hypo for a T2 on Metformin only is most probably self limiting and not a threat. I had one this last 2 days ( because of something I did, but I do not want to divert this thread)

 

[Winnie53]

For me, hypos were preceded by hunger so I was able to head them off most of the time by snacking. The problem for the OP is that if a diabetic increases carbs, he/she is also increasing insulin levels, so my vote would be to lower the medication.

Your point about how meters calculate blood glucose differently was important and interesting. I think I read somewhere this week that we don't have that problem in the US, unless you're using a very old US meter.

 

[Brunneria]

To @StuOnTwo
apologies for the incoming rant. it is off topic, but no more off topic than several posts already on this thread.
- and for the record, if your reading was in the 4s, then it does sound like it was a false hypo. In which case, the more time you hang around in the 4s and 5s, the more comfortable you will feel there - until it feels just like home.

Right, where was I...? Oh yes,

[rant]

Just because a drug 'does not provoke hypos' doesn't mean that hypos are impossible when taking that drug. Somehow, the myth that hypos are impossible when on metformin has permeated a collective mindset, and is regurgitated regularly on this forum.

Similarly there is a myth that T2s don't hypo unless they are on Glic or Insulin.
- yes they do. I do. So do several people who post on the forum.

I am not aiming this at anyone who has posted on this thread, or anyone in particular, but

I wish people would stop automatically assuming that just because THEIR body works in a certain way, that everyone else's body works the SAME way.​

[/rant]

 

[Oldvatr]

For me, hypos were preceded by hunger so I was able to head them off most of the time by snacking. The problem for the OP is that if a diabetic increases carbs, he/she is also increasing insulin levels, so my vote would be to lower the medication.

Your point about how meters calculate blood glucose differently was important and interesting. I think I read somewhere this week that we don't have that problem in the US, unless you're using a very old US meter.

The meter problem we have is that only a couple of manufacturers have changed their calibration unilaterally. The people who wrote the guideline ranges and targets still use the older system, so this will affect anyone using SD Codefree or Any Accuchek meter, regardless of country. Until all meters are made to conform to the same system, and the guidelines are re-published for that system, then this problem will persist, I'm afraid. Most users will not be aware of this but the result will be that those specific meter users will be seeking tighter control than necessary i.e. 12% lower than everybody else to match the target ranges. It affects me as a driver since I cannot afford to have a hypo when out driving. I am also on a medication that regularly drops me into the hypo range, so I need to be aware so I can avoid needing assistance.

 

[Winnie53]

@Brunneria apologies...a "false hypo", meaning non-life threatening, has the same unwanted symptoms as hypo. You're right.

 

[Godderz]

The meter problem we have is that only a couple of manufacturers have changed their calibration unilaterally. The people who wrote the guideline ranges and targets still use the older system, so this will affect anyone using SD Codefree or Any Accuchek meter, regardless of country. Until all meters are made to conform to the same system, and the guidelines are re-published for that system, then this problem will persist, I'm afraid. Most users will not be aware of this but the result will be that those specific meter users will be seeking tighter control than necessary i.e. 12% lower than everybody else to match the target ranges. It affects me as a driver since I cannot afford to have a hypo when out driving. I am also on a medication that regularly drops me into the hypo range, so I need to be aware so I can avoid needing assistance.

I'm new to all this and am currently monitoring things quite closely using an SD Codefree that people on here recommended, trying to control BG just by diet and excercise. I have in the last couple of months achieved some fasting levels in the 5s but in the last week I've been disappointed that I can't seem to get below 6.2 at the lowest and 6.7 at the higher end. Does this mean I'm worrying unduly and even at 6.7 (less 12%) I'm still within recommended range (just)? Also, can anyone please suggest a meter that is calibrated to the older system so perhaps I could do some comparisons, if only for my own peace of mind. Great site by the way, best resource I've found - thanks.

 

[Oldvatr]

I'm new to all this and am currently monitoring things quite closely using an SD Codefree that people on here recommended, trying to control BG just by diet and excercise. I have in the last couple of months achieved some fasting levels in the 5s but in the last week I've been disappointed that I can't seem to get below 6.2 at the lowest and 6.7 at the higher end. Does this mean I'm worrying unduly and even at 6.7 (less 12%) I'm still within recommended range (just)? Also, can anyone please suggest a meter that is calibrated to the older system so perhaps I could do some comparisons, if only for my own peace of mind. Great site by the way, best resource I've found - thanks.

You worry unduly IMO. Anything below 7 on an SD is a good value. When you get more experienced you can think about trimming it down further, but as a Newbie you are doing fine. The actual meter number acccuracy is only really important at the lowest values (<4 mmol/l) above 5 they just show basic numbers that are for info only. It is the lab test HBA1c that the GP uses to guage how well you are progressing.

I use two meters, an SD Codefree and an Optium NEO in parellel, but the cost of strips for the NEO is much higher than the SD. The NEO is more reliable I find, and I can also use ketone test strips if I buy them. At the moment my GP funds my NEO strips because I am on Gliclazide, and prone to hypo. I am also a driver. If that is withdrawn, then I would only use the NEO to double check / confirm a low SD reading

Generally I am mainly interested in the delta changes between readings (spike, suddent drops etc) and averaged trends to make decisions on, not any one reading in isolation. So if I have a bad meal choice and spike up to 15 then I shrug my shoulders and note that meal as a poor choice. I don't beat myself up over it.

This is a long term condition. As a T2 on oral or diet, you can be relaxed about bgl's except when near Hypoland.