Brief Answer:
I recommend performing some tests

Detailed Answer:
Hello!

Thank you for asking on HCM!

I read carefully your question and would like to explain that your symptoms don't seem cardiac related. The performed tests in the ER are reassuring of this fact.

Did they check your blood sugar in the ER? A high blood sugar, caused by an abrupt absorption of glucose contained in the candy in an empty stomach could cause an acute raise in blood sugar. In a diabetic patient, where the body release of insulin or its effects are not appropriate, a high blood sugar, could cause a similar symptomatology. The fact that after taking 4 bottles of water (a good hydration), you felt better, is another argument in favor of this explanation.

I recommend consulting with your endocrinologist and performing a fasting sugar glucose, an oral glucose tolerance test, sugar and ketone levels in the urine and HbA1c, to examine better your diabetes situation.

Another issue, to take into consideration would be a gastro-esophageal disorder, like gastritis or an esophageal spasm. Sweets can increase acid containing in your stomach, causing irritation, especially in an empty stomach. A fibrogastroscopy would be necessary to exclude this possibility.

I would also advise performing thyroid hormone tests. Sometimes thyroid gland dysfunction can increase glucose intolerance and cause similar symptoms. It would also explain the sleeplessness and tiredness.

Regarding the cyst on your kidney, it may mimic a similar symptomatology, but it would not be related to sweet taking and the symptoms would not be relieved by water intake. So it is a low possibility of its implications in this acute situation.
Although a scheduled check up with ultrasound is necessary to monitor its evolution.

You should discuss with your GP on the above possibilities and tests.

I hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Best wishes,
Dr. Iliri

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Brief Answer:
I recommend consulting with an endocrinologist.

Detailed Answer:
Hello again,

Your episodes of sweating, troubles with sleeping seem to be related to nocturnal episodes of hypoglycemia (low blood sugar), which are common in diabetic patients and even more common when metformin therapy.

I recommend consulting with the endocrinologist and perform further tests to establish the cause.

Regarding your back pain and body aches, I would like to explain that a differential diagnosis of back pain should be performed:

- the kidney cyst, may cause back pain with acute exacerbations.

-a chronic diabetic neuropathy could be the cause of chronic back pain and body aches. An autonomic neuropathy could explain the episodes of face redness and tachycardia, but other symptoms would be present (intermittent diarrhea or orthostatic hypotension). I recommend performing a nerve conduction study to examine your nerves and rule in/out this possibility.

-an adrenal gland dysfunction could cause a similar clinical scenario associated with glucose intolerance and back pain.The abdominal CTscan (that you have performed) has ruled out a possible obvious hypertrophy of these glands, but not a dysfunction. I recommend performing cortisol plasma levels and thyroid hormone levels, besides blood electrolytes and diabetes tests. It is necessary to exclude these disorders, which are commonly closely connected in the sugar metabolism of the body.

Hope to have been of help and fulfilled your expectations!

Best wishes,

Dr. Iliri

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