I finally have found a group of doctors that believe in low carbing and "normal" blood sugars! This is exciting! However, they are trying to get my fasting blood sugars down and have put me on Amaryl to do this. (I have been on Metformin for years. They added Actos, which made not a dent in the bg, then added the Amaryl)

Well, it has worked alright, but it is causing me to have low blood sugars throughout the day, also! I just had a nice low carb supper and then went for a short walk. Two hours after eating my bg was 71 and it was going down from there, according to how I felt. I had to eat a snack. This is frustrating because it is ruining my low carb diet!

I saw the doctor today and asked him to take me off of it and let me just try the low carb diet. He did agree to take me off of my Actos, but I am to stay on the metformin and Amaryl for now.

Any ideas on how to deal with the low blood sugars? I have no choice but to eat some carbs when they are low, right? This is all new to me - I normally have just had to deal with high numbers!

By the way, my numbers during the day had been fine when they added only 2 mg of the Amaryl. I hate to say it, but I am wondering if a small bit of insulin in the evening would take care of the morning bg? What other choices do I have? Nothing else seems to work, and I have tried everything!

Thanks,
Ramona

Before I started on insulin, I was on Amaryl also. Since it stimulates your pancreas to secret more insulin, you can have low BG's. (Amaryl will also eventually burn out your beta cells, requiring you to take insulin)

You are correct, you have no choice but to eat carbs to get a low BG back up, just be sure you use glucose tablets or something like "Smarties" candy which are dextrose (glucose) with flavoring. By using glucose you can be sure exactly how much your BG will rise (5 mg/dl per gram of glucose), and how long it will take (five minutes).

BTW, I was on Actos for a while also - it did absolutely NOTHING for me, so I quit taking it.

You probably have a couple of options:

- take your Amaryl at night (may not help)
- break the tabs in half, and take only 1 gram (may not reduce your BG's enough)
- control your low BG's with glucose (like you are now)
- Make your lowest carb meal your evening meal, rather than in the morning. (this should be effective)
- reduce your metformin dosage (could cause a period of adjustment during which your BG's will not be in control)
- start on a slow acting insulin at night, such as lente (you may still have low BG's during the day)

For me, I started on insulin and got completely off of all the pills. I still have low BG episodes, especially during exercise or walking, but I always have a roll of "smarties" with me to correct this. But my biggest problem was BG control, not weight loss, and going on insulin may make it harder to lose weight.

My BG's are in much better control since ditching the pills. I had to tell my Dr. what I wanted to do, I did not let them drag things out forever, as they tend to do. (Very conservative, most doctors are)

I did not really give you a good answer, just some ideas and some things to try.

- Danny