hypoglycemia?

[shuman13]

I have been diagnosed with type II diabetes, and my physician at the time immediately put me on actoplusmet (no discussion of diet and excersise control first). I told him that I previously had gestational diabetes that once on diet alone caused my blood sugar levels to drop so low that the meter read in the 40's and sometimes just LOW. The nutritionsts then changed my diet so that it was double portion sizes and everything read perfectly. Due to this it was decided that I would take the medication only once per day instead of twice. Actoplusmet along with diet has caused daily reading to be perfectly between 80 and 120 and A1C levels have averaged between 5.5 and 5.0. This is all without any exercise program (I do stand and walk all day, but that's all). All of this is to say that I want to take as few medications as possible. I was also prescribed Lexapro, Lamictal, and Welbutrin for dystymia and anxiety. I recently taperd off the Lexapro. I now have all the symptoms of hypoglycemia: tingling in lips (its constant, no break) and dizziness at just the slightest turn of the head, heart rate that is averaging 100 beats per minute (this has been constant not in little bursts for about three days now), and tightness in the chest/lung area, slight muscular type pain during deep breathing (also for about 5 days now). I stopped the Lexapro (I still take all other meds) about 2 weeks ago with only the tingly in the lips as a side effect. My sugar readings seem normal. The last one I took was after have a little mocha (I justified because I had to drive a long distance and have issues with falling asleep while driving). After about 1/3 of the mocha my sugar level was only 114. Should I try to catch a low blood sugar reading  (how often and how long after meals) or assume it's side effects of coming off the Lexapro? Do I seek immediate medical help (have no money for co-pay until Aug. 31st...would have to go to ER)?

[Zoelula]

If it is hypoglycemia, which I tend to doubt, 2 hours after meals is the least likely time. More likely is first thing in the morning or right before you are due to eat a meal.But if you are taking your blood sugar when you feel the worst and it is not low, then obviously something else is going on. I'm sorry I'm not a doctor and couldn't begin to guess what it all indicates, and not even sure which forum would be useful to ask.

My main concern is that when you are talking about accelerated heart rate, chest pain and difficulty breathing that it could be cardiac related which really should be ruled out ASAP.

[shuman13]

After re-reading my post, I realize that it was very confusing. I have had type II diabetes for 5 years. The only medication I stopped taking was Lexapro. I took 20 mg, and under physcian directions cut into 1/2 for a month. I stopped completely approximately 2 weeks ago. I had no serious symptoms, mostly just a slightly higher level of irritability. I started feeling sick on Saturday (fatigue and general malaise). By Sunday I felt flu-ish. Monday I felt better, but still fatigue and generaly blah but started feeling dizzy. By Tuesday morning my lips were tingling and feeling kinda numb - really it's more like my whole face, but most noticeable in my lips. The dizzy sensations were more pronounced, and I had a pain in my side that I was afraid might be the beginning of a kidney stone pain. Then I noticed that it hurt worse when I took a deep breath and so thought it might just be a pulled muscle (I do have 3 kids that like to be held). The pain kinda spread around my whole midsection: abdomin and ribs. When I got home, I felt very flu-ish again and had a low grade fever around 100. From that point forward I have not had a fever, but have had the tightness in the chest in the sense that when I take a deep breath I can feel it like after a hard run, and I've had the accelerated heart rate. I may have had the accelerated heart rate previously, but didn't think about checking it. The thing is I know stress just adds to it. It is just really frustrating because I didn't know what to do about it except try to rest and relax. The reason I'm asking about how to check for the hypogycemia is that I didn't know if it is the same as checking levels for regular hyperglycemia, or if I might need to test under a different time frame (other than 2 hours after a meal). Again, these symptoms have been constant, they have not stopped or paused despite sitting, resting, and irregardless of what I ate. I just don't want to keep feeling this way, but if it's symptoms of withdrawal, I would rather deal with it than take the Lexapro again.

[Zoelula]

Your situation is complicated by the other meds you are taking, or tapering off of, and I don't have any recommendations for that. In terms of lows, however. If you have symptoms of lows, test your blood sugar. If you are under 60, you need to treat it. (Some people treat under 70). I would suggest using glucose tablets so you don't overtreat the low with good tasting sweets. I take 2 of them, you may need the same or more, we're all different. 114 is not a low reading, and food and drinks take between one and 2 hours to raise your blood sugar.

Re-reading your post it sounds like you have these symptoms all the time and your blood sugar is normal. The only thing diabetes-related that accounts for that is if you have been very high for awhile then you feel low at normal blood sugars until you get used to them. So my guess is something else is causing these symptoms. If you are experiencing tightness in the chest I would be concerned about this and recommend an emergency clinic or something just to make sure it isn't heart related.

Low blood sugars do not necessitate immediate medical help if you are conscious and able to treat them yourself with glucose tablets or other fast acting carbs.