Help! What am I doing wrong?

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Stef17
Veteran Member


Date Joined Feb 2003
Total Posts : 1811
   Posted 7/21/2016 6:42 AM (GMT -6)   
Hi all. I'm new here, but not new to HW. I have Crohn's disease, PA, and hypothyroid. Newly dx'd as "pre diabetes". I am suffering and I'd love some input.

My glucose is normal, but my insulin is high. So doc put me on 500mg of Metformin 1x/day about 2 weeks ago. I've practically eliminated all carbs. I eat a lot of protein and my carb count is usually about 15-30g/per meal. Trying to get in those veggies, but I mostly eat fruit. I'm eating every 2-2.5 hours, very small meals like ham and cheese and a banana. Or Greek yogurt and cut up strawberries. Or a cheeseburger (no bun) and a salad. I only drink water - no milk, juice, soda, coffee, tea, etc.

Here's my issue. At some points in the day I feel fine, but not even half the day. But mostly at night I get this horrible tremor/shakiness and it won't go away. If I don't get up and eat, it gets worse and I literally feel like I'm going to pass out and die. If I eat, it only mildly subsides and I can sleep for two more hours. I'm seriously about to lose it. I need to sleep and it's so exhausting having to eat all the time. So here are my questions:

Am I doing something wrong? Should I be on a higher dose of metformin? How long does it take for the Metformin to work? Why do I feel so horrible after changing my diet? I've been scouring the web and no one seems to be suffering like this. I'm desperate. Can't continue like this. Have a doc appointment today, but would appreciate feedback from those of you who live with this. Thank you so much!

Stef

Post Edited (Stef17) : 7/21/2016 6:46:12 AM (GMT-6)


Lanie G
Forum Moderator


Date Joined Nov 2006
Total Posts : 5924
   Posted 7/21/2016 7:33 AM (GMT -6)   
Hi Stef! Welcome to the Diabetes Forum. I'm sorry for these shaky feelings and all that's going on with it. You know I'm not a doctor but I can help you sort some of this out. First, are you testing your blood sugar? If you're on metformin or told by your doctor that you have prediabetes, then you need to test. So, do you know what your blood sugar is when you get up in the morning, before you eat a meal and about two hours after you eat? Knowing what your blood sugar is can help you choose food that will help keep blood sugar more level, especially if you're on metformin.

You wrote that your glucose is normal, then why did the doctor put you on metformin? What blood tests did they do and what were the results? Has the doctor told you that you were insulin resistant? Metformin helps the body take up the blood glucose more efficiently; people who are insulin resistant have a problem with this and are usually prescribed metformin as the first drug of choice along with a diet and exercise plan.

Feeling shaky, anxious, about to pass out can all be caused by low blood sugar but you would need to test to confirm that that's the reason.

I'm glad you're seeing the doctor today and the information that you (and the doctor) need to know is: what is your blood sugar readings when you wake up (fasting), what is your blood sugar right before you eat and about two hours after you eat. Knowing those figures will help you choose what to eat.

In the meantime, I'm posting a link to a site that has a lot of information about blood sugar: www.phlaunt.com/diabetes/

I'm glad you're posting and please keep us updated! Good luck with the appointment! (I'm eager to find out what tests were done and what your blood sugar readings have been.)
Lanie

diabetes moderator
diabetes type 2 controlled by diet and exercise and
metformin
very low carb way of eating

Stef17
Veteran Member


Date Joined Feb 2003
Total Posts : 1811
   Posted 7/21/2016 8:13 AM (GMT -6)   
Thanks for responding Lanie! Here's a little more information.

I am so weak that I am unable to do a fasting blood test. So, my doctor did a one hour glucose (drink the orangey stuff) test. They also did a finger poke. My whole blood glucose was 118. They told me that's normal, but the test range on the labwork says 99 is the high end of normal. My insulin was 93 and the high end of normal is 27. They also did a gestational diabetes screen (I'm not pregnant) and it came out at 150, high end of normal is 139.

So- with those as the results I was told I am insulin resistant and have "prediabetes". Doc put me on the Metformin and the nurse told me to limit my carbs to 45g/meal. They really gave very little info. This is an internal med doc, not an endocrinologist.

They never told me I had to check my blood sugar. I don't know why. Apparently because they 3 times they checked it, it was normal? I even went to the e.r. a month ago before I knew what was wrong and my blood sugar kept reading 80. I'm so confused. Just trying to get better.

Thanks for taking the time to read my post. I sincerely appreciate it.

Lanie G
Forum Moderator


Date Joined Nov 2006
Total Posts : 5924
   Posted 7/21/2016 9:09 AM (GMT -6)   
That really IS confusing. I'm wondering if your blood sugar is bouncing high and low and in between. I think an endo would be very helpful because of this.

Even though your blood sugar was 'normal' when they tested you, you still could be having highs and lows at other times and a person whose blood sugar comes down to normal from a high could be feeling shaky and anxious even with normal blood sugar if their body was used to higher blood sugar. Do you follow what I mean? It's like when I was a kid, we used to spin around on our front lawn really fast and then stop and watch everything spin around in front of our eyes. We were stopped, not moving, but just standing normally made us feel queasy. We were feeling the aftereffect of the spinning. So, your shaky feeling with normal blood sugar is just an aftereffect of it being higher sometime before. This is my guess. I do know that diabetics who have lived with critically high blood sugar for awhile will feel queasy, dizzy when their blood sugar is brought down to normal.

Normally when blood sugar is this erratic, the person benefits from smaller, more frequent meals/snacks throughout the day. The goal is to keep the blood sugar as level as possible to avoid weakness and shakiness. For example, start the day with an egg or two, some cheese and half a piece of bread, a few hours later eat some no-sugar yogurt, nuts and a hard boiled egg or a piece of meat, lunch could be tuna or chicken salad (mayo and celery, maybe some walnuts or almonds) and a large lettuce leaf for a wrap, a couple of grapes. Other snacks and meals: peanut butter and cheese, small salad, olives, chicken piece and two vegetables, etc.

And as I said, you do need to test so you know what your blood sugar is when you're feeling shaky. Keep a journal with the date, time, blood sugar and what you've eaten.

And - I would find a doctor who's more knowledgeable or an endo. The nurse who told you to limit your carbs to 45/meal is quoting what the ADA recommends and following that will keep your blood sugar very very high. I went through that when I saw a dietitian who recommended the same thing.
Lanie

diabetes moderator
diabetes type 2 controlled by diet and exercise and
metformin
very low carb way of eating

Stef17
Veteran Member


Date Joined Feb 2003
Total Posts : 1811
   Posted 7/21/2016 10:14 AM (GMT -6)   
Thank you so so much for your response! I totally get your explanation. It makes perfect sense! I'm going to ask my doctor today if I should see an endocrinologist. I know that every body is different and will respond to carbs differently. Last week I was eating 30-45g of carbs per meal and I felt horrible. This week I'm barely eating any and I feel so much better.

I'm just so tired of having to eat so frequently. It's exhausting to come up with ideas of what to eat, especially when I have no appetite. I'm forcing myself to eat. I really hope I can get this figured out fast. I can't stand feeling this way and I know it's not normal.

Thanks again for your help! I am so grateful!

Lanie G
Forum Moderator


Date Joined Nov 2006
Total Posts : 5924
   Posted 7/21/2016 12:41 PM (GMT -6)   
I hope your appointment went well! (Can't wait to hear what the doctor says!)
Lanie

diabetes moderator
diabetes type 2 controlled by diet and exercise and
metformin
very low carb way of eating

Stef17
Veteran Member


Date Joined Feb 2003
Total Posts : 1811
   Posted 7/21/2016 5:49 PM (GMT -6)   
Doc was a little baffled. I cried a lot because I'm so exhausted and so she said she thought i was having anxiety and asked if I have been taking Xanax. Then she said I should talk with their health therapist! I almost lost it. I told her, this is not in my head! I'm having some kind of true physical problem and I need help to get it figured out. For the record I am not opposed to seeing a therapist. I was just annoyed that that was her first response.

Anyway, then she asked how I was taking care of my children and if I was able to get things done at home. I thought, oh my gosh, she's going to call cps on me. It's frustrating the luxury these doctors have to be so unaware of how chronic health issues can wear a person down, so yeah.... I might cry after 6 weeks of this with no answers.

I came home with a blood glucose monitor and was told to take my blood sugar anytime I feel shaky or weak. For anything 90 or below I need to call her. Otherwise I should come back in a few weeks. I had to convince her to let me take 1000mg of Metformin.

I'm hoping between the blood sugar testing and the increase in Metformin I will get more information.

Lanie G
Forum Moderator


Date Joined Nov 2006
Total Posts : 5924
   Posted 7/21/2016 7:12 PM (GMT -6)   
I'm not a doctor but considering what you've written here, I would have thought the doctor would have approached this differently and ordered an A1c (a blood test to see your average blood sugar for 90 days) and also had you come in for a fasting blood test.

And you should have had a blood sugar meter from the beginning if you were prescribed metformin and told you were insulin resistant. But that's the past. Ok, now you have the meter and this is what I think you should do to find out what's going on.

Get a spiral notebook and use it as a blood sugar journal. One page, two sides if you want for one day. Write what your fasting is when you get up. Test before breakfast and write that down with the time. Eat breakfast. Write down what you eat for breakfast and then test again about two hours after you started to eat. Do that for each meal and if you eat anything in between write that down too. This should work even if you have snack if you don't eat more often than two hours between snacks and meals.

This will show you how the food you eat affects your blood sugar. And, yes, you'll be using lots of test strips that first day. If you don't want to test for every meal, ok, then just do it in the morning to lunch. And if and when you get shaky, of course test at that time.

Now, about the levels. A non-diabetic's fasting is always in the low to mid 80's, averaging 82, 83, 84, or 85. If a non-diabetic is tested at random during the day, the blood sugar would most likely be about 85. If you are lower than 90, that would be a normal reading. If you feel shaky at 85, for example, it's because you were probably used to much higher blood sugar. Once a person's blood sugar stabilizes, then the shakiness will go away. And that is if it's related to blood sugar. Of course there are other reasons for feeling shaky and that's what the doctors was thinking. But don't panic if you do test in the 80's because that's normal.

about metformin. By itself, metformin does not lower blood sugar and it will not produce lows. Metformin works to help the blood sugar circulating get into the cells where it's needed for energy. People who are insulin resistant benefit from metformin for this reason and it will help control blood sugar when you eat a lower-carb plan and have some sort of exercise on a regular basis.

You have a lot of things going on with this and other health issues and you need to find out what's going on. Of course one of the things a doctor is looking for is depression and anxiety in patients that cry in their office. A red flag would be if you told her about feeling you'll pass out and die. This is a signal to them so in a way, be glad that she was attentive to that even if you think she was off base. Years ago I did go through this and I didn't know what it was. So, I learned something about myself at that time.

Rereading your first post here makes me wonder about your blood sugar because you wrote you were diagnosed as prediabetic and put on metformin but the mystery to me is what was your blood sugar? Without testing, how would the doctor know if the shakiness and feeling of passing out and not sleeping is related to that?

If your blood sugar is going haywire, then eating smaller meals more frequently should help, as I said. Be sure to take the metformin with food so it doesn't upset your stomach, too. Keep a journal and hopefully you'll be able to figure this out!

And write how you're doing! I hope this is a better night for you!
Lanie

diabetes moderator
diabetes type 2 controlled by diet and exercise and
metformin
very low carb way of eating

MusicForLife
Regular Member


Date Joined Nov 2014
Total Posts : 380
   Posted 7/26/2016 9:51 AM (GMT -6)   
Good luck to you. Doctors... I hear you about doctors.
I hope your new meter is able to tell you a story about how you feel, hopefully offer up an explanation to the way you feel.

21Jellybeans
Regular Member


Date Joined Jul 2012
Total Posts : 61
   Posted 4/3/2017 1:22 PM (GMT -6)   
I would look into a low carb diet. My blood sugar was really high last year... 294. I went on metforim and low carb, and now my sugar levels are 120 to 140.
Not great I know, but if I take a glipizide then they crash to 60.

Lanie G
Forum Moderator


Date Joined Nov 2006
Total Posts : 5924
   Posted 4/3/2017 2:38 PM (GMT -6)   
Good for you that your food plan is helping keep your blood sugar under control!
Lanie

diabetes moderator
diabetes type 2 controlled by diet and exercise and
metformin
very low carb way of eating

Check out the following site for more info on blood sugar:
www.phlaunt.com/diabetes/
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