wondering about adjusting to the medication

I have been on 500mg extended release Glumentza
my doctor suggested twice a day but I am finding that only once a day is enough to lower my
blood level through my testing daily

today I took med as normal and after an intense workout I found my blood level to be
very low
made me feel lightheaded,extremely anxious and I am wondering if my body needs to adjust to the medication
i have,since taking the medication,changed all  my eating habits,no carbs
no sweets and working out
could it be that I am doing enough to bring my blood sugar down without the medication or is the medication bringing it down so drastically

possibly I need a lighter dose on the medication?

[Anita Ramsetty, MD]

Hi,
First,congratulations on taking the bull by the horns, so to speak, and being very proactive about changing your diet and lifestyle overall. That is fantastic!

In regard to the low blood sugars, the answer is "yes" to both of your suggestions. When we exercise it helps improve sensitivity to insulin, and for most people with diabetes this means that their blood sugars drop with/after vigorous exercise. This is also seen with sustained exercise as a habit, both as a result of weight loss but also the effect of exercise itself. You should let your doctor know about this development. You may need a lower dose of your medication on those days when you plan to exercise. The other option is to have a light snack prior to exercising to help keep your blood sugar from dropping, but this may temper weight loss, so I would prefer decreasing medication on those days instead. It's up to you and your doctor.
Take care and keep up the good work!