Am I supposed to feel like crud?

Semi-new to the diagnosis of Type II. I had severe early GDM requiring insulin with both pregnancies many moons ago.

Finally passed over the line between “borderline” and diagnosis. A1c was 9.8; fastings 200, after meals 300. (I think this was complicated by a cortisone shot 5 weeks ago, but then again, the A1c is showing the larger picture)

My general practitioner put me on Janumet, which helped me lose 10 lbs in 3 weeks and I felt great, with little hunger. Unfortunately my morning fastings were no better than130+, after meals were modest increase with pure protein at 150-170, and 180-230 with carbs. But I felt really good! Low carbing was a piece of cake. My hunger was under control.

Decided to see an endo for treatment. He just put me on 2 mg glimepiride twice daily, and 1000 metformin twice daily. It’s only been 24 hours but I feel awful, and I’m craving carbs and sugars. I’m not hitting lows, but feel shaky at 115-120. I expect that because of my body being used to high numbers, but I can’t see how to get through these cravings and general feeling of malaise.

This is so frustrating. I can’t even get decent post-prandial readings because I’m eating things I shouldn’t. A stronger med defeats the purpose if it causes cravings. This is crazy…

Today’s the first day that I want to cry. I suppose I should give the new meds some more time…

At diagnosis my A1c was 13.1 BG 394 4 hrs after a carby meal. They put me on metformin and glipizide., but I didn’t start getting reasonable numbers until I cut carbs drastically. I would feel terrible when I got below 100. This lasted for several months although the time between these “spells” gradually got further apart. One day I realized it hadn’t happened for a month. I think it takes a while to get used to your new more normal numbers.

Can’t comment on the cravings, I cut carbs drastically and the cravings disappeared almost immediately.

Hope this passes, high sugars were causing me to be drowsy all day long and I sure didn’t miss that. If you can get past this I’m sure you’ll feel better too.

Thanks, Bad Moon. Maybe I’m just having a bad day; maybe I’m coming down with something. I do have terrible dark circles under my eyes today.

How quickly did you see your numbers move down with the glip/met combo?
I’ll start with a clean slate tomorrow as far as no/low carb eating again, endo said he wanted to see me eating 40 carbs per meal. I thought that was insane…it appears me body agrees. :wink:

My numbers came down pretty fast to where I was hitting 180 after meals. I stumbled on the BloodSugar101 website and decided this was still too high. My goal now is to never go over 140, although I still can’t meet that all the time. I adopted the “Eat to your Meter” approach advocated by this website and started cutting out the foods that were spiking me. They turned out to be some of my favorites grains, potatoes, fruit, beans etc. With these foods out of the picture my carbs per meal went way down, many days I am 40g for the whole day. I was able to eliminate the glipizide with diet and exercise

The foods that cause spikes also cause cravings so if you can eliminate the spikes the cravings should subside. The neat thing about eat to your meter, is that since our diabetes is so different, foods that cause me problems may be fine for you. Basically it’s a little science experiment you conduct on your own diabetic body, and only limit or eliminate whatever is causing you problems.

Some people like to cut gradually. I think this avoids some of the bad reaction to the new diet, but you may still be dealing with the cravings. I went cold turkey but got it all over with, and I would do it that way again.

Hope this helps, it’s a big change and a lot to deal with. This website is a great resource spend some time reading old posts and delve into the various groups. Diabetes is a do it yourself condition and different people find different ways to meet their goals. This website and others can help you can get yourself up to speed quickly and develop a plan you can live with long term.

Thanks again. I appreciate your advice and support. I’m pretty versed on what foods work for me, and what ones don’t. I guess I’ll just have to ignore my doctor’s carb advice and stick with what I know. I was just totally shocked on how crappy I feel on this med change.

To tell you the truth when you said “endo said he wanted to see me eating 40 carbs per meal. I thought that was insane…it appears me body agrees. ;-)” I didn’t know if you thought it was insanely high or insanely low.

I’ll spare you my usual rant about the diet advice the newly diagnosed routinely receive. Sounds like you’re well on your way to getting a handle on things. Hope you feel better soon.

40 carbs per meal to me is definitely, insanely HIGH! I think the introduction of any non-vegetable carb shoots me up, which is why I’m feeling crappy, my blood sugars aren’t really moving, and I’m craving. For fruits I stick with an apple or a few strawberries for a special treat.

I remember when I was pregnant, I couldn’t eat anything. And forget milk, it shot me up to 300! I was more fortunate with my second pregnancy; I was in another state and my endo there would help me adjust insulin when I was eating right and still struggling. The endo for my first pregnancy would just yell at me, and I ate nothing.

I’m now in yet another state, and although I’ve just met him, the endo seems easy to talk to. I suspect that if I continue to have problems with this combo, he will see me before my next appt. in 2 months.

Sounds like you have arrived at a similar program to mine. Here’s a couple of groups on TuD I have found particularly helpful Bernstein Group and Low Carb Recipe Swap

Thanks Aimee, I think I was a little low last night after absorbing my first round of med increase and I did sip (seriously, just two tiny sips) a little OJ before bed as I was a bit low for me and paranoid about being hypo in the middle of the night. Maybe that little bit set me in motion for a bad day. I was surprised that my morning reading was quite high, considering these meds were supposed to be stronger.
Your comment makes me feel better that tomorrow is another day and I’ll be starting from scratch!

You’re getting good advice, but be careful to test. Very low carb plus all these meds might shoot you too low, believe it or not. 2000 Metformn sounds like a pretty big “starting” dose, to me. I seem to remember my doctors easing up on it.

From the interwebs re. Metformin: “DOSING: For treating type 2 diabetes in adults, metformin (immediate release) usually is begun at a dose of 500 mg twice a day or 850 mg once daily. The dose is gradually increased by 500 mg weekly or 850 mg every two weeks as tolerated and based on the response of the levels of glucose in the blood. The maximum daily dose is 2550 mg given in three divided doses. If extended tablets are used, the starting dose is 500 mg or 1000 mg daily with the evening meal. The dose can be increased by 500 mg weekly up to a maximum dose of 2000 mg (2500 mg of Fortamet) once daily or in two divided doses. Glumetza tablets are given once daily. Metformin should be taken with meals.

Just be sure to test your fasting, two hours after eating, before you go to bed and before you get behind the wheel, and any time you have symptoms of hypoglycemia, until you know how the combination of very low carbs and the meds work together.

From the interwebs re. Glimepiride: “Take care not to let your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.

I also feel awful when I have a big change in BG’s – either a big rise or a big drop, even if I’m still “normal” after the drop (e.g. dropping from 220 to 120.) However, depending on how frequently you’re testing, you might be having hypos and not know it. Just be a little extra careful about testing as you transition to very low carb.