Download FREE Practo app
Get ₹200 HealthCash
Low blood sugar on regular basis
My mother has type 2 diabetes and recently started having repeated low sugar episodes around noon. Earlier, her blood sugar was often around 230 mg/dL in the morning, then dropped to 77 mg/dL or lower around 12:00 pm, almost daily. She wakes at 5:00 am, eats breakfast at 7:30 am (egg + chapati), and again at 10:00 am (dosa + dates), but was still getting low sugar before lunch. Her medicines are metformin 500 mg and glimepiride 1 mg, along with atenolol, amlodipine, rosuvas-F10, telma, and veltam. She had also completed a course of Faronem for UTI. Today her sugar was 140 fasting and 209 two hours after lunch, and she did not have a low episode today. She also complains that when her sugar gets low, her urine seems to stop / does not clear properly. Please review whether her diabetes medicines, especially glimepiride, could be causing the noon lows and whether the urinary symptom needs evaluation.
Not finding what you need? Ask Practo AI
FREE
Chat with Practo AI on Whatsapp
Didn't find the answer you are looking for?
Talk to experienced doctor online and get your health questions answered in just 5 minutes.
Not finding what you need? Ask Practo AI
FREE
Chat with Practo AI on Whatsapp
Not finding what you need? Ask Practo AI
FREE
Chat with Practo AI on Whatsapp
Not finding what you need? Ask Practo AI
FREE
Chat with Practo AI on Whatsapp
The repeated low sugar episodes around noon are most likely related to glimepiride, especially at 72 years of age. Metformin alone usually does not cause hypoglycemia. The fact that her sugars are sometimes high in the morning but drop significantly before lunch can occur with sulfonylurea treatment.
Her diabetes treatment may therefore need adjustment to avoid further hypoglycemic episodes. The urinary complaint should also be evaluated separately, as difficulty passing urine or reduced urine flow can be due to UTI, urinary retention, dehydration or bladder dysfunction.
Next Steps
If you are taking glimepiride 1 mg, please discuss reducing or stopping it with your treating doctor rather than continuing the same dose despite recurrent low sugars.
Check fasting, pre-lunch and 2-hour post-meal glucose for a few days. HbA1c, serum creatinine/eGFR and electrolytes should also be reviewed.
For the urinary symptoms, a urine routine/culture and ultrasound with post-void residual urine measurement would be useful to check for infection or incomplete bladder emptying.
Health Tips
If the sugar is below 70 mg/dL, take 15 g of fast-acting carbohydrate such as glucose or sugar water and recheck after 15 minutes.
At her age, preventing recurrent hypoglycemia is more important than achieving very tight sugar control. If she develops confusion, excessive drowsiness, seizures or is unable to take food orally during a low-sugar episode, seek emergency medical care immediately.
Answered
Let others know if this answer was helpful
Not finding what you need? Ask Practo AI
FREE
Chat with Practo AI on Whatsapp
Not finding what you need? Ask Practo AI
FREE
Chat with Practo AI on Whatsapp
Not finding what you need? Ask Practo AI
FREE
Chat with Practo AI on Whatsapp
Articles you may like
Tell us what's troubling you
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.