Diabetes Support - metformin and low blood glucose




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fatmad
07-16-2011, 11:07 PM
I hijacked this from the chat thread, because I think its worth a discussion in general, not hidden away there. i am interested in peoples' reactions, if they have had lows, where they didn't before and are not on any other meds for diabetes.
The pharmacology sites don't say that lows are impossible, but are not a common or usual side effect, the way other meds for type 2 diabetics can be. From the pharmacology, which is interestingly, not completely understood, there does not "seem" to be any obvious way that it would "cause" hypoglycemia.
So many of us have a history of hypoglycemia before we had diabetes, or pre-diabetes. So I wouldn't tend to think that a low sugar was "caused" by my metformin, I would think I just wasn't eating properly.
But for those who were told they were having lows, and they are common on metformin, that certainly isn't backed by studies or science.
Lots of type 2 diabetics are on other meds as well. In Ruth's case, for instance, she is also on glyburide, and low sugars are a common side effect of this med. In addition, the combination of glyburide and metformin is very effective, more than the effect provided by other med, they seem to work together so well, some people can have lower doses when they are used together.
Of the people who take metformin, who has had lows?
If so, did you have hypoglycemia before? Are you on other meds?


Riemontana
07-16-2011, 11:15 PM
Hi Fatmad,

I think this is worthy of it's own discussion as well. Lots of the girls on the PCOS thread are also taking metformin.

Currently I take 2000 metformin and one januvia each day. When I started, I took the metformin and glypizide at night. Within a month, I was having lows every evening into the 40's and 50's. Basically, I was consuming 2-3 doses of carbs to get it to stay above 70. Once I switched to Januvia, my bs has been much more stable. Almost never over 110, rarely over 100, and rarely under 70.

Thanks for the thread.

Rie

Ruthxxx
07-17-2011, 06:19 AM
Right! It's probably the glyburide causing my lows.


pattygirl63
07-17-2011, 09:34 PM
I had that happen when I first went to 1000 mg of Metformin, but doctor said metformin doesn't cause lows and promptly checked to be sure everything else was okay. Later I read that it can happen if you go too long between meals. So I just try not to go so long between meals. I did read today in the new Atkins' book that when low carbing you shouldn't ever go more than 6 waking hrs without eating a meal or a snack. Also read what I remember Dr. Atkins used to say, that if you get dizzy or lightheaded doing Atkins that you probably are not eating enough salt. So now whenever I start feeling wierd like a low coming on, I just assume that I've gone too long without eating since doc said I Met doesn't cause it. Also, I don't use a lot of salt and I know that could cause me to have those feeling.

As for before I was diabetic? Yes I was diagnosed hypoglycemic years before I was diagnosed diabetic. Back then it was thought that if you were hypoglycemic that you would never have to worry about being diabetic... of course we now know that was wrong.

astrophe
07-17-2011, 10:46 PM
PCOS person here. :)

Before when I was IR, I took 2000 mg Metformin XR to help with that and to help regulate cycles.

Now that my IR in under control with diet, my endoc suggested going back on 500 mg to see if it would help with weight loss. I did not need it for IR -- in her words, my labs were so great you wouldn't even know I was a PCOS/IR patient because they are so normal.

I took it and I felt sick. We tried Glumetza, Fortamet -- still wiggy. It makes me want to eat like crazy, which I attribute to it pushing me low. Then it wrecks my calorie count for the day so it isn't worth it to me to take it.

*shrug*

I'm not sure how the chemistry all works, but my experience is what it is.

HTH!
A.

fatmad
07-17-2011, 10:49 PM
Interesting Trish, because there is good evidence that hypoglycemia predisposes to type 2 diabetes. And the tendency to hypoglycemia doesn't go away with the diabetes. When I do the 75g ogtt, if we do a 3 hour blood sugar after the loading dose, it is always below 4, usually a 2 or 3. even though it might be over 10 at the 2 hour mark.
I would agree, its "basic" hypoglycemia we have. I rarely go more than 5 hours between meals or snacks, and even before I started low carb, I always made sure snacks had a balance of nutrients, making sure there was some protein and even a bit of healthy fat to burn slower than any carbs I was getting.
Even though I am good about sticking to low carb, if I get cranky and woozy like a low at any time, I make sure that there are some carbs in my snack. (whole or 2% milk is always good)
Ruth, with the januvia, I am surprised the doc keeps you on glyburide. You have had quite a problem with low, even with bedtime snacks. hope that gets better soon.
Rie, thanks for you input too. Please invite anyone on the pcos forum to give feedback too.
I have this curiosity

Wannabehealthy
07-18-2011, 08:49 AM
Of the people who take metformin, who has had lows?
If so, did you have hypoglycemia before? Are you on other meds?

As I mentioned on the chat thread, I am on Metformin and have never had a low. I was diagnosed in 2008 and on Metformin ever since. A nurse online and a therapist at cardiac rehab told me I WILL have lows. But in three years I haven't had lows. So I guess I am one of the ones who really don't have lows on Metformin. I have never been hypoglycemic and I am not on any other meds for diabetes. Also, I rarely go more than 4 hours without food, except for overnight. I have tested during the night several times and was not low at that time, either. I would also like to mention that any time I test, my BS is usually higher than it should be, but I rarely get a reading over 200.

I never knew very much about diabetes except that I am supposed to test and take my Metformin with meals. I have learned a lot from reading about the experience of others on this board. I think the training for newly diagnosed diabetics is very poor, at least it was for me. I was never told anything about classes for education. They would have really saved me a lot of confusion. When I was diagnosed, I was in the hospital recoving from open heart surgery. I think they were more concerned about my heart and the diabetes was just a blip. The surgeon told me that the diabetes was caused by the surgery and that it would go back to normal in time, but although it improved, it never went completely back to normal.
Carol

pattygirl63
07-18-2011, 12:31 PM
As I mentioned on the chat thread, I am on Metformin and have never had a low. I was diagnosed in 2008 and on Metformin ever since. A nurse online and a therapist at cardiac rehab told me I WILL have lows. But in three years I haven't had lows. So I guess I am one of the ones who really don't have lows on Metformin. I have never been hypoglycemic and I am not on any other meds for diabetes. Also, I rarely go more than 4 hours without food, except for overnight. I have tested during the night several times and was not low at that time, either. I would also like to mention that any time I test, my BS is usually higher than it should be, but I rarely get a reading over 200.

I never knew very much about diabetes except that I am supposed to test and take my Metformin with meals. I have learned a lot from reading about the experience of others on this board. I think the training for newly diagnosed diabetics is very poor, at least it was for me. I was never told anything about classes for education. They would have really saved me a lot of confusion. When I was diagnosed, I was in the hospital recoving from open heart surgery. I think they were more concerned about my heart and the diabetes was just a blip. The surgeon told me that the diabetes was caused by the surgery and that it would go back to normal in time, but although it improved, it never went completely back to normal.
Carol

Carol I don't any other medicine for diabetes either. And I didn't get any class, but my doctor did give me loads of info to read. Took me about a year of trying different diets before I settled on Atkins. I went to one class when I had diabetes years ago and knew right away that the dietician wasn't going to be of much help to me when she said she wanted me to eat 9 to 11 servings of starchy carbs. Sorry to say that I never returned. She also told us she wanted us to eat lots of green veggies and she looked me in the eye and said "and I don't mean green beans". #1 I loved green beans and we were on food stamps and there were times green beans were easy to purchase.

The doctor I have now told me that he knows I have trouble with starches because it shows with my #s. I can't seem to eat them much. I am blessed not to have extremely high glucose readings either. Had it one time when I ate oatmeal which is supposed to be diabetic friendly. I learned I can eat steal cut, but not other versions. One big lesson I've kind of learned on my own is that a diabetic needs to take control of their own diabetic life. Hope you are doing well with heart and bs.

fatmad
07-18-2011, 11:11 PM
Apostrophe, what do you mean by feeling sick? Are you talking upset stomach? nausea? the gassy bowel that is common with metformin?
It doesn't sound like you are having trouble with low blood sugars from it.
ALso, I don't know what IR is? thats a new one to me.
It not great that you are feeling hungry and that must make it hard to watch your weight, and lose some weight.
thanks for your input. Not everyone can take the side effects with metformin, and don't adapt over time as many of us do.

Wannabehealthy
07-19-2011, 06:58 AM
Carol I don't any other medicine for diabetes either. And I didn't get any class, but my doctor did give me loads of info to read. Took me about a year of trying different diets before I settled on Atkins. I went to one class when I had diabetes years ago and knew right away that the dietician wasn't going to be of much help to me when she said she wanted me to eat 9 to 11 servings of starchy carbs. Sorry to say that I never returned. She also told us she wanted us to eat lots of green veggies and she looked me in the eye and said "and I don't mean green beans". #1 I loved green beans and we were on food stamps and there were times green beans were easy to purchase.

The doctor I have now told me that he knows I have trouble with starches because it shows with my #s. I can't seem to eat them much. I am blessed not to have extremely high glucose readings either. Had it one time when I ate oatmeal which is supposed to be diabetic friendly. I learned I can eat steal cut, but not other versions. One big lesson I've kind of learned on my own is that a diabetic needs to take control of their own diabetic life. Hope you are doing well with heart and bs.

I know what you mean about the dietician. When I was in the hospital their diabetic diet consisted of 5 servings of carbs per meal. It was not 5 starchy carbs, but still, isn't that 75 gm of carb at each meal? Isn't that high? If I didn't get my BS down they were going to send me home with insulin and I didn't want that. I have done Atkins years ago and I knew how to play the game to get my carbs down low enough to get good BS readings. I know what I can and can't eat, but I'm not always good at sticking to it.

Carol

fatmad
07-19-2011, 08:44 AM
I know what you mean about the dietician. When I was in the hospital their diabetic diet consisted of 5 servings of carbs per meal. It was not 5 starchy carbs, but still, isn't that 75 gm of carb at each meal? Isn't that high? If I didn't get my BS down they were going to send me home with insulin and I didn't want that. I have done Atkins years ago and I knew how to play the game to get my carbs down low enough to get good BS readings. I know what I can and can't eat, but I'm not always good at sticking to it.

Carol

I agree, the dietitian at my place was also big with carbs. I also asked her if she calculated carbs differently for type 1 and 2 diabetics, she said no....!
I was shocked. I can see having a "normal" carb intake for folks who HAVE to have insulin, but not lower for those who are trying to avoid getting to that point. While she was explaining the "diet" to me, I calculated the calories (over 2000) asked how I was supposed to lose weight that way, and she replied that I would lose weight. No explanations. My diabetes educator really likes working with her, but the midwives in my practice won't send gestational diabetics to her for this reason too.
She doesn't seem to get it.
I think most of us on this thread restrict carbs to some degree, either going for low glycemic carbs, lower carbs in general, and variations of this. We find we feel better, can manage blood sugars better and don't find it difficult to do, depending on the degree to which we restrict the carbs.

Riemontana
07-19-2011, 09:04 AM
I am still surprised about the dietary recommendations for diabetes. I don't think that I could control my bs on the recommended carbs. ( I was recommended 45 for meals and 25 for snacks. Wow.

Fatmad, IR is insulin resistance

fatmad
07-19-2011, 06:20 PM
Rie: thanks for the clarification about Insulin Resistance. that helps! Sometimes I just block these things, of course I've heard of that before!

Riemontana
07-19-2011, 09:46 PM
At my appt today, my dr was considering taking me off the metformin because they cannot determine a cause for my belly pain. I thought it was weird because I started the met in September. I feel like i am really in control of my bs and I have even begun adding more fruit. I panicked. He is going to hold off. He would like to either stop the metformin or the januvia. I think it is an ulcer, and it is improving..... I know that this isn't a medical site, but has anyone heard of metformin causing belly pain after several months. I have been on my current dose since september 2rd and I only had a little diarhea in the first week.

Wannabehealthy
07-20-2011, 07:36 AM
At my appt today, my dr was considering taking me off the metformin because they cannot determine a cause for my belly pain. I thought it was weird because I started the met in September. I feel like i am really in control of my bs and I have even begun adding more fruit. I panicked. He is going to hold off. He would like to either stop the metformin or the januvia. I think it is an ulcer, and it is improving..... I know that this isn't a medical site, but has anyone heard of metformin causing belly pain after several months. I have been on my current dose since september 2rd and I only had a little diarhea in the first week.

I have been on Metformin since 2008 and to my knowledge, I have never had a side effect. My bowels have always been on the loose side, more what I would call "easy" and I occasionally get diarhea, but I never connected it to the Metformin, because it's just once in a while. Now antibiotics are another story. They give me diarhea big time!

Carol

fatmad
07-20-2011, 08:33 AM
I did get some pain and discomfort for a while, but it got better after a couple of weeks. Without stopping the metformin altogether, why not skip a couple of doses. Won't totally screw your sugars if you eat carefully and if its the metformin, you will get better quickly.
Some people don't tolerate the side effects. I was getting very bad leg pain, (like a bad cramp, but didn't get better with walking) but found taking a b100 supplement helps, (metformin affects B12 and folic acid uptake. )
For another list member (Butterbutt, hasn't been here for a while) she got the leg pain a couple of months into using the metformin, but the B's didn't help enough. I can understand. This was pain, (not discomfort) and if I hadn't found a solution, I wouldn't have been able to take it.
While metformin is a good drug with lots of benefits, its not for all of us.
Hope you find an answer to the issue though!

Wannabehealthy
07-21-2011, 08:26 AM
I did get some pain and discomfort for a while, but it got better after a couple of weeks. Without stopping the metformin altogether, why not skip a couple of doses. Won't totally screw your sugars if you eat carefully and if its the metformin, you will get better quickly.
Some people don't tolerate the side effects. I was getting very bad leg pain, (like a bad cramp, but didn't get better with walking) but found taking a b100 supplement helps, (metformin affects B12 and folic acid uptake. )
For another list member (Butterbutt, hasn't been here for a while) she got the leg pain a couple of months into using the metformin, but the B's didn't help enough. I can understand. This was pain, (not discomfort) and if I hadn't found a solution, I wouldn't have been able to take it.
While metformin is a good drug with lots of benefits, its not for all of us.
Hope you find an answer to the issue though!

Hmmm, I get leg pain, but I have been blaming it on the statins I take. Maybe I better rethink that. What is this B100 that you take?

Carol

Riemontana
07-21-2011, 09:00 AM
Carol,

At my dr's advice, I take a Bcomplex vitamin daily in addition to my regular multivitamin supplement. I'll let Fatmad answer for herself.

Rie