New to all this.

Hi Sarah80, sorry to hear your having a rough time, like you i went to my doc' feeling unwell,my bs was 28.6 gave me metforminx2 500 and told me to lose some weight and not to eat to many sugary things.....this is their standard blah blah, and although metformn helps a bit , the best way for most who have gained control of their bs is lchf, since finding this forum and following lchf exercising more mt bs has now dropped to an average of 5.0mmols i will ask@Daisy for the info for new posters,please come back with any questions,clive

Oh yes, that rings a bell alright!

You need to get back in touch with your GP and inform him you are having low blood glucose levels with the meds you have been given.

But first, what are the readings you are getting and the timing of those readings, because. It all depends on what you are eating as well.
Did you not get any advice on diet?
The tests will be the deciding factors of what type you have.

Have a read around the low carb forum and there are lots of knowledgeable posters who have control, I've tagged @daisy1 to give you the newcomers welcome information.

Welcome to the forum.

Welcome Sarah. Firstly, the Zicron med you're on is actually just a brand name of the diabetes medication Gliclazide - which a search should call up more information for you using the generic name.

As for feeling rough when your numbers are low - what actual numbers are you getting? The reason for asking is that it perhaps isn't a full-on hypo, but what's called a false hypo. When your body has got used to hyperglycaemia and you start meds or change diet and start lowering your blood sugar, your body panics, thinking that you're going too low and gives you the symptoms of a hypo, without you actually having one. Especially if you've dropped your numbers quickly - it's the rate of change as much as the numbers themselves that can cause symptoms.

When I started on insulin about a year ago and finally got long term high numbers under control, I went through this for a week or two - having quite wild and unpleasant symptoms of a hypo (in fact I think it was @nosher8355 who posted above that educated me about them at the time), without actually having a proper one - my worst was at a reading of 6.5. I'd shake, get palpitations, go dizzy, sweat and feel generally very poorly - a glass of orange juice would soon abate that feeling, but it can leave you wobbly afterwards. Ironically, I've had problems with my insulin lately and been having proper dangerous hypos and get very few actual symptoms before I notice I'm on the verge of blacking out - so in my experience, the false hypos are far more unpleasant to experience than an actual medical hypo, but much less potentially dangerous.

The good news is that they don't last long and your body soon adjusts to the improved figures and please be assured that if your numbers are above 4, you're not likely to be in danger - it just feels truly horrible. The way to treat a hypo is to have something that will get your BG up quickly, like orange juice, glucose tablets, a teaspoon of syrup, a few jelly babies etc., then eat something carby like a slice of toast, then eat something more substantial and balanced. You don't need much to pick it up and if you gorge yourself in the initial panic, which is easy and tempting to do, you're likely to rebound up to high again - so gently does it.

If you had an infection when the high numbers were first noticed, it's very possible that the infection helped elevate them, so once that is under control, you may not need quite such aggressive medication longer term. I don't seem to get a noticeable elevation in BG when I'm poorly, but some people experience wild spikes if they're sickening for something.

Sorry Sarah I was typing as your post appeared, I see your numbers were pretty low, so you were certainly right to treat it. I think if you've already dropped that much from over 30, a conversation with your DN is certainly in order about medication etc. as maybe the current treatment is too aggressive if you're recovering from an infection. A slow and steady reduction will feel better than a rapid decline. Especially if you plan to modify your diet too.

An average of 6.8 is pretty good if you were at over 30 a couple of weeks ago - you should be between 4 and 7 before a meal and ideally below 8.5 after one - so you're pretty much on the money, which is pretty good going in a fortnight.

I totally agree with @BooJewels assessment. It does sound like a false hypo.

But I would be really interested in your fasting hba1c level in a couple of months time after you've reduced your carb intake.

What the Shakes are are also called a sugar crash. Which is not good, you should reduce your carb slowly but surely. It will be difficult but if you can achieve them results even on glicizide, you must be doing something right.

nosher8355 said:

But I would be really interested in your fasting hba1c level in a couple of months time after you've reduced your carb intake.

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It would be interesting to know what it is now too - if it's high, it would suggest that she genuinely is diabetic and has hyperglycaemia for a while and clearly needs intervention. But if it's not that elevated, it might indicate that the infection was a significant and maybe short-lived factor.

BooJewels said:

It would be interesting to know what it is now too - if it's high, it would suggest that she genuinely is diabetic and has hyperglycaemia for a while and clearly needs intervention. But if it's not that elevated, it might indicate that the infection was a significant and maybe short-lived factor.

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It might be hyperglycaemic now, but, it could be another blood glucose disorder.
I'm not suggesting it is but that sort of dramatic drop even with meds is not usual.
Do you @Sarah80 do your bloods when you wake?

nosher8355 said:

I'm not suggesting it is but that sort of dramatic drop even with meds is not usual.

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No, it sounds rapid to me. Metformin doesn't tend to cause a speedy response, it works gradually as it builds over time. And it's perhaps not that good for her either (i.e. the rapid drop) - it feels horrible if nothing else. My DN has always advocated a slow and steady approach to decreases in BG with carefully titrated doses to keep the decline comfortable and to give the body time to adapt. Sarah was given a lot of meds in a short space of time without a steady titration of them. Even when I started on insulin we only increased it by 2 units every few days and I experienced false hypos and blurred vision. So it's no wonder she's felt horrible.

I just spotted that the nurse did take bloods - was an HbA1c one of the ones done? What dose of the Zicron/Gliclazide were you given?

[Edited for clarity]

BooJewels said:

No, it sounds rapid to me. Metformin doesn't tend to cause a speedy response, it works gradually as it builds over time. And it's perhaps not that good for her either (i.e. the rapid drop) - it feels horrible if nothing else. My DN has always advocated a slow and steady approach to decreases in BG with carefully titrated doses to keep the decline comfortable and to give the body time to adapt. Sarah was given a lot of meds in a short space of time without a steady titration of them. Even when I started on insulin we only increased it by 2 units every few days and I experienced false hypos and blurred vision. So it's no wonder she's felt horrible.

I just spotted that the nurse did take bloods - was an HbA1c one of the ones done? What dose of the Zicron/Gliclazide were you given?

[Edited for clarity]

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Once again I was agreeing with you. It is so quick and unusual.

When I was misdiagnosed, I had hyperglycaemia.. But that was disguising my hypoglycaemia.
My fluctuating bloods led to some horrible symptoms. And the quick spikes and going into hypoglycaemia had my body all over the place, I couldn't rely on any readings after eating because of my condition until I went very low carb all the time.

nosher8355 said:

Once again I was agreeing with you. It is so quick and unusual.

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Sorry Nosher, my first phrase was sloppily worded. What I meant was; No, it's not usual and yes, I agree it sounds pretty **** rapid to me too. Sorry for the misunderstanding. My mind is elsewhere today.

I did wonder about reactive hypoglycaemia too - very high to hypo in short order - and feeling horrible with it. I think her situation warrants a bit more attention from medics than they've given her thus far.

But hark at me, my own BG has gone totally bonkers this month in a way that we can't understand or explain, so I'm a fine one to comment really. Need to get my own house in order first really.

Hi and welcome. Gliclazide (Zicron) doesn't often cause side effects other than hypos but Metformin commonly causes bowel problems in which case the Slow Release version avoids that. If you are overweight then Metformin will help more than the Gliclazide. If your blood sugar is going too low then the Gliclazide dose may need reducing or even stopping as it stimulates the pancreas to produce more insulin; talk to the nurse. Glic is usually only needed if your pancreas is starting to fail and perhaps you are not overweight; there are exceptions of course. A low-carb diet will usually be the best way forward with medication as needed. The glucose meter will guide you.

Sarah80 said:

I honestly don't know about HbA1c, I googled what it meant and this wasn't explained to me.

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You've perhaps grasped it by now then, but this is a post I made explaining it some time ago and I've managed to find it to paste it here:

There are two main regular blood tests for diabetics - the finger prick test that you do yourself and the HbA1c. The finger prick just measures the amount of glucose in that droplet of blood at that moment. If you take it again from another finger or a little while later, it will likely give a slightly different result as it perpetually changes with what you eat, activity, stress etc.

The HbA1c test is rather different as it measures the glucose attached to red blood cells. As red blood cells live for anything up to 6 months, a sample of venous blood (taken at the docs) will include cells of a multitude of ages. So testing the glucose on all of those, gives an average reading for the life of those combined cells. So some cells will be brand new and show your blood glucose recently, old cells will reflect what it was like a few weeks ago. So the HbA1c shows an average for something like the past three months or so. They're generally only done routinely every six months - there's not much to be gained by doing them too frequently.

So one is immediately responsive to your food, activity etc. and he HbA1c shows the general trend of the last few weeks.

The Gliclazide dose you're on sounds reasonable considering that high in A&E, you'd normally start on 40mg once or twice a day - I was on the maximum of 320mg daily when we decided that it simply wasn't working for me. I wouldn't have thought 80mg would have dropped you that quickly alone - but it might if you're already down at these new lower figures.

But if you're getting a 5.6 after eating, I feel that's a bit low, especially as you were over 30 a couple of weeks ago - that's a significant and speedy drop. I really feel that this warrants further discussion with medics and personally, I'm happy that you've stopped the Gliclazide until you get further attention. It might simply be that the chest infection drove your BG very high and decisions were made on that basis - and now the infection is passed, it needs reassessment in light of your improved health. There may be something else going on too - but your medics really are the place to start and I'd urge you to address that in a timely manner.

@Sarah80

Hello Sarah and welcome to the forum As suggested above, here is the information we give to new members and I hope you will find it helpful. It will give you a lot of advice on diet. You have had loads of useful answers but if you need to, ask more questions and someone will help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.