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Should A Episode Of A Drastic Drop On Blood Sugar Level Be Medically Addressed And Treated?
Question: Hello,
My mother is a type 2 diabetics for last 15 years. Her last HBA1C was 7.5 , and overall she is perfectly healthy. As a precautionary measure we did a 4 days CGM recording for her . In one early morning ( 5 am) her sugar level fall to 44 and it recovered back after that. When I looked at the data, I saw her sugar falled to 44 in about 4 hrs while sleeping and had a sudden rise after 5. This only happened in 1 morning out of total 5 morning where she was tested. The CGM report is attached.
Medicines taken :
Jalra M 50/500 + Glucobay 50 - 10 AM after breakfast
Glucobay 50 - 3 PM with lunch
Jalra M 50/1000 - 10 PM after dinner
On this day that I am talking, she took her medicine at 11 PM , and she had her dinner at 10.
I am worried if I should take it as one off case. What should be my next step. Any change in medicine / dosage/timing needed. Please review the report and advise.
Thanks
XXX
My mother is a type 2 diabetics for last 15 years. Her last HBA1C was 7.5 , and overall she is perfectly healthy. As a precautionary measure we did a 4 days CGM recording for her . In one early morning ( 5 am) her sugar level fall to 44 and it recovered back after that. When I looked at the data, I saw her sugar falled to 44 in about 4 hrs while sleeping and had a sudden rise after 5. This only happened in 1 morning out of total 5 morning where she was tested. The CGM report is attached.
Medicines taken :
Jalra M 50/500 + Glucobay 50 - 10 AM after breakfast
Glucobay 50 - 3 PM with lunch
Jalra M 50/1000 - 10 PM after dinner
On this day that I am talking, she took her medicine at 11 PM , and she had her dinner at 10.
I am worried if I should take it as one off case. What should be my next step. Any change in medicine / dosage/timing needed. Please review the report and advise.
Thanks
XXX
Brief Answer:
One episode can be overlooked.
Detailed Answer:
dear sir,
Most of the things seem to be normal. One episode of hypoglycemia does not warrant change of treatment.
The ongoing treatment does not warrant hypoglycemia. The medicines presently going on are safe medicines. In case of repeat episode, I would suggest to take off Jalra M before dinner dose.
Regards
One episode can be overlooked.
Detailed Answer:
dear sir,
Most of the things seem to be normal. One episode of hypoglycemia does not warrant change of treatment.
The ongoing treatment does not warrant hypoglycemia. The medicines presently going on are safe medicines. In case of repeat episode, I would suggest to take off Jalra M before dinner dose.
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
thanks Doctor. I have a follow-up question. how will we come to know about any repeat episode of hypoglycemia as it would be while sleeping. and what can be the reason for that kind of fall when the medicine she is taking does not induce hypoglycemia. also someone told me that type 2 diabetes hypoglycemia is not good but is not as dangerous as if it would be in type 1 or insulin dependent patients. so type 2 on oral medicine is safe from severe hypoglycemia. please advise.
Brief Answer:
frequent monitoring is required.
Detailed Answer:
Dear sir, very valid query. you need to monitor more frequently or put her on AGP for 14 days. These drugs are safe , still she had "hypo". This needs a RFT, LFT, TSH , FT4 assessment. hypo is equally bad in type 1 and type 2, but the severity is less in type 2 as patients are mostly on oral tablets, safer tablets as in your mother's case. whereas in type 1 , patients are on insulin, so hypo is severe.
regards!
frequent monitoring is required.
Detailed Answer:
Dear sir, very valid query. you need to monitor more frequently or put her on AGP for 14 days. These drugs are safe , still she had "hypo". This needs a RFT, LFT, TSH , FT4 assessment. hypo is equally bad in type 1 and type 2, but the severity is less in type 2 as patients are mostly on oral tablets, safer tablets as in your mother's case. whereas in type 1 , patients are on insulin, so hypo is severe.
regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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