Concerned, Mortified, Shocked, Relieved, Confused

By rbergman Latest Reply 2011-07-04 12:30:37 -0500
Started 2009-03-02 16:11:35 -0600

This was my roller coaster of emotions this morning. It started when Laura checked her BGL and it was 74, not a drastic low but the lowest she has ever been, and considering her dosage was just upped on Friday I was concerned. I sent her meter to school with her and told her to take it to the school nurse and to check her BGL 2 hrs after breakfast. The school nurse called me at 10:05am and said Laura's BGL was 57 and reported Laura had eaten all of her breakfast and taken her 1000mg of Metformin with the meal, this mortified me. I in turn called Laura's Ped Endo with my concerns of these low numbers only to find out they were moving to a new office and was given a 2nd phone # to call. Upon calling this # I was told the doctor was between offices as they were moving…ok knew that but how do I get ahold of her then. I was told they would have the doctor call me back as soon as she came into that office (the 2nd one I called). About 10min later she did call, I told her about Laura's numbers, how she hadn't had such low numbers before and that Laura had been battling the worst diarrhea she has had since starting this medication, all weekend long and that I had to give her immodium because it was so bad. The shock came when the Ped Endo told me these were GOOD numbers, BETTER numbers then the 80s and 90s and 100s Laura had been having. HUH??? She further told me it wasn't anything to worry about that these "lows" as I call them are not lows at all for someone who does NOT take insulin. She also said that since Laura did not "crash" but took a gradual downward turn on her numbers it was a good thing, this is where I felt some relief.
I asked her then, if this is NOT a low # what is a low number for Laura, and she said as long as she stayed above 40 she was doing well, however, if the diarrhea persisted she may drop her back to 1500mg of Metformin as the 2000mg may just be too much for her tummy to handle, but that these numbers were awesome and show that the 2000mg are doing their job. Confused as ever I asked her what would be Laura's idea range only to be told it would be 40-90. HUH??? Before I could ask any more questions she informed me that she had left a patient to call me and that she would call me this evening when she is finished seeing the days patients. So, here I sat confused as ever.
I cannot understand how a low for me, who takes insulin, is NOT a low for someone who only takes oral medications though we are both considered Type 2. I've searched the internet and cannot find anything to support this doctors statement that 40-90 is normal range, and I can't find anything that tells me the difference between insulin patients and oral med patients.
At a little after 1pm the school nurse again called me to report that Laura's BGL was 142 2 hrs after lunch, I packed Laura's lunch myself today she did not eat the school food (breakfast either), and she didn't even finish the food I did make for her which was 42g of carbs total counting the milk she got at school to go with it. So now I'm even more confused, 74-57 fasting to after breakfast to 142 after lunch, which according to her Ped Endo would be a high if she wants her between 40-90. Every time I think I have things figured out, it all changes again.

This is what I would like to know, if any of you Type 2 diabetics are only on oral medication and have never needed insulin is this a normal range, 40-90? I mean I realize the doctor's know more than we are supposed to but it just seems too low to me, I hit 68 and I get all shaky and weird, at 31 I'm unconscious, does oral vs. insulin therapy make that much difference in the so called "normal range"?

I should also add, when I told the school nurse what the doctor told me she was as confused as I was, of course, she has only dealt with Type 1 diabetic kids on the pumps and not a diabetic like Laura.
Confused As Ever,


21 replies

AuntieM234 2011-07-03 23:41:44 -0500 Report

I can't even understand why a child would be given 2000mg of Metformin/day, especially 1000mg in a single dose! I take 2600mg/day, 850 4x/day. Of course, I don't know how small your child is, but still … My Dr prefers that I stay above 70. He doesn't want my body to adjust to being that low, because he says it would be too easy for my bs to slip too dangerously low before I notice it. He feels ideal for me is 80-120. Now I realize your child's Dr is a Ped Endo, but it just doesn't make sense to me. ;-) Mara

Mistletoe 2011-06-30 23:25:00 -0500 Report

I am a diabetic taking Metformin and was told that 70 to 100 is a normal range for a Blood sugar testing (although mine is usually a little above 100). I just read in my Diabetes Type 2 book by Gretchen Becker (copyright 2001) that under 70 is hypoglycemia (low blood sugar)." Symptoms of hypoglycemia are: shakiness, sweating, rapid heartbeat, anxiety and a feeling of nervousness or impending doom. Some people feel hungry or irritable or act confused. Hypoglycemia means your brain is not getting enough sugar and can impair your thinking". So, I too, think your doctor has a screw loose…

AuntieM234 2011-07-03 23:55:44 -0500 Report

The symptoms I experience for both low and high bs are the same, which are all those Mistletoe has listed above. It is difficult for me to tell the difference, so I have to test to make sure whether its low or high bs I'm dealing with. I know about the possibility of lactic acidosis from taking Metformin, but having labs done once each quarter eliminates the worry for me about that. I'm perplexed, though, about the child. ;-) Mara

Mistletoe 2011-06-30 23:54:00 -0500 Report

I just checked out Metformin warnings on and it says that Metformin can cause lactic acidosis which is rare but is a very serious condition. Diahrea is one of the symptoms. Please read the warnings on the insert with the Metformin.

Richard157 2009-03-07 14:00:26 -0600 Report

Robin I have been posting in diabetes support forums for almost three years and I have never heard 40-90 as being a safe range under any circumstances whatsoever!!! I would be shakey in the low 40s. No diabetic should be below 60 at any time if it can be helped. Many diabetics use 80-120 as a target range. That should give an average blood sugar of about 100 if you can stay in that range most of the time. It would also give an A1c below 6.0 which is excellent. Using 40-90 as a target range is dangerous and unecessary. I would not take my child to that doctor!!

I will admit that 80-120 is difficult for me so I am happy with 70-130. I am in that range about 85% of the time and my A1c is 5.6. Your doctor has a few loose screws and I am wondering what other bad advice he/she is giving.

rbergman 2009-03-07 15:35:34 -0600 Report

Hi Richard, I too still have issues with those numbers being considered safe. I did get a call from this doctors office on Friday, but not the doctor herself, it was her nurse, who apologized for not getting back with me sooner, yada yada yada and then asked me again what my concern was, so I told her about the "low" Laura had had the other day and that Dr. E. said that as long as Laura stayed above 40 she was ok, that 40-90 was normal. The nurse put me on hold and after a moment or so she got back on the line and said Dr. E. was not in the office but Dr. B. (This is a fully staffed Endo Facility not just Ped Endo practice) anyway, Dr. B. said his advice is no lower than 60 and not over 120 is a safe range for someone with Laura's conditions. The nurse told me she would have Dr. E. call me on Monday when she returns to the office. THIS sounded more reasonable to me, however I'm still left with the question of why Dr. E. thought the 40-90 was okay. I did some research and I cannot see where Laura's other conditions would warrant a 40-90 being a safe range for her, maybe I'm missing something but if I am I don't know what it is and cannot wait to hear her explanation of why she said as long as she was above 40 its good.

2catty 2009-03-08 19:20:55 -0500 Report

The only time they wanted my sugar reading a little lower than usual is when I was pregnant. They wanted it between 70-79 in the morning and as usual through the rest of the day. Now it is like all other diabetics. Of course I never had those sugars. They told me I was on more insulin than any pregnant woman they ever seen. If there was a award I would have won it. Unfortunetly. So there seems to be something odd about the numbers they want for your child. I wouldn't take it at face value just yet.

lipsie 2009-03-08 22:35:28 -0500 Report

I am waiting to hear what you find out. This is just overwhelming to me, I can only imagine for you two. Anyhow, My thoughts are with you two. Take care, and keep us updated. Sheila

rbergman 2009-03-02 22:38:04 -0600 Report

I appreciate everyone's input on this, I was sort of hoping for someone to tell me the range I was given is NORMAL, just to reassure me that the doctor isn't nuts lol, I did NOT get a call back from her this afternoon and we had family plans this evening and left at 5pm and returned at 9pm and there were no missed calls or messages so I guess she forgot to call me back with moving to a new location and such. Tonight after supper Laura's BGL was 103, so, we went from 74 to 57 to 142 to 103. I even re-researched all her different meds on and can't find where anything she is on would counteract or react with anything else she is taking. She still has the diarrhea and I know its the Metformin but she has only been at full dosage since Friday. The fact that the doctor is willing to back off 500mg per day for the diarrhea but NOT for the 57 BGL still baffles me. Am going to call her again tomorrow and get the answers I need and I'm going to call another doc for an opinion too, she isn't an Endo but does have diabetic patients.
Thanks again all, its just another joyous day on the roller coaster from hell around here.


rbergman 2009-03-02 23:46:05 -0600 Report

Something else I wonder, am I wrong to give her Immodium to stop or lessen the diarrhea? I mean is that defeating the purpose of the Metformin to some extent?

Mistletoe 2011-07-04 12:30:37 -0500 Report

You might want to try acidopholous…it puts the natural bacteria back in the gut. Yogurt with active bacteria in it does the same thing.

2009-03-03 06:03:12 -0600 Report

My mother takes Immodium all the time with her Addison's and is works well for her. I only take insulin, but the strong vitamins I'm on kill my stomach. Immodium doesn't help me at all. In fact it made it a little worse. I wish I had a better answer, but the Immodium will not hurt her, I just know it doesn't help me.

Muffet 2009-03-07 12:36:33 -0600 Report

Don't use Imodium. Try some natural pro-biotics and flora to get the intestinal system back on track. Imodium will just stop the symptoms temporarily; pro-biotics will keep the intestinal system on track with the right enzymes and flora. Go to a health food store and have them help you. Right now I use Papaya enzymes (chewable tablets) and Kombucha (a drink). This also helps with some Byetta symptoms of constipation due to the slowing of the food going from the stomach to the intestinal track. There are many brands of pro-biotics. Just be sure to go to a health food store and get a good one. I order mine from several different companies on-line, but don't know if I can name name brands on this board. Good luck.

sparkysmom 2009-03-02 18:49:35 -0600 Report

Just me but when I get to 60-65 I'm starting to shake and sweat I'm type 2 and take 1000 metaformin 2 X day.

2009-03-02 18:38:50 -0600 Report

Wow Robin, it sounds like that person had no idea what he/she was talking about. I am type 1 but I have hit 20 and 40 several times and fell down because I was so weak. That's how I finally wound up in ICU for 2 weeks when I found out I was diabetic! I would keep pushing and make that person clarify that answer or call another doctor or 10 other doctors! I can understand why you are shocked and I would be mad as heck! She has been through enough and they need to stop kicking you around! As always, you are in my thoughts and prayers. Please let me know when you get the correct answer! Be it Type 1 or Type 2, that just cannot be correct! Hugs friend, Angie

BeckyJ 2009-03-02 18:25:27 -0600 Report

Add me to the confused category. I've never heard of that low a number being called good. I once had a doctor tell me that I should never go under 60. I've had several ranges for "normal" though. One told me 60-140 another said 90-130. Both told me that it was an individual goal though so maybe this range isn't so bad. Seems rather low to me, especially for someone so young. Good luck on finding the right range for your little one.

lipsie 2009-03-02 17:53:03 -0600 Report

I would be frustrated as well, it does sound quite low to me as well, I do take insilin sliding scale though, but when my sugar drops I also get shaky and have fallen out of it even. I would check into a second opinion on this one. I am sorry you two are going thru this. :(

2catty 2009-03-02 18:10:18 -0600 Report

I am not a Dr. but that does sound strange. Someone that is not diabetic is not that low. I am confused about my little one too. I seen his nurse the other day and she said 184 fasting was normal at his age because he eats differently than adults. And he eats several times a day in little portions. I am confused because I am getting different things told to me from different Professionals that deals with children. I am puzzled about what your child's endo said, I think I would be getting a second opinion on that. Does not set right, and I am sure it does not with you either. Good luck!

Randy42 2009-03-02 16:58:19 -0600 Report

I been a type 2 diabetic since 2004 and I'm still a little confused about the normal range. My doc told me that it's different with everyone. The insulin and the oral meds will make the difference in range. I was told that my normal is 80 to 155. I don't know what is truly a normal range. I went through the diabetics classes that my doctor put me in. The normal range that I got from the class was 90 to 120. So take a pick I guess. I know your frustration.

firefightermom 2009-03-02 16:34:56 -0600 Report

hey, Shina is type one but like you said at 68 she is shakey and feels bad I have not heard that range before If 70 to 120 is the nondiabetic range seems to me 40 would be low for anyone!! has she called you back yet? shina feels real real bad at 40 was Laura feeling bad? that just seems sort of dangerous to me I would be freaking too. The range we try to keep is 70 to 150! so a 142 would be good for her. Hope you find out something soon. take care if u want to talk I'm here just a click away!