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Medical Forum / Diseases and Disorders / Diabetes / April 2006Low Glucose after cough mixture?
I getting this low blood glucose readings since yesterday and today and I would appreciate very much for any advise. First I had the flu, middle of February. For about 3 weeks my fbg was a bit high, from 7.1 mmol (128 mg) to the highest once at 9.6 mmol ( about 175 mg). I was on docycline. Then I recovered. My fbg's went to the 6's range for 2 weeks. Then I had this cough with 2 or 3 days of fever. I bought a cough syrup from the pharmacy, a cough syrup suitable for diabetics. My fbg's started to go into the 5's range, minimum was so far 5.1 mmol ( about 90 mg) to 5.9 mmol (107 mg). I am pleased, yes. however, yesterday, at about 3 pm, I felt a bit unwell, tested my glucose level and it was 3.2 mmol (about 59 mg?) ...... and today at about 1 pm, I had 3.9 mmol (70 mg). I have completed my cough syrup 3 days ago. I have an appointment with the Diabetic nurse on the 10th of this month. I was wondering as to whether if I should decrease my 2 x 500 mg metformine to 1 x 500 mg a day? or should I snack to keep my glucose level stable. Please advise me. Thank you very much, San >I getting this low blood glucose readings since yesterday and today and I >would appreciate very much for any advise. [quoted text clipped - 14 lines] >Thank you very much, >San Hi San A little more info needed before anyone could comment. Do you test after meals, what do you eat, what other meds are you on? You said 3pm and 1pm - what time did you eat before those tests and what did you eat? Had you done any exercise close to those times? I would not be waiting until the 10th - I'd be ringing the nurse now, or preferably a doctor, to ask questions. It could be reactive hypos after highs you are missing - or it could be something completely different. I would not be changing meds without a doctor's advice and I'd be seeking that advice now. However, if you are going to wait until the tenth, keep your meter and some fast carbs with you. While you arrange that, do some testing an hour after eating your meals, and see whether you are getting spikes at those times. Cheers Alan, T2, Australia. d&e, metformin 2x500mg  SignatureI have no medical qualifications beyond my own experience. Choose your advisers carefully, because experience can be an expensive teacher. Everything in Moderation - Except Laughter. > Hi San > [quoted text clipped - 20 lines] > Cheers Alan, T2, Australia. > d&e, metformin 2x500mg Hi Alan, I don't normally check before and after meals now. I used to do it for months after my first diagnose. Since I felt uncomfortable these days, I have been checking more often. 5 April 1000 hrs = FBG : 5.1 10.30 hrs breakfast had 1 rice pancake (was sweet), 2 koffie (my koffies and teas are without sugar and milk) 1230 hrs = 10.1 1500 hrs = 3.2 1501 hrs = 2 pieces bread with kaya jam and 2 sweets 1700 hrs = 7.7 mmol 1830 hrs = dinner, had 2 pieces fried chicken wings, vegetables in curry sauce, 2 tbsps fried noodle 2200 hrs = less than a handful peanuts 6 April 0800 hrs = FBG 5.4 0830 hrs = 1 rice pancake, 2 koffies 1200 hrs = lunch oats porridge 1300 hrs = 6.5 1400 hrs = 5.8 1800 hrs = dinner 2 piece brown bread, tuna salad with tomatoes and lettuce leave 2200 hrs = 5.3 2201 hrs = teeny weeny bit of peanuts 7 April 0840 hrs = FBG 5.9 0900 hrs = breakfast 2 slice brown bread with kaya (egg jam) 1300 hrs = 2 marie biscuits 1309 hrs = 3.9 1310 hrs = was fed up, so ate 4 small pieces chocholate 1421 hrs = 1 hr PP = 6 1531 hrs = 2 hrs PP = 7.1 1607 hrs = 5.3 I haven't been doing any exercise since I got ill in Mid February. Only thing I do is housework, cooking, cleaning, walking my two lovely little ones. I did get some boils on my rear and I started on minocycline 3 days ago. Once beginning of this week I took a diclofenac for my back muscle pain due to all the coughing. My glucose levels were already in the 5's before I took the minocycline and diclofenac. I realise after typing the above that I am actually not eating enough. I normally eat 5 small meals a day. But just that I haven't had the appetite to eat. It's just this past month after the flu. I have not been panicking or stressing myself out since I got the 5's range, actually, I was pleasantly pleased. It's only the lows that concern me a little. Should I change my attitude towards the low and feel panicky. I don't like to get stressed Alan and I am calling the doctor now. San > 1000 hrs = FBG : 5.1 > 10.30 hrs breakfast had 1 rice pancake (was sweet), 2 koffie (my koffies [quoted text clipped - 3 lines] > 1501 hrs = 2 pieces bread with kaya jam and 2 sweets > 1700 hrs = 7.7 mmol San, you're all over the place! I think you need to go back to the beginning and test your meals thoroughly, looks like something has changed. I'm betting you're going to high after some of those carby meals / snacks, then rebounding. Nicky. SignatureA1c 10.5/5.4/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg >> 1000 hrs = FBG : 5.1 >> 10.30 hrs breakfast had 1 rice pancake (was sweet), 2 koffie (my koffies [quoted text clipped - 10 lines] > > Nicky. Yes Nicky, I do need to do something about my meals. That rice pancake was a big big mistake, just that I was so fed up with the lack of appetite this time around that I just caved in. I normally would have had 10 gms carb for breakfast. This last week, since my figures went into the 5's, that's when I started to add more carbs. When I had the flu in mid february I was hungry all the time. Middle March I started with the fevers and cough and that's when I lost my appetite. I lost my mood to cook or prepare food too. I shan't give any more excuses and start all over again. Thanks Nicky Sansi, part of what is happening is that you are eating too many carbs for breakfast at the moment. It is raising your bg and your natural insulin is lowering the bg further than it needs to be. Think of it as acting too well, lowering your bg's long afteer you need it to. You can avoid that by eating only the amount of carb that raises you very little. Also, for the moment, you might like to check how all your meals are affecting you by testing before every meal and after the meal testing at one hour and two hours. If bg is up by a lot at the 1 hour and two hour then expect the low anytime within 5 hours of eating. Perhaps you could try less carb at each meal but have more meals/snacks. Same daily carb but spread over more meals so the carb has less negative impact on your bg's. >>> 1000 hrs = FBG : 5.1 >>> 10.30 hrs breakfast had 1 rice pancake (was sweet), 2 koffie (my [quoted text clipped - 18 lines] > Yes Nicky, I do need to do something about my meals. That rice > pancake was a big big mistake, just that I was so fed up with the > lack of appetite this time around that I just caved in. I normally > would have had 10 gms carb for breakfast. This last week, since my > figures went into the 5's, that's when I started to add more carbs. > When I had the flu in mid february I was hungry all the time. Middle > March I started with the fevers and cough and that's when I lost my > appetite. I lost my mood to cook or prepare food too. I shan't give > any more excuses and start all over again. > Thanks Nicky > Sansi, part of what is happening is that you are eating too > many carbs for breakfast at the moment. It is raising your [quoted text clipped - 12 lines] > meals/snacks. Same daily carb but spread over more meals so > the carb has less negative impact on your bg's. Thanks for putting it so simply Jan. Appreciate it very much. I will take your advise. San Hi Sansi Reply interleaved. You've had good advice from the others already, so this is just a bit of analysis. I've converted some numbers for US readers. >Hi Alan, >I don't normally check before and after meals now. I used to do it for [quoted text clipped - 3 lines] >5 April >1000 hrs = FBG : 5.1(92) Excellent >10.30 hrs breakfast had 1 rice pancake (was sweet), 2 koffie (my koffies and >teas are without sugar and milk) >1230 hrs = 10.1(182) And I'll bet it was even higher at 11:30. >1500 hrs = 3.2(58) No surprise - classic reaction if it was myself. The roller-coaster - go much too high, the insulin arrives eventually - too much and too late. >1501 hrs = 2 pieces bread with kaya jam and 2 sweets What is kaya jam? What sweets? >1700 hrs = 7.7 mmol(139) Again, too high at two hours and would have been higher at 1600. >1830 hrs = dinner, had 2 pieces fried chicken wings, vegetables in curry >sauce, 2 tbsps fried noodle No PP test? Probably would have been OK, depending on the actual weight of those noodles. >2200 hrs = less than a handful peanuts > >6 April >0800 hrs = FBG 5.4(97) Excellent again. >0830 hrs = 1 rice pancake, 2 koffies Do yourself a favour. Find all copies of the rice pancakes recipe, and any other high-starch recipes that you have, and hold a ceremonial funeral pyre after dinner tonight. Then erase them from your memory. >1200 hrs = lunch oats porridge >1300 hrs = 6.5(117) >1400 hrs = 5.8(105) Great - you've discovered that you can handle oats at lunch - but don't try that at breakfast. >1800 hrs = dinner 2 piece brown bread, tuna salad with tomatoes and lettuce >leave >2200 hrs = 5.3(95) >2201 hrs = teeny weeny bit of peanuts Your numbers are starting to show that we are very similar - I can't handle carbs in the morning at all, but I can eat a reasonable carb portion in the evening. >7 April >0840 hrs = FBG 5.9(106) Excellent again. >0900 hrs = breakfast 2 slice brown bread with kaya (egg jam) Ack!! That's over 30gms carb in the bread before you add the jam! >1300 hrs = 2 marie biscuits So, somewhere between 0900 and 1300 you've spiked high, then swung down to: >1309 hrs = 3.9(70) The Marie biscuits would have helped bring you back up, prosably had more effect than the chocolates, depending on type. Next time, have a small OJ or sugared soft drink and test again in 15 minutes. Don't overcorrect. >1310 hrs = was fed up, so ate 4 small pieces chocholate >1421 hrs = 1 hr PP = 6(108) >1531 hrs = 2 hrs PP = 7.1(128) Interesting. It took 2 1/2 hours for the peak, which wasn't terribly high - must have been a lot of fat in those chocolates. >1607 hrs = 5.3(95) Back to normal. Some comments. With all due respect - your diet is bloody terrible for a type 2. The only protein I could see on day one was the egg in the "Kaya jam", some fried chicken wings and some peanuts. That appeared to also cover the fats apart from the frying oil for the noodles, although you didn't mention what veges were in the curry. All the rest appears to be starch - rice pancakes, breads, fried noodles, sauce thickener. Then on day 2, apart from the egg jam and the peanuts, just the tuna - hopefully with some good veges in the salad. But more bread for breakfast, oats (which aren't bad, but are still more carbs without much protein) for lunch. Obviously eggs aren't a problem for you. Instead of your kaya egg jam - try a real egg or two for breakfast tomorrow, in any form you like - omelette, fried, poached, whatever. But do NOT have them on toast, or with a pancake. Try for no carbs at all for breakfast as an experiment and see what your numbers are at both one hour and two hours after you finish breakfast. Then, limit yourself to less than 15gms of carb for lunch - that's one slice of bread or equivalent - and make up the difference with veges or tuna or both, or equivalent, but no extra carbs. And test again at one and two hours. Then, eat the carbs you missed earlier at dinner, that's when you could have those noodles or the extra slice of bread, or a starchy vege in the mix. But keep it under 45gms - for experimental purposes - and do those tests again. Cut back on those fried things - the chicken wings, fried noodles etc - until you get this thing under control. Add more greens and other non-starchy veges to your diet, more fish, including breakfast, less starches, and more tests. That handful of nuts late in the evening seems to help those morning numbers. Good luck, Cheers Alan, T2, Australia. d&e, metformin 2x500mg I have no medical qualifications beyond my own experience. Choose your advisers carefully, because experience can be an expensive teacher. Everything in Moderation - Except Laughter. > Hi Sansi Alan, Thank you so much for your time in analysing my food intake. I have copied this mail to my folder and will read it again and again. Learn and understand and put to practice. I normally would include in my daily food intake cheese, ham, 1 cup soya milk, snacks of carrots or cucumbers or tomatoes, 1 fruit a day. I have not had bread for months actually, I normally eat wasa crisps. I do eat a tablespoon or two of rice for dinner with lots of vegetables and some meat. Peanuts for that night time snack or cheese. It's just this last 2 weeks that I have lost my appetite. This is the first time I have experienced low glucose levels and I must be prepared for it in the future. I will keep a can of soft drink on standby and yes I will learn not to overcorrect. My question is still why I was in the 6's range for months and suddenly went into the 5's. Only once last year in October I had fbg of 5.7 (105). So I was surprised that that it had gone down to 5's range. I know most people are aiming to be in the 5's range. When I typed out my food intake yesterday, I realised how little I was eating. These last 3 days, since I felt a bit better, I started rushing of into the day to catch up with my spring cleaning, so I actually forgot to eat lunch. I now see what consequence I get if I didn't eat at proper times. Yesterday, I felt much much better in my system with some extra food. Something has changed and I have to learn from all of this. I don't like that feelings of low glucose nor high glucose for that matter. Thank you so very much Alan and everyone who has helped me with advise. I appreciate it very very much. Sandra >> Hi Sansi >> > Alan, Thank you so much for your time in analysing my food intake. I > have copied this mail to my folder and will read it again and again. > Learn and understand and put to practice. > I normally would include in my daily food intake cheese, ham, 1 cup > soya milk, snacks of carrots or cucumbers or tomatoes, 1 fruit a day. > I have not had bread for months actually, I normally eat wasa crisps. > I do eat a tablespoon or two of rice for dinner with lots of > vegetables and some meat. Peanuts for that night time snack or cheese. > It's just this last 2 weeks that I have lost my appetite. This is > the first time I have experienced low glucose levels and I must be > prepared for it in the future. I will keep a can of soft drink on > standby and yes I will learn not to overcorrect. > My question is still why I was in the 6's range for months and > suddenly went into the 5's. Only once last year in October I had fbg > of 5.7 (105). So I was surprised that that it had gone down to 5's > range. I know most people are aiming to be in the 5's range. > When I typed out my food intake yesterday, I realised how little I was > eating. These last 3 days, since I felt a bit better, I started > rushing of into the day to catch up with my spring cleaning, so I > actually forgot to eat lunch. I now see what consequence I get if I > didn't eat at proper times. Yesterday, I felt much much better in my > system with some extra food. > Something has changed and I have to learn from all of this. I don't > like that feelings of low glucose nor high glucose for that matter. > Thank you so very much Alan and everyone who has helped me with > advise. I appreciate it very very much. Have you perhaps lost some weight. Insulin resistance can improve with weight loss. It did for me. I lost 45 kg over a few years. 15 kg at a time, then a break. I am now at a point where I can eat more carbs if I want to and still stay low. > Have you perhaps lost some weight. Insulin resistance can > improve with weight loss. It did for me. I lost 45 kg over a > few years. 15 kg at a time, then a break. I am now at a > point where I can eat more carbs if I want to and still stay > low. Hi Ozgirl, Fantastic that you lost so much of weight. Amazing. I on the other hand was 67 kg, lost 2 kilos during the illness but now my weight shows 66.5 kg. I seem to be on a plateau here. I need to start my walking again. Waiting for my boils to get healed and then it will be comfortable to walk again or even sit on my hometrainer. Jan, do you think that being in the 5's range for fbg has made my insulin resistance improve ? I wish I could write in better english what I am trying to say or ask. If it has improved, then, it's a good thing isn't it. I feel encouraged. After all the months of hard work, it might have actually paid of. I think I need to let my body get adjusted to this level. At the 6's range I was happy and jolly and energetic, don't feel that now. Kind of slow and sluggish a bit. Enough said. Thanks for all your advise and Alan and Nicky. I appreciate all of you. San >> Have you perhaps lost some weight. Insulin resistance can >> improve with weight loss. It did for me. I lost 45 kg over a [quoted text clipped - 5 lines] > Fantastic that you lost so much of weight. Amazing. I on the other > hand was 67 kg, lost 2 kilos during the illness but now my weight > shows 66.5 kg. I seem to be on a plateau here. I need to start my > walking again. Waiting for my boils to get healed and then it will > be comfortable to walk again or even sit on my hometrainer. > Jan, do you think that being in the 5's range for fbg has made my > insulin resistance improve ? More likely the other way round, that's why I asked about the weight loss. As insulin resistance improves (by weight loss, gaining more muscle or certain medications) numbers start looking better, especially fasting numbers. I wish I could write in better english > what I am trying to say or ask. It's ok, you are coming across well. I don't think I have misunderstood anything. If it has improved, then, it's a > good thing isn't it. I feel encouraged. After all the months of hard > work, it might have actually paid of. I think I need to let my body > get adjusted to this level. At the 6's range I was happy and jolly > and energetic, don't feel that now. Kind of slow and sluggish a bit. > Enough said. Thanks for all your advise and Alan and Nicky. I > appreciate all of you. Every change means an adjustment period for the body. Some people feel hypo and sluggish at 8.0 or whatever after a long time being 15.0. I think you mentioned while you were sick you weren't eating a lot? That in itself could lead to lower numbers and feeling sluggish. Called the doctor, and I am to reduce my metformine to one and to eat more often and to test more often. That the particular brand of cough mixture I took couldn't have brought my sugar levels down. San > Called the doctor, and I am to reduce my metformine to one and to eat > more often and to test more often. That the particular brand of cough > mixture I took couldn't have brought my sugar levels down. > San No, it seems more likely that the foods you are eating are doing that. If anything the cough mixture only does what I mentioned in my other post. Raises the bg if it has sugar in it, then you get a low sometimes afterward because of the insulin your body produced. It may not have been the Metformin either. Just a case of needing to balance your carbs more effectively throughout the day. And don't eat your kids' leftovers ;) >> Called the doctor, and I am to reduce my metformine to one > and to eat [quoted text clipped - 11 lines] > carbs more effectively throughout the day. And don't eat > your kids' leftovers ;) Hahahahahahah. I had a good laugh. My kids, my two little ones are dogs. I don't think I will ever eat their leftovers. *smile* . Laughter is good for the soul. Anyway, the cough mixture didn't have any sugar in it, it was saltish. One of the components in it was liqorice. I had this stupid idea that, if taking that brought my BG's down, then why not take a capful everyday. But that was just a silly thought. Restricting my carbs is safer. Thanks for the good laugh Jan. Have a great day ahead. San |
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