Metformin and low blood sugar

[FirstTimeMama36]

I was told that my HBAC1 blood test came back fine however consultant wanted me to do daily blood sugar prick test at home to test 'in case I become diabetic' so thought there was no harm in doing this. A week later had to ring diabetes consultant who saw my readings through the app and decided I needed to start on tablets straightaway and arrange an appointment for me to go in which I'm still waiting on. Most of my readings were all fine just some red where I could have cut out what was causing it so I didn't have to go on tablets but she insisted.
2 days ago my heart rate went through the roof and had shortness of breath so midwife advised to go to A&E which I did yesterday and my ECG and bloods were fine. However my blood sugar was borderline low and said I was close to collapsing and could've needed to be injected with insulin.
The doctor thinks the metformin is the cause of this. I couldn't understand why I was prescribed this when it's used to treat type 2 diabetes but I was never told I was diabetic. Told me to speak with midwife and diabetes consultant again which will do today. Has anyone been in the same situation and what did you do?

[YerAWizardHarry01]

Hi :)

I am currently 30 weeks pregnant with my second and have had gestational diabetes in both pregnancies. What were your high readings? Did they tell you what your hospitals cut off is eith regards to high blood sugars? Are they doing the GTT or is it just done by the hba1c?

Have you spoken directly to the diabetes midwife team? They may be able to shed more light if not? X

[SpillingTheTea]

Not quite the same but I had GD. I was on metformin x3 daily.
Do they suspect you have GD or diabetes? Because GD should hopefully disappear once baby has been born.

[YerAWizardHarry01]

Sorry just saw it was the diabetes team you were speaking to! I'd have thought the readings do qualify for medication and monitoring then if its come from them but weird they didn't officially diagnose you and explain it all! Gestational Diabetes UK on Facebook and Instagram is amazing for advice and tips on keeping those sugar levels down, although unfortunately sometimes medication is needed as and when your tolerance becomes less over the pregnancy x

[Idontgiveagriffindamn]

I had gestational diabetes with my first and developed type 2 before my second. I was on metformin for the second pregnancy. They don’t like blood sugars to go about the threshold at all - it’s important to have really tight control so no excess sugars are passed to the baby. So they don’t see it as a wait and see situation (or my diabetic care team didn’t).
Are you sure it was low blood sugar they said would be treated with a shot of insulin? I’m no expert at all but in all my experience insulin is used to treat high blood sugar levels not low.
You need to get back in touch with the diabetic team. There’s usually a pregnancy specialist on the team that you need to speak to.
I did go see my doctors about certain things but they literally rang up the specialist team as diabetes in pregnancy is a niche area where some of the normal rules for diabetes are different. The A&E consultant may be right but may be talking about diabetes outside pregnancy.
Hope you get it sorted.

[Idontgiveagriffindamn]

Oh and the blood test looks at your 3 month sugar levels so won’t necessarily pick up W recent spike due to pregnancy hence the monitor. The monitor is the best way of judging what’s going on in the present

[endofthelinefinally]

That makes no sense OP. The last thing a person with low blood sugar needs is a shot of insulin. You need a proper consultation with your obstetrician with input from the diabetes team.

[Wickerbaskets]

Insulin wouldn’t be used to treat low blood sugar - that would seriously exacerbate the problem. Are you sure your sugars weren’t high rather than low?

The HBAC1 isn’t a reliable indicator of gestational diabetes which is why they had you monitoring your sugars - a few high readings is a clear indicator of gestational diabetes, which is why they’ve put you on medication. This usually happens if you have 3 or more high readings. Because high blood sugar can have such serious consequences for babies they don’t tend to wait and see if you can diet control etc - if you have a few high readings they will normally get you on metformin quite quickly to help control them.

It doesn’t sound like they have explained things very well - I also recommend the GD U.K. Facebook group as there is so much useful information there. Hopefully your chat with the team today will help resolve your queries.

[FirstTimeMama36]

Thanks for your replies. He definitely did say insulin 💁‍♀️ god help me if that's the case!
It's for gestational diabetes sorry should've made that clearer. I've had a few readings since taking the metformin where my blood sugar was 4.1. The few highest I've had were normally after breakfast of between 8.0-10.0 but tea and lunch were both fine.
This is why I was confused and yes they haven't explained anything to me properly or given me the option to ask questions about it so hopefully I will get more answers today 🤞

[FirstTimeMama36]

Oh and will look at GD uk thank you!

[Yorkshirepudding1987]

8 - 10 is high and needs to be avoided really.

Mornings are hardest for a lot of women with GD. You might find you cannot tolerate carbs at all for breakfast. Its also worth noting GD is progressive and so what you could tolerate last week, you might not tolerate today.

I dont understand the insulin comment. Insulin is used to lower sugars. Did they tell you what your blood sugar was in hospital?

I have had my baby now but had GD in my last pregnancy and remained diet controlled. I think you need to speak to your diabetic nurse/ midwife to clarify what is going on.

I would also highly recommend GD UK on Facebook and their website.

[FatGirlShrinking]

What are you eating for breakfast?

Those are high readings but if your other post meal readings are good it suggests you may need to change your diet at breakfast time and go for something lower in carbs and higher in fat/protein.

[FirstTimeMama36]

Yes the first reading at the hospital was 4.3 and second was 4.1 even after eating a bag of crisps it went down.

I had been having special k for breakfast thinking it was healthy as I have done throughout my pregnancy and realised it's high in sugar so stopped eating it and had granary/seeded toast instead which has been fine but this morning it's spiked to 8.7 so gone from one end to the other.
Think it's just poached eggs for breakfast from now on!

[Rhubarbe]

It would be unusual for metformin on its own to cause low blood sugar. 4 is within the normal range.

[FatGirlShrinking]

Egg is a good choice and has options, poached, fried, scrambled, boiled, omelette.

Boiled egg with asparagus spears
Fried egg, mushrooms and bacon
Rye bread is better than granary, the darker the better
Full fat Greek yoghurt with berries
Ryvita with avocado slices

Avoid anything low fat, they dump tonnes of sugar in. The worst reading I ever had was after a muller light yoghurt which turned out to have 25g sugar in back then.

Basic tip I was given by GD nurse was to always pair a carb with a protein/fat.

Apple slices with peanut butter
Toast with egg
Muesli with Greek full fat yoghurt

And so on.

Look up Low GI lists of food, the lower the better and don't feel like you need to give up all treats just think more carefully about them. Nutella for instance isn't that bad. It would be rubbish if slathered on a thick slice of white bread but you can have a bit on rye bread or crackers to satisfy the chocolate need.

[FirstTimeMama36]

Thanks for those food options! Some sounds delicious and will try them out. To be honest I don't even have a sweet tooth. I do enjoy a bit of chocolate every now and again but I don't eat it every week and can go for months without it 💁‍♀️