T 1.5 or ? On Metformin, Getting lows!

My newly diagnosed friend is experiencing a rather odd phenomenon. A few times over the past few months, he’s been experiencing lows, dropping down to 60. This shouldn’t be possible on Metformin, and he’s not injecting insulin.

The best I can figure, since I haven't found any common thread to the incidents, is that randomly, his pancreas decides to produce insulin. Last night, he'd had a muffin and a glass of milk before bedtime, and a short while later, felt bad/sick. So he tests, and he's at 60. He put down some Pepsi (peanut butter tasted nasty to him at that moment) and other carbos, and straightened back out.

Obviously this isn't a textbook Type 2. Any of you have any firsthand experience with this? If so, what was the outcome?

No, he doesn't have regular insurance, just a sliding scale discount at the local clinic, which does NOT have any specialists available... which is why we're figuring this one out on our own.



Sounds like maybe reactive hypoglycemia, where a person goes low after eating carbs. You might try googling that. Is he sure he’s diabetic? No reason to think 1.5 from what you are saying.

JT, I’d appreciate hearing any other information you gain, and I will share same.

Was talking with Mom last night (Type 2 many moons), who has been experiencing lows seemingly tied to going on Actos. Her original Lantus dose was 20, now cut back to 6 to avoid lows both day- and night-time, and has lost a bit of weight (not much). Not sure if weight loss preceded Lantus decrease, but wondering about possibility of dropping even a few pounds having such an impact.

It is difficult to comprehend lows on 6 units of Lantus, but I forget she’s a T2. She’ll see endo in a week or so, decreases in Lantus have been on endo’s recommendation.

It’s just weird…

I have heard may people say they have had issues with reactive hypoglycemia prior to being diagnosed as T2.

JT, I am in your friends club. I am on metformin only. 500 mg for breakfast and 500 mb for lunch. I stopped my night dose because I kept hitting the 60’s in the middle of the night. I would ride my bike for about 10 miles and in the middle of the ride I would hit 60’s to 70’s. This would be after having 3 slices of pizza for dinner with my metformin dose. Not good while excercising. I dont take any insulin in at all so it bothers the crap out of me when I should not be going low at all. I sometimes check my bgs 30 minutes before I go to lunch. I would be at 120 30 minutes before lunch and as soon as I would be in line I would get the shakes. Its almost like a pavlov effect. I smell food, body notices food, and all of the sudden pancreas and insulin decide to blast insulin. I would think panic attack and take our my meter and bam I would be like at 70 with the shakes while waiting to eat.

the other night I had a cup of cherios and a glass of milk and I woke up at night at 50. So I dont know if the metformin may be preventing the body from releasing glucose from the liver, the natural mechanism to feed the body if you have not eaten and all of the sudden you have no glucose sources and just a bunch of insulin in the body.

Who knows because my docs cant explain it either

You friend may do better with a high protein ;low carb diet . This is not uncommon for hypoglycemic person to have these symtoms.Often a person may start out hypoglycemic and then they bouce between low BG and High BG before the become full T2. They might due well on the “Zone” diet.

Low carb high protein made the lows come faster for me I tried it and my long distance suffered. I needed the carbs for long rides

Do you have a diabetic clinic in your area? or a free clinic? Some churches will have a nurse that can offer help.
This is something that should be tracked by a dr. or endo. Do you have a diabetic educator group in the area? Some people maybe willing to give free advice to help him out.

If I remember correctly one side effect of Metformin is that Hypoglycemia is an issue in some people. As we all know drugs react differently in all people and you friend may be one of them. Your friend needs to get back to the clinic to inform his Dr If I dont eat enough I can get a hypo at night too, Not a low one experiences on insulin but enough to make me feel very uncomfortable. I am on 1000 mgs a day on Metformin.

Sounds like he could have reactive Hypoglycemia which is a form or precursor to diabetes. More medical investigation is warranted here.

Working out is when this happends to me. I hit 70 and if I dont take 15 grams of carbs I get a nasty spike after feeling like crap. So I have learned to test sugar every hour during the day. If I hit 80 at any time during the day I take a very small control amount of carbs. I will eat an orange, drink some G2, or a granola bar. Everything i eat during that time is 15 grams of carbs. For some crazy reason if I hit 80 and dont eat anything my body decides to tank and go even further down and on the way down it decides to dump a lot of glucose. So i figure controlled 15 grams is more predictable than not eathing anything. I try to stay around 100 and if I hit anything between 70 and 80 15 grams of carbs seems to do the trick.