Zoloft Causing Hypos

Has anyone had an issue with Zoloft causing hypos. I’ve had to to reduce my daughter’s Tresiba quite a bit since she started Zoloft. We’ve carefully monitored her overnight numbers with her Dexcom and have had to lower it quite a bit since she started Zoloft last month.

I don’t know why Zoloft itself would cause hypos. However, if your daughter was feeling a great deal of stress or anxiety, she may have been releasing hormones that can cause blood sugar spikes.

Gary Sheiner discusses this here: http://insulinnation.com/treatment/how-stress-hormones-raise-blood-sugar/

Has Zoloft helped reduce her stress/anxiety? If so, then she may need less insulin than she did when she was having those feelings regularly.

Interesting, it seems to be some cases where it can induce hypoglycemia. Some old studies and data. I even found a very interesting report of someone with NO diabetes who had severe hypoglycemia episodes. Have you talked to her endo?

“Sertraline has been shown to blunt postprandial hyperglycemia in rats and to potentiate the hypoglycemic effects of sulfonylurea agents in humans. It has not been reported to cause hypoglycemia independently, but in this case, a nondiabetic patient experienced multiple episodes of hypoglycemia that resolved after discontinuation of sertraline.”

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Absolutely, hormones having contrary effect to insulin. That could also explain her need of higher insulin dosis as @katers87 mentioned.

Still I’d definitely contact her endo…

It’s been such a drastic drop in her Tresiba dose that I started to doubt that it may have been due to less anxiety, though that certainly could be the case. She had Tresiba dialed in perfectly at 9 units every night, with perfect overnight numbers. We have been lowering it for the last week and will be down to 5 tonight. She is 16 and weighs 130 pounds, so even the 9 units seemed to be a small dose compared to most. To be clear, she is not honeymooning and has been a t1 for five years. We’ll continue to tweak the basal and watch carefully. I’d hate to stop the Zoloft because of this as it seems to have given her some relief from the anxiety and depression.

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Stress, Anxiety and depression are all triggers. I had a day last week where I was stressed out so bad I thought I was going to pass out and my numbers climbed 3X normal, and nothing I did could lower them. I signed out of work, met up with some friends and relaxed - and they dropped to normal levels. Hang in there - it is not something that can be fixed, or guaranteed by Tech - our moods, anxiety, and depression lead to some “off” days. She is also 16 - and in the middle of a life changing hormone hurricane. Take it one day at a time and work through it. Best of luck to you and your daughter.

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