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How fast is it safe to lower blood sugar
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nikitakev posted:
My husband has been diagnosed with diabetes 3 days ago, his blood sugar was not measurable in the doc office and was not measurable after 20 units of Insulin. The doc told him to take 1000mg Metformin twice a day and eat normal!!! He is taking his pills and reduced carbs ( complex ones ) to 150g a day. His blood sugar is down to around 210 two hours after eating. But he feels miserable, muscle pain, exhausted ,sleepy, headache. Is his sugar coming down to fast? Is this normal? Should I take him to the emergency room?
His A1C was off the charts at 18, he is active , exercises 5 times a week, weights 180 pounds at 6'2 , he is 45 years old.
His doctor did not feel it necessary for a dietitian referral but I insisted , but that appointment is weeks away.
Any help would be greatly appreciated.
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auriga1 responded:
Not measurable...way off the charts maybe? Not sure as I am not a medical professional.

A 210 blood sugar reading is too high a reading two hours after a meal. It should be 140 or under.

I, for one, need to reduce my intake of carbs drastically. My body is "allergic" to carbs, any kind of carbs. We are all different, but some of us react to any kind of carb we eat with a higher blood sugar.

Your husband's A1C is way off the charts, as you said. An A1C of 18 averages about 470 blood glucose reading daily for three months. That is dangerous. He needs to get it down as fast as possible.

He needs to see an endocrinologist. The emergency room is not in order at the moment unless his blood sugar rises to around 500. Then he needs to get it down immediately.

My A1C was 13.2. The dietician suggested 35-45 carbs per meal. I stick to the lower number and even then I only eat 20 or so carbs per meal. For many of us, 150 grams of carbs per day is too much. That averages to 50 per meal, which can be too much for someone like your husband. Seeing you husband's numbers, I believe he should cut down his carb intake further. This may help until he sees the dietician.

When he sees the dietician, it should be mentioned that his numbers are always high.

It does take awhile for the body to adjust to lower numbers, especially since his have been running high.

Metformin takes awhile to kick in before you see any reduction in numbers. To the right of this forum you will see an expert column written by Dr. Dansinger. Have your husband take a look. It is very informative.

I use two insulins to keep my diabetes under control. My doctor did not think oral medications would be beneficial. My last A1C was taken this past Thursday - 5.8, a far cry from my very first one.

I don't know what type of insulin was administered to your husband. There are many types in which actions start immediately, such as Humalog (10 minutes after injection.) Others take longer to make its effects known.

I think it best your husband start to lower his intake of carbs. If he can, exercise should be done at least 7 1/2 hours per week (Dr. Dansinger's suggestion.) Drink plenty of water. Take his medication at the same time every day. If none of this works, it is time to re-evaluate his therabpy.

I was labeled an "uncontrolled diabetic." When insulin therapy was begun, I was to journal the food I ate at every meal, the amount of carbs in that food. I was to take my blood sugar before eating and then two hours after. This was for every meal. Anything I put in my mouth needed to be documented. I did this for two weeks and then I was re-evaluated. It was extremely helpful to see everything in black and white.

As I stated before, there is not need for the ER unless his sugars are extremely high. I know he's feeling badly at the moment. Did he eat something high in carbs that would cause his sugar to rise rapidly and then fall rapidly? Sometimes that can happen.

This is the weekend. It tends to be slow on the forums. Hopefully, others will come along with more advice.
 
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davedsel57 responded:
Hello.

We are not doctors, but from what you have posted it would seem wise to contact your primary doctor today. If they can not or will not help then I would think a trip to a local hospital emergency room is in order. While a reading of 210 is usually not high enough for an emergency situation, your husband symptoms sound to me like he needs medical attention asap. Home glucose monitors are not 100% accurate so the reading could actually be higher.

As long range education and treatment, you husband should get a referral or recommendation to see a dietician, nutritionist or Certified Diabetic Educator. WebMD has an excellent Diabetes Health Center here: http://diabetes.webmd.com/default.htm

I pray your husband can get proper treatment soon.
Click on my user name or avatar picture to read my story.

Blessings,

Dave
 
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davedsel57 responded:
You can see the two of us that have replied have two different opinions. Neither of us is wrong or right. You need to do what you feel is best for your husband.

This is the reason that this disclaimer is at the bottom of each page at WebMD.com:

"Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately."
Click on my user name or avatar picture to read my story.

Blessings,

Dave
 
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nikitakev replied to davedsel57's response:
Thank you both for your input.I will take him to the doctor today. His doctor refuses to refer him to an endocrinologist but I have contacted the insurance carrier directly to see what can be done.

He was told not to expect to lower his BS from a" normal "for him of 560 to levels lower than 140 for 3-4 weeks, that is why I was wondering if his levels are dropping too fast in 3 days and this is bringing up these symptoms.
He was told to eat 60-75 g of carbs a meal plus 2 snacks for around 20g of carbs. He comes nowhere close to that intake in the last 3 days.
Thanks again for all your input. I will post the findings when we come back from the emergency room.
 
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nikitakev replied to nikitakev's response:
The emergency doc told my husband his symptoms are coming from the Metformin as side effects ( heart burn, painful muscles , fatigue ) in addition to the blood sugar drop, he was at 179 in the hospital.
The doctor told him he is dropping too fast and should aim to eat 200 - 250 grams of carbs a day (for the next week ) to lower his sugar count more gradual. He also told him not to exercise when his blood sugar is above 250 because of the dangers of Ketosis. That is the hardest for him since he is so used to working out almost daily for the last 25 years ( military)
Cant wait to get to the appointment with the dietician to get some more concrete answers!
I have been reading a lot on this site and the ADA and realize that there is no "one fit all" but diabetes is a very individual condition.
One day at a time!
 
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davedsel57 replied to nikitakev's response:
Hello again.

I'm glad your husband was able to get further treatment.

You are absolutely correct - there is no "one size fits all" treatment for Type 2 Diabetes. Each of us is unique. There are some basic principles that apply to all, though, such as proper nutrition and exercise.

I pray you and your husband learn how to control his Diabetes effectively. It is a huge challenge, but it can be done.
Click on my user name or avatar picture to read my story.

Blessings,

Dave
 
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56Angelou replied to nikitakev's response:
I just finished lowering my sugar from an average 300 to 158 over a three month period.
Three things : at first cutting carbs to fast made me a little sick ; After four months I still cannot eat over 20 grams of carbs per meal because it makes my sugar stay high ( I have a low tolerence for carbs ) and number three - a big one - I cannot take the full 1000 mg of metformin all at once. I cut my pills in half and take 500 mg every 4 - 6 hours, with my meals. Ask the doctor if cutting them in half is an option. That was the only way I could stomach them, and it may be the only way your husband can.
 
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nikitakev replied to 56Angelou's response:
Thanks for your input 56Angelou!

Somehow it comes across everywhere that after one is diagnosed with diabetes blood glucose should be down to "normal" immediately! it did not get to those levels overnight so why should it be down after 2 days?!
My husband no longer takes Metformin ( he is G6PD deficient and this medication can destroy his red blood cells and be deadly - in layman's terms- that is where his symptoms came from ). He does take a different one and so far no side effects.
His readings are continuing to go lower with diet and exercise, over the last 1 week he went from 560 to 159 today 2 h after eating a 65 carb wholegrain meal.
Off course he levels are still all over the place but no higher than 250, to complicate matters he works permanent night shift so I do expect it to take a few months to get into normal ranges.
One day at a time


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