STUPID DIABETES!!
trish55011
Posts: 139 Member
Well shoot fire dad-blame-it! Was feeling awesome, more energy and brain clarity than I have had in many years, all to be undone by low blood sugar. Took a little nap today, woke up and my sugar was 61, got down to 55 before I could get it to start coming back up again to 88. 1tbsp peanut butter, 1.5tbsp unsweetened applesauce, and my son force fed me harvest cheddar sun chips, 9 carbs worth. I haven't gone over 20g carbs, but I introduced sugar back into my liver. So disappointed right now I could cry. Will definitely adjust the diabetic meds on the morning.
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Have you checked in with your doctor recently? You may need to reduce (or eliminate) your medications, since your blood glucose is so low. That's an awesome situation to be in! Congrats!0
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MyriiStorm wrote: »Have you checked in with your doctor recently? You may need to reduce (or eliminate) your medications, since your blood glucose is so low. That's an awesome situation to be in! Congrats!
He has encouraged me with keto, (his idea actually) and has pretty much given me free rein with my meds for 30 days. I just have to keep a really close check on my numbers if I drop a med. I love my dr. He is absolutely awesome.4 -
You're type 1? Glad you caught it before it got any lower.
9g of carbs is nothing. Don't worry. There is usually sugar in the liver. Just less of it at keto levels (as I understand it). You're doing fine.
I agree that you may need lower meds. Congrats. 1 -
trish55011 wrote: »MyriiStorm wrote: »Have you checked in with your doctor recently? You may need to reduce (or eliminate) your medications, since your blood glucose is so low. That's an awesome situation to be in! Congrats!
He has encouraged me with keto, (his idea actually) and has pretty much given me free rein with my meds for 30 days. I just have to keep a really close check on my numbers if I drop a med. I love my dr. He is absolutely awesome.
that is an awesome doctor! since starting keto I've dropped to diabetic meds and just use metformin now I hope to be med free at my keto-versary 2 -
My daughter is T1D, on a pump and low carbing. She's always made her own adjustments to insulin because, well you kinda have to when you're T1... but anyway, she went from 120+ units a day of fast acting plus her long acting insulin down to about half the first day and now uses about 35-45 units a day,
Her reservoir holds 300 units and she could only wear the pump 2 days when she first used it a couple years ago. Still ended up in ICU 5 times that year! Now she doesn't even fill it all the way, can wear it the whole 3 days and hasn't had DKA since right before going Keto.
I love that people always want to associate DKA with Keto, warning non T1 people of non existent risks, and here someone that could actually become acidotic hasn't had an episode since going Keto! Lol5 -
trish55011 wrote: »Well shoot fire dad-blame-it! Was feeling awesome, more energy and brain clarity than I have had in many years, all to be undone by low blood sugar. Took a little nap today, woke up and my sugar was 61, got down to 55 before I could get it to start coming back up again to 88....
Sounds like you weren't symptomatic, so I'm not sure I see any cause for panic or tears. ??
(Also wondering about your conclusion about your BG was comtinuing to sink, if it was drawn on the strength of only 2 readings....)
Since starting LCHF, I regularly have BG readings down into the 50s. I'm on Glucophage only, which is not supposed to cause low BG.
I was pretty alarmed at first, but my endocrinologist urged me not to worry about asymptomatic hypoglycemia at those levels.
Phinney reported that well-functioning athletes in ketosis have experienced significantly lower BG levels, still without any of the classic symptoms.
So..... If you're not experiencing symptoms on a ketogenic diet at BG levels traditionally considered low, maybe the problem is with "tradition," not "low."
Anyhow, congratulations on your progress. Sounds like things are going well!
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@nvmomketo I am type 2.0
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@RalfLott , was symptomatic. Sweats, shaking, weakness... Then 6 hours later it dropped out on me again.0
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@genmon00, yes he is amazing!0
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@Sunny_Bunny_ am type 2. Congratulations to your daughter! That is awesome.0
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trish55011 wrote: »@nvmomketo I am type 2.
Being T2, @RalfLott has a good point then. It's not uncommon for new low carbers, especially Keto, to see blood sugars in those ranges. Even non diabetic people. However, since you take insulin?, it was at least in part caused by meds and therefore has the potential to dip dangerously low.
The difference would be if you were T1, because it would be more likely to have been caused by fast acting insulin and a falling bg in those circumstances can continue to fall very fast.
My daughter will only correct a low if it's under 65 and falling, but she wears an insulin pump. Of course, she will suspend that. She has even been able to correct non urgent lows in those ranges by eating nuts. People that regularly experience lows can lose the ability to feel the symptoms, but in general the idea is that as long as you feel normal, the low isn't as much of an issue on Keto as when you are high carb because overall your bg will run a lot lower.
Anyway, it sounds like you handled it just fine. Doctors typically say to treat with 15g carbs even if that's more than needed. You made the correction without overdoing it and those few carbs shouldn't be an issue.
It might help to have glucose tablets or smarties around for corrections. Something that can fix it quick but not be a temptation at the same time. And then you won't have to eat grains as part of the correction. I guess I'm assuming you don't eat grains though... lol
My wheat bias is showing1 -
@Sunny_Bunny_, I don't take insulin. That's why I'm doing keto, so that I can get off all diabetic meds, and not have to start using insulin. Since starting keto (until yesterday) have eaten no grains at all, and had no refined sugar. Carbs were coming from spinach and other low carb veggies. My tummy was happy. I think I may have mild gluten intolerance. So I don't want to eat grains, pasta, etc. Glucose levels were a mess yesterday. I did have symptoms when it dropped on me. The bad thing is it dropped on me again 6 hours later. So today I have only taken my glyburide metforman. May have to break it on down and just do one in the morning and one in the evening. Hopefully soon I will be able to come off all together.1
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trish55011 wrote: »@Sunny_Bunny_, I don't take insulin. That's why I'm doing keto, so that I can get off all diabetic meds, and not have to start using insulin. Since starting keto (until yesterday) have eaten no grains at all, and had no refined sugar. Carbs were coming from spinach and other low carb veggies. My tummy was happy. I think I may have mild gluten intolerance. So I don't want to eat grains, pasta, etc. Glucose levels were a mess yesterday. I did have symptoms when it dropped on me. The bad thing is it dropped on me again 6 hours later. So today I have only taken my glyburide metforman. May have to break it on down and just do one in the morning and one in the evening. Hopefully soon I will be able to come off all together.
If I understand your post, you are taking a combined metformin/glyburide pill? Ask your doc for a separate script for each of them and try dropping/halving the glyburide. I went too low (Glu and BP) on Jardiance and dropped it. This is why I do not like combined pills. Isn't this diet (oops WOE) amazing? My fasting this morn was 83, compared to the 140's before diet.1 -
trish55011 wrote: »@RalfLott , was symptomatic. Sweats, shaking, weakness... Then 6 hours later it dropped out on me again.
Uh-oh. Sorry, my bad!
That can't have been fun!
What other med(s) were you taking at the time, other than glyburide + metformin?
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When first switching to low carb, it might be a good idea to decrease or eliminate Metformin use. After a couple months - once you are fat adapted - you can revisit taking it (if you are very low carb, fat adapted, and regularly in ketosis; you likely will find that you do not need it).3
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@trish55011 you are lucky to have such a doctor. Being diagnosed T2 only a year ago and it still being early (A1c = 6.6), I only ever took Metformin. At the time, I was totally unaware of Keto, but it just made logical sense for me to cut carbs way more than what my doc was saying and sure enough, I was off Metformin and down to 5.9 in less than 6 months. My mistake was then following the ADA recommendations for carbs and it went back up to 6.2.
I just started really getting to understand Keto and see it is very near what I was doing on my own initially, and am now getting fasting readings in the mid to low 90's from around 110 in just a few days. Also, after meal readings (1 and 2 hour) have all been under 100.
I was offered Metformin at the last appointment and declined.
Keep it up. Sounds like you will be be off your meds before you know it.4 -
midwesterner85 wrote: »When first switching to low carb, it might be a good idea to decrease or eliminate Metformin use. After a couple months - once you are fat adapted - you can revisit taking it (if you are very low carb, fat adapted, and regularly in ketosis; you likely will find that you do not need it).
Hmm. I'm not sure I would recommend dumping Metformin cold turkey, unless you're able to meet all your BG goals without it, especially considering the first few months of LCHF will be full of trial & error anyhow.
But I would suggest switching to name-brand Glucophage (more consistent from batch to batch and more potent) and perhaps reducing the daily dose while carefully monitoring your BG (I still test up to 10x daily 8 months after starting LCHF).1 -
Stupid diabetes indeed!! I am T2 and my doctor has just taken me off of the glipizide. I am currently still on my metformin for the time being but she said that she wants me to monitor my bg closely to see if I need it anymore. I was seeing bg in the 60's and feeling gross.
Sounds like you have a great doctor and just keep working with him/her to get everything under control.
I would not worry about the carbs when having a low bg episode. Just get back to your way of eating after 4 -
GlitterRayne wrote: »Stupid diabetes indeed!! I am T2 and my doctor has just taken me off of the glipizide. I am currently still on my metformin for the time being but she said that she wants me to monitor my bg closely to see if I need it anymore. I was seeing bg in the 60's and feeling gross.
Sounds like you have a great doctor and just keep working with him/her to get everything under control.
I would not worry about the carbs when having a low bg episode. Just get back to your way of eating after
Awesome. Congrats on your progress!0 -
midwesterner85 wrote: »When first switching to low carb, it might be a good idea to decrease or eliminate Metformin use. After a couple months - once you are fat adapted - you can revisit taking it (if you are very low carb, fat adapted, and regularly in ketosis; you likely will find that you do not need it).
Hmm. I'm not sure I would recommend dumping Metformin cold turkey, unless you're able to meet all your BG goals without it, especially considering the first few months of LCHF will be full of trial & error anyhow.
But I would suggest switching to name-brand Glucophage (more consistent from batch to batch and more potent) and perhaps reducing the daily dose while carefully monitoring your BG (I still test up to 10x daily 8 months after starting LCHF).
I'm not sure what dose OP is taking, or how much time passed from a BG of 62 to 55, but Metformin slows down introduction of glycogen. During early stages of LCHF, BG is heavily subsidized by glycogen in order to maintain normal levels because glycogen is available quickly when glucose from carbs is not available. Subsequent to starting LCHF and prior to becoming fat adapted, glucose from fat conversion is going to come slowly. In the early transition stages, glycogen may be (in OP's case, BG evidence shows it is - for others, "may be") necessary, depending of course on carb intake (both amount and timing) and physical activity (both intensity and timing). If OP experienced a quickly declining BG during / after a normal day (both for carbs and physical activity), then she is taking too much Metformin to allow sufficient glycogen supplementation. If that is true, she should at least decrease the Metformin dose, and may need to eliminate it entirely to avoid future hypoglycemic instances.2 -
midwesterner85 wrote: »midwesterner85 wrote: »When first switching to low carb, it might be a good idea to decrease or eliminate Metformin use. After a couple months - once you are fat adapted - you can revisit taking it (if you are very low carb, fat adapted, and regularly in ketosis; you likely will find that you do not need it).
Hmm. I'm not sure I would recommend dumping Metformin cold turkey, unless you're able to meet all your BG goals without it, especially considering the first few months of LCHF will be full of trial & error anyhow.
But I would suggest switching to name-brand Glucophage (more consistent from batch to batch and more potent) and perhaps reducing the daily dose while carefully monitoring your BG (I still test up to 10x daily 8 months after starting LCHF).
I'm not sure what dose OP is taking, or how much time passed from a BG of 62 to 55, but Metformin slows down introduction of glycogen. During early stages of LCHF, BG is heavily subsidized by glycogen in order to maintain normal levels because glycogen is available quickly when glucose from carbs is not available. Subsequent to starting LCHF and prior to becoming fat adapted, glucose from fat conversion is going to come slowly. In the early transition stages, glycogen may be (in OP's case, BG evidence shows it is - for others, "may be") necessary, depending of course on carb intake (both amount and timing) and physical activity (both intensity and timing). If OP experienced a quickly declining BG during / after a normal day (both for carbs and physical activity), then she is taking too much Metformin to allow sufficient glycogen supplementation. If that is true, she should at least decrease the Metformin dose, and may need to eliminate it entirely to avoid future hypoglycemic instances.
How would you prevent BG spikes if you eliminate the least hypoglycemic med available?
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midwesterner85 wrote: »midwesterner85 wrote: »When first switching to low carb, it might be a good idea to decrease or eliminate Metformin use. After a couple months - once you are fat adapted - you can revisit taking it (if you are very low carb, fat adapted, and regularly in ketosis; you likely will find that you do not need it).
Hmm. I'm not sure I would recommend dumping Metformin cold turkey, unless you're able to meet all your BG goals without it, especially considering the first few months of LCHF will be full of trial & error anyhow.
But I would suggest switching to name-brand Glucophage (more consistent from batch to batch and more potent) and perhaps reducing the daily dose while carefully monitoring your BG (I still test up to 10x daily 8 months after starting LCHF).
I'm not sure what dose OP is taking, or how much time passed from a BG of 62 to 55, but Metformin slows down introduction of glycogen. During early stages of LCHF, BG is heavily subsidized by glycogen in order to maintain normal levels because glycogen is available quickly when glucose from carbs is not available. Subsequent to starting LCHF and prior to becoming fat adapted, glucose from fat conversion is going to come slowly. In the early transition stages, glycogen may be (in OP's case, BG evidence shows it is - for others, "may be") necessary, depending of course on carb intake (both amount and timing) and physical activity (both intensity and timing). If OP experienced a quickly declining BG during / after a normal day (both for carbs and physical activity), then she is taking too much Metformin to allow sufficient glycogen supplementation. If that is true, she should at least decrease the Metformin dose, and may need to eliminate it entirely to avoid future hypoglycemic instances.
How would you prevent BG spikes if you eliminate the least hypoglycemic med available?
Eliminating spikes results by eliminating carbs and eating no higher than moderate protein levels.0 -
midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »When first switching to low carb, it might be a good idea to decrease or eliminate Metformin use. After a couple months - once you are fat adapted - you can revisit taking it (if you are very low carb, fat adapted, and regularly in ketosis; you likely will find that you do not need it).
Hmm. I'm not sure I would recommend dumping Metformin cold turkey, unless you're able to meet all your BG goals without it, especially considering the first few months of LCHF will be full of trial & error anyhow.
But I would suggest switching to name-brand Glucophage (more consistent from batch to batch and more potent) and perhaps reducing the daily dose while carefully monitoring your BG (I still test up to 10x daily 8 months after starting LCHF).
I'm not sure what dose OP is taking, or how much time passed from a BG of 62 to 55, but Metformin slows down introduction of glycogen. During early stages of LCHF, BG is heavily subsidized by glycogen in order to maintain normal levels because glycogen is available quickly when glucose from carbs is not available. Subsequent to starting LCHF and prior to becoming fat adapted, glucose from fat conversion is going to come slowly. In the early transition stages, glycogen may be (in OP's case, BG evidence shows it is - for others, "may be") necessary, depending of course on carb intake (both amount and timing) and physical activity (both intensity and timing). If OP experienced a quickly declining BG during / after a normal day (both for carbs and physical activity), then she is taking too much Metformin to allow sufficient glycogen supplementation. If that is true, she should at least decrease the Metformin dose, and may need to eliminate it entirely to avoid future hypoglycemic instances.
How would you prevent BG spikes if you eliminate the least hypoglycemic med available?
Eliminating spikes results by eliminating carbs and eating no higher than moderate protein levels.
My own experience is that this effect may take a while to achieve, and LCHF+exercise is not sufficient to get BG into the desired range.
(My target = A1c < 5.2, with no spikes over 125. Modest goals = avoid heart & kidney disease and Alzheimer's.)
Plus, if you think there's value in getting nutrients from vegetables and not supplements alone, completely eliminating carbs is not really an option.
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midwesterner85 wrote: »midwesterner85 wrote: »midwesterner85 wrote: »When first switching to low carb, it might be a good idea to decrease or eliminate Metformin use. After a couple months - once you are fat adapted - you can revisit taking it (if you are very low carb, fat adapted, and regularly in ketosis; you likely will find that you do not need it).
Hmm. I'm not sure I would recommend dumping Metformin cold turkey, unless you're able to meet all your BG goals without it, especially considering the first few months of LCHF will be full of trial & error anyhow.
But I would suggest switching to name-brand Glucophage (more consistent from batch to batch and more potent) and perhaps reducing the daily dose while carefully monitoring your BG (I still test up to 10x daily 8 months after starting LCHF).
I'm not sure what dose OP is taking, or how much time passed from a BG of 62 to 55, but Metformin slows down introduction of glycogen. During early stages of LCHF, BG is heavily subsidized by glycogen in order to maintain normal levels because glycogen is available quickly when glucose from carbs is not available. Subsequent to starting LCHF and prior to becoming fat adapted, glucose from fat conversion is going to come slowly. In the early transition stages, glycogen may be (in OP's case, BG evidence shows it is - for others, "may be") necessary, depending of course on carb intake (both amount and timing) and physical activity (both intensity and timing). If OP experienced a quickly declining BG during / after a normal day (both for carbs and physical activity), then she is taking too much Metformin to allow sufficient glycogen supplementation. If that is true, she should at least decrease the Metformin dose, and may need to eliminate it entirely to avoid future hypoglycemic instances.
How would you prevent BG spikes if you eliminate the least hypoglycemic med available?
Eliminating spikes results by eliminating carbs and eating no higher than moderate protein levels.
My own experience is that this effect may take a while to achieve, and LCHF+exercise is not sufficient to get BG into the desired range.
(My target = A1c < 5.2, with no spikes over 125. Modest goals = avoid heart & kidney disease and Alzheimer's.)
Plus, if you think there's value in getting nutrients from vegetables and not supplements alone, completely eliminating carbs is not really an option.
Some may be a target for reducing Metformin rather than eliminating it, but many patients are prescribed a version that does not help with spikes because it is extended release. Metformin alone can't eliminate carb spikes, but obviously more carbs = more spike. I have trouble keeping to lower carb sometimes too, so I understand it. In the event of eating heavier carbs, a way to blunt (not eliminate) spikes is to pair it with fat consumption. More recent studies show that keeping BG's over 140 mg/dl for long periods of time sharply increases risk of diabetic complications. A spike and then a quick drop from 140 isn't the same as staying there for 8 hours every day. That is long-term risk, not short-term. Short-term risk of hyperglycemia doesn't start until at least 225 mg/dl and often much higher. However, short-term risk with hypoglycemia exists as soon as symptoms are noticeable. So for someone who is reaching hypoglycemic levels containing short-term (immediate) risk with only Metformin during regular daily food consumption and physical activity, the advice should be to reduce or eliminate Metformin (current dosage will determine whether to reduce the dose or to eliminate it - and we don't know current dose for OP yet) in order to reduce the risk of recurring hypoglycemic instances.2 -
trish55011 wrote: »@nvmomketo I am type 2.
I agree with the others that a near low is not a problem for those of us with T2D. I've been at those lows in the past while LCHF, and I felt fine. Perhaps a bit weak. I added no extra carbs and eventually it evened out.
When I had false hypoglycemic symptoms in the past, it was due to BG falling quickly. Like all the way down to an 80 (LOL
). It was the drop that felt bad. 6 -
I wonder if supplementing with l-glutamine would help ease that transition - from reducing meds to not having lows? It is an amino acid that helps folks break sugar cravings, at least in part because it can be converted to glucose. http://www.foodrenegade.com/how-beat-sugar-cravings-glutamine/ I know it combined with other aminos, vitamins, and minerals is definitely helping my craving monster be shrunk in the background... I'm not worried about hard-core keto ATM as I'm trying to find a level place withour cravings and without adrenal stress, etc., but I'm not testing glucose either, because I'm not diabetic. I have NOT noticed any spikes within my previous dramatic insulin resistance reactions, though, either.0
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When I had false hypoglycemic symptoms in the past, it was due to BG falling quickly. Like all the way down to an 80 (LOLtrish55011 wrote: »@nvmomketo I am type 2. ). It was the drop that felt bad.
@nvmomketo -
That's interesting! I hadn't considered the possibility of the speed/degree of drop in BG, rather than the level iteself as, the culprit. I have never done better than blind luck when trying to infer BG levels from how I feel, but perhaps the few times I wrongly imagined having low BG, it was really a decrease I was feeling.
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When I had false hypoglycemic symptoms in the past, it was due to BG falling quickly. Like all the way down to an 80 (LOLtrish55011 wrote: »@nvmomketo I am type 2. ). It was the drop that felt bad.
@nvmomketo -
That's interesting! I hadn't considered the possibility of the speed/degree of drop in BG, rather than the level iteself as, the culprit. I have never done better than blind luck when trying to infer BG levels from how I feel, but perhaps the few times I wrongly imagined having low BG, it was really a decrease I was feeling.
Yes, this is common with type 1's when dropping quickly due to artificial insulin. I would think your own insulin could cause an even faster drop, so it would fit that anybody could experience similar symptoms - even without diabetes. I've had false hypoglycemic symptoms even when BG was high, simply because of a quick drop. It is common enough that it was mentioned in the initial training I received as a type 1.3 -
@RalfLott - When we were trying to figure out my crashes (me and my various medically associated professionals), they had me doing all the testing, and my glucose was always on point. I have a friend that she felt freaking fantastic if she was in the 400's, in the 200's she had major hypo symptoms... Then she started controlling it, and it totally flipped on her. Her new sweet zone was 40. If she got up to 80, she felt major high glucose sickness stuff, and she didn't get the lows until 20. Scary, huh?
My main understanding is that the higher you stay for the longer time, your body gets used to compensating for making that your new normal marker, so when you drop to reasonable levels, you can feel super low, because you're used to being so high and functional... So it's all crazy relative to N=1. There are goals, sure, but baselines and personal reactions make more difference in when folks feel lows, in my personal experience. It's all about resetting that baseline.1 -
@RalfLott. I was also taking Invokana I'm the morning and Januvia with my glyburide metforman in the evening. Did not take anything last night, checked by this morning and was 131. Checked it just before eating lunch, was 98 with only the 2 glyburide metforman!! Whoop whoop. I'm right back on track. No sugar cravings, buttered coffee is helping with satiety, and electrolyte levels are right where they should be.!4
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