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What Do Low Blood Sugar Levels While On Metformin And Actos Indicate?
Question: Male, age 73, 240 lbs., 5' 10". Have been on Metformin 850 2x daily plus Actos 30 mg once daily. 7-8 weeks of sleep difficulties, resulting in loss of wt 25 lbs. to 240 (5'10"). About 2wks ago began having low blood sugar episodes. For some time, often skipped PM Metformin. Recently cut both diabetic Rx's in half, for 4 days, then suspended them and suspended Zocor (40 mg) altogether 4 days ago, continue to have low sugar episodes. If I can get stable enough to go to store, plan fresh fruits and beans (w/o sugary sauce), currently have fig bars, canned fruit in heavy syrup, bread. Need help please on how to stabilize my sugar. What best to eat. Thanks, many thanks
Brief Answer:
About hypoglicemia;
Detailed Answer:
Hello,
I have gone carefully through your concern.
To find a cause for your hypoglycemic events, it is very important to know the lowest level of the blood sugar you have had during these 4 days that you suspended the oral treatment and at what time of the day do the episodes occur (fasting or during the day?).
Can you find a reason for your weight loss (have eaten less or have had more physical activity) or is it unexplained?
What are your current diagnosis except of Diabetes?
Will be a pleasure to help you further after the above information.
Kind regards,
Dr.Mirjeta
About hypoglicemia;
Detailed Answer:
Hello,
I have gone carefully through your concern.
To find a cause for your hypoglycemic events, it is very important to know the lowest level of the blood sugar you have had during these 4 days that you suspended the oral treatment and at what time of the day do the episodes occur (fasting or during the day?).
Can you find a reason for your weight loss (have eaten less or have had more physical activity) or is it unexplained?
What are your current diagnosis except of Diabetes?
Will be a pleasure to help you further after the above information.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Raju A.T
I have not tested blood sugar since the last tester I had approved by Medicare (and cheapest!) gave me divergent results from the SAME blood sample, +/- 30 points.
Low blood sugar episodes have been both fasting in AM and during the day, a while after meals.
During the 6-7 weeks of sleeplessness, my appetite also declined a great deal. I think that was enough to account for the weight loss. My G.P. knows of both, and said both were the result of anxiety. I am currently taking Ativan as needed, had success with Tranxene until they tripled their price, and my copay went up to $100!
Other Dx's: UR allergies, followed by sinus infections several times a year. Best controlled by Flonase spray. Also taking Zyrtec generic.
Hypothyroidism, taking .88 mg Synthyroid generic.
Taking Mobic for arthritis.
Taking Prilosec generic for acid reflux.
Taking Zocor 40 mg. for cholesterol.
Taking low dose aspirin 1x day.
Low blood sugar episodes have been both fasting in AM and during the day, a while after meals.
During the 6-7 weeks of sleeplessness, my appetite also declined a great deal. I think that was enough to account for the weight loss. My G.P. knows of both, and said both were the result of anxiety. I am currently taking Ativan as needed, had success with Tranxene until they tripled their price, and my copay went up to $100!
Other Dx's: UR allergies, followed by sinus infections several times a year. Best controlled by Flonase spray. Also taking Zyrtec generic.
Hypothyroidism, taking .88 mg Synthyroid generic.
Taking Mobic for arthritis.
Taking Prilosec generic for acid reflux.
Taking Zocor 40 mg. for cholesterol.
Taking low dose aspirin 1x day.
Brief Answer:
Check the blood sugar at the moment of hypoglicemia.
Detailed Answer:
Welcome back!
It is very important to check the blood sugar at the moment you have symptoms of hypoglicemia.
If it results under 50 mg/dl ( without treatment) further exams are needed. The best method is to check it in the laboratory.
Anxiety does not cause low blood sugar levels (under 50 mg/dl).
If no low blood sugar is detected than anxiety may be the cause of anorexia, insomnia ect.
I would recommend also to check the HbA1c level.
Regards,
Dr.Mirjeta
Check the blood sugar at the moment of hypoglicemia.
Detailed Answer:
Welcome back!
It is very important to check the blood sugar at the moment you have symptoms of hypoglicemia.
If it results under 50 mg/dl ( without treatment) further exams are needed. The best method is to check it in the laboratory.
Anxiety does not cause low blood sugar levels (under 50 mg/dl).
If no low blood sugar is detected than anxiety may be the cause of anorexia, insomnia ect.
I would recommend also to check the HbA1c level.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Prasad
Dear Dr. Guni:
I see the importance of timely blood sugar tests. I cannot do that earlier than Monday (today is Saturday, 12/31/16). I plan to contact my G.P. Monday about the best tester available, & hope I can afford it.
My G.P. tests my A1c every three months: Recent results:
9/6/16: 6.8
12/7/2016: 6.3 (after the weight loss previously mentioned).
If you have a recommendation for the best carbohydrate sources to eat during a low blood sugar episode, please do so. I found most of the things in my pantry are high sugar, or contain sugar, etc. Apple juice is fast, but needs followup with something that digests & metabolized more slowly.
I just bought some navel oranges, which I like to eat by whole sections, after peeling. I have high hopes for them. I also got applesauce, and refried beans & tortilla for bean burritos. The tortillas are wheat flour & some shortening, which I believe will be good.
If you can recommend something I have neglected, please say so, OR
if my A1c data suggest more to you, THEN reply; otherwise I don't need any more of your time.
Thank you so much. Among other things, you confirmed my need for a home blood tester, and I WILL follow up on that. During the week I can call my G.P. It's a small town, and I know him personally.
Thanks again.
XXXXXX
I see the importance of timely blood sugar tests. I cannot do that earlier than Monday (today is Saturday, 12/31/16). I plan to contact my G.P. Monday about the best tester available, & hope I can afford it.
My G.P. tests my A1c every three months: Recent results:
9/6/16: 6.8
12/7/2016: 6.3 (after the weight loss previously mentioned).
If you have a recommendation for the best carbohydrate sources to eat during a low blood sugar episode, please do so. I found most of the things in my pantry are high sugar, or contain sugar, etc. Apple juice is fast, but needs followup with something that digests & metabolized more slowly.
I just bought some navel oranges, which I like to eat by whole sections, after peeling. I have high hopes for them. I also got applesauce, and refried beans & tortilla for bean burritos. The tortillas are wheat flour & some shortening, which I believe will be good.
If you can recommend something I have neglected, please say so, OR
if my A1c data suggest more to you, THEN reply; otherwise I don't need any more of your time.
Thank you so much. Among other things, you confirmed my need for a home blood tester, and I WILL follow up on that. During the week I can call my G.P. It's a small town, and I know him personally.
Thanks again.
XXXXXX
Brief Answer:
Hypoglycemia treatment.
Detailed Answer:
If it is a matter of 2 or 3 days until you check the blood sugar and you are sure that the symptoms improve after taking carbohydrates, than they should be considered hypoglycemic events.
Initial treatment depends on your symptoms. Early symptoms can usually be treated by consuming 15 to 20 grams of fast acting carbohydrates, such as candy, fruit juice, regular — not diet — soft drinks, or glucose tablets or gel.
Once the symptoms are back to normal, it's important to have a snack or meal to help stabilize your blood sugar. Refried beans and tortillas would be a good choice.
Of course this is a 3-day solution, because the treatment of hypoglicemia ( if confirmed) would be the elimination of the cause ( an insulinoma is the most important to excluded). Do not take antidiabetic tablets until you see the GP.
Wish you good health,
Kind regards,
Dr.Mirjeta
Hypoglycemia treatment.
Detailed Answer:
If it is a matter of 2 or 3 days until you check the blood sugar and you are sure that the symptoms improve after taking carbohydrates, than they should be considered hypoglycemic events.
Initial treatment depends on your symptoms. Early symptoms can usually be treated by consuming 15 to 20 grams of fast acting carbohydrates, such as candy, fruit juice, regular — not diet — soft drinks, or glucose tablets or gel.
Once the symptoms are back to normal, it's important to have a snack or meal to help stabilize your blood sugar. Refried beans and tortillas would be a good choice.
Of course this is a 3-day solution, because the treatment of hypoglicemia ( if confirmed) would be the elimination of the cause ( an insulinoma is the most important to excluded). Do not take antidiabetic tablets until you see the GP.
Wish you good health,
Kind regards,
Dr.Mirjeta
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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