Boy, was I stupid!

I made a HUGE mistake. I don’t know why I did it, but I didn’t think about the consequences. I am fairly new at this diabetes stuff. I need to take better care of myself.

I didn’t have breakfast and found myself eating some candy (handful of gummy hearts) right before lunch. I then had my byetta, and a nice healthy, low carb salad and my other meds after the salad. Metformin and glipizide.

Shortly after lunch, I had a major low. Well, major for me to ever had. It was 59. I started sweating, had the shakes, and was sick to my stomach. I also had nothing on me to bring my sugar up quickly. I was at work and had a student worker run and get me a coke. It was scary and another co-worker stayed with me until I felt better. I was scared. I guess what happened was my sugar was high and then with the byetta, it crashed?

I knew better to eat that Candy, I don’t know why I did. I was weak, but I caused trouble for people at work. I guess I will learn.

The mistake you made was finding a doctor who prescribed you Byetta and glipizide.

That is a REALLY bad combination of drugs and one that I’m pretty sure is contraindicated in the Byetta prescribing information because it causes exactly what you just experienced.

Meh, that’s nothing. I’ve had seizures in the office and passed out on the floor. (Not something to emulate, but just know you could be worse.) People are happy to help, so long as it doesn’t happen every day and doesn’t stress them out (you know, the way banging your head on the floor would…something I’ve done when I have low episode seizures). It gives them something to talk about. I mean, I wouldn’t try to make yourself low, but I also wouldn’t beat myself up. And it’s okay to have candy every once in awhile. Just remember this and know, in the future, to eat a few more carbs or more protein. And, of course, always have some juice or something around.

It can be scary when you feel yourself going low and you have nothing to eat. I’ve done that before. I keep kashi bars around - in my pockets, bag, desk drawers. And I feel nervous if I don’t have one handy. They are not too hig on carbs (about 16 or so after removing the fiber) and have some protein and fat to balance it out. I wish they had a little more protein, but whatever. One thing I learned is that salad without chick peas or beans or some kind of carb just doesn’t work for me. I have to have at least 25 grams of carbs at a meal or I don’t feel good at all! Croutons work ok too…chick peas work better.

Also, for me breakfast is non - negotiable. I’m impressed you even made it to lunch! I’d be a goner by about 10 am…

Why Metformin, Byetta, and Glipizide? Just curious??

that’s what I was given. I’ve seen others with that too, ( i think on some forums). Is this wrong? I have no experience, and I don’t believe everything doctor’s say, etc. But, I have seen others with the same combo, so I didn’t think it was that strange to put together. But, I am a newbie, so I don’t know. Not a winning combination?

I’m on Metformin and Byetta but my endo said no glipizide or anything like that as they will make you crash too often, even without the Byetta, and are hard on your liver and kidneys.

Yeah - I would say you were high from the gummies…and then combined with the Glipizide, the Byetta’s effect crashed you. My CDE told me to ALWAYS eat a protein with a carb and that should help the Byetta have something to hang on to.

Are you testing frequently? You can really see where the Byetta and the Glipizide contraindicate each other this way.

Also make sure you have at least 6 hours between shots of Byetta. You also could have eaten the gummies and then taken the Byetta, and I’ve read that taking Byetta after you eat can produce lows also, so perhaps your body reacted that way.

Sorry that happened - that had to be scary.

With Metformin, I cannot tolerate carbs. I had a half of a baked potato and that caused me to have an attack. So did a half of a cup of oatmeal, no sugar or milk. My body just cannot tolerate carbs. I can eat vegetables because they are so low. But I have learned my lesson with Metformin!!


Nowhere in your message do you say you tested your BG before eating. You must do this. I don’t know if you are on a sliding scale of Byetta or how that works, but if you tested low before eating, it would have made a difference in how much Byetta was taken (IF it works like insulin). I have also heard that if you are on Byetta, the oral meds may often have to be reduced or stopped.

I don’t know how your Byetta dose is calculated, but with insulin, you test before eating. Then you take a certain amount of insulin to compensate for the overage (if high) and then carefully count carbs and dose for that using the formula you’re given. You see, you didn’t know if you were high or you were low before. Your entire regimen would have changed. Assuming doesn’t help because, if you’re anything like me, sometimes you feel the same way high as you feel low. It’s really strange.

Without further details, I wouldn’t like to assume you did anything stupid or you just made a mistake … one that anyone could make at any time. Cheer up and call your endo or nurse educator to discuss this in more detail.

Hope you have better days ahead.

Lois La Rose

P.S. It would be nice if you could follow up on this with your DR or whatever and let us know what is shakin’!!!

I did not test before. I had just munched on a few candies because I had a busy day, didn’t have breakfast and it was somewhat close to lunch time. Didn’t pay attention at all. I normally do not test before I eat since I don’t take insulin. Even when I had gestational diabetes nobody told me to test before. Just use a ratio of insulin to carbs. I haven’t been THIS low before. I just know I need to watch better and absolutely should not have had just plain candy.

I find it really hard to do all of this. I have a fast paced life, and sometimes just don’t have the time, or am tired and don’t feel like cooking. This is really hard to time, anticipate, and cook healthier all the time. Sometimes I don’t even have a set lunch time. I don’t know how I am supposed to eat on a regular basis. But, if there’s a will there’s a way…

I will not see my doctor until May. I live in a more rural area and the only endo I see is 2 hours away. That is why I am looking at this wonderful discussion board for help and ideas!

Thank you everyone for all your replies! I will probably start checking before meals, just so I can get an idea of what is going on.

I live the busy life, too, but you can never be too busy to test. I made that rule in my life. One thing that helped me is keeping testing supplies EVERYWHERE. I am a private music lessons teacher, running between four campuses during passing periods, missing and/or teaching through lunch periods, staying late, arriving before school, etc. But I will test anywhere and whenever I need to. I can test and drive, test and play piano, test and talk, test and walk. I have even been spotted testing my blood sugar while singing opera arias.

I skipped lunch today - I don’t do this often, I swear - it’s not a great idea for a type 1 - but I knew I could because my continuous glucose monitor showed me sitting pretty all afternoon between 104-106. Around 3:45pm, I finally decided I was hungry and tested and took insulin for my 32g of sandwich - which I had no qualms about scarfing down while going over the German diction for a Mozart aria with a 12th grade alto. You do what YOU need to get through your day in a healthy way.

So I guess what I’m saying is that I think you need to make a commitment to one thing or the other. Either life slows down (yeah right) or you learn how to fit diabetes control on top of your fast pace. You cannot choose the faster pace without the control to back it up.

Yes, it is really hard to manage diabetes when life is overwhelming with work and other responsibilities. Last summer I found myself working 50 hours a week and finally had a talk with my supervisor to say, even though the company “climate” is to work until it’s done no matter what, with my diabetes I just can’t do that. I even had a note from my doctor (though I didn’t need it, my supervisor understood completely), which said that in order to manage my medical condition I needed to work no more than 40 hours a week. When my doc and I talked about it she made the comment, which I think is so true, that you even need “thinking time” to manage an illness like this, to figure out what has to be done and do it–to do things like regularly read and post to this board. My work is still way too stressful, but now I only do it 40 hours a week. My priority is my health first (though it’s not always possible to manage to do that).

Another lesson learned.You will keep on making mistakes and hopefully learn from them.After a while you’ll be an expert!

Amen, Ellie.

In 2004, I was living in the city. I taught in one suburban school district 30 miles north of my apartment in the mornings, then drove 40 miles southeast to teach in another school district in the afternoons, then drove back to the city to work a 5-6 hour shift as the assistant manager for a retail store. I was driving over 100 miles a day, not sleeping, not testing much, not eating a healthy diet, and working myself sick. I ran my car off the service road one Sunday working a (fourth) job as a church musician because I decided to nap at the wheel. (My parents helped me out by replacing the axle and two tires.)

My endo pointed out that I worked longer hours than she did and ate more chocolate than her. “I’m the doctor - you’re the diabetic. Do you see anything wrong with this?” On her orders to work and drive less, over the course of the next six months, I quit the afternoon and evening jobs and moved to an apartment in the suburbs north of the city nearer to the more lucrative teaching job and church job. She was right. I was crazy.

You have to do what you have to do, sure. But one of the things you have to do is take care of yourself.

Byetta is completely different from insulin. There is no carb to insulin ratio - it is a fixed dose. It’s quite different from being on insulin, but it is contraindicated with sulfonureya drugs because it does pretty much lower your BG already. You wouldn’t adjust your Byetta dosage based on what you eat or when you eat. Just to let you know.

Aprylsky: I can relate. I would definitely test more to see if you are as low as that or if it was because you ate the gummies then took the Byetta, which will make you low anyway and if you crossed way under due to having Glipizide as well as the Byetta. Then you can really give your doc some numbers. And if it starts to happen more frequently, not after eating a higher sugar content or if you take your Byetta spaced properly, then by all means, put a call into your endo.

It’s hard when you are a busy person - I can understand that. When were you gestational?

I was gestational in 93, 95, and 97 - things have really changed, I’ve noticed.

And everyone’s protocol is different.

This is a good place to come to learn and have camaraderie. You were good to notice that and treat for it.

Don’t beat yourself up - it will be ok. The good thing is that you are aware! :slight_smile:

That was really good of you to advocate for yourself like that! I’ll have to think more like that. I’m glad to know others are processing their work like that. I find I just can’t burn the candles at both ends like I used to…sometimes that makes me feel impaired, and sometimes, I welcome the respite, but most of all, it’s just annoying! :slight_smile: I’m a teacher, too - Melissa - funny - work more AND eat more chocolate. How I gauge my life, too!

Thanks for all the great input from everyone! I am already having a better day. This is new life adjustment for me and I am learning what I need to do. (and not to do, lol). I am not used to taking care of myself first, but I know it must be done. Especially if I want a good quality of life. I will take time for me to adjust my lifestyle, and my family to have to adjust with me, but I know we will get there. This board is great!


I do not know anything about Byetta and I thank you for the lesson, too. I am on an insulin pump and don’t know how things are calculated with Byetta. If it is not an insulin, what is it? Do you mean to tell me that, if your numbers are low before a meal, you don’t decrease? Won’t that drive the numbers lower?

I know you aren’t a DR (I think!) , but you seem to know a lot about it. I am interested too.

Lois La Rose