The Glade 4.0

Correct Me If I'm Wrong?
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Author:  Jasmy [ Wed Sep 27, 2017 4:04 pm ]
Post subject:  Correct Me If I'm Wrong?

Carbohydrates and alcohol turn into sugars in the bloodstream after ingestion? I ask because even after eating carbs and drinking (small amounts of) alcohol my afternoon blood glucose readings are sometimes (as in several times over two weeks) very low. My doctor and I are trying to figure out why this is so.



Author:  Screeling [ Wed Sep 27, 2017 6:37 pm ]
Post subject: 

Ethanol isn't a carb and isn't metabolized via glycolytic pathways. It's not uncommon to have high triglycerides though with boozing. Depending on the drink though, it may have carbs in addition.

Might want to have your kidney function checked to make sure you're not pissing your sugar out. Has he done a urine analysis on you?

Are you checking your pre- or post-prandials, and what's the timing of those checks?

Author:  Jasmy [ Wed Sep 27, 2017 7:24 pm ]
Post subject:  Re: Correct Me If I'm Wrong?

I do a blood test every morning when I get up and one (or more) during the day if I am feeling low (believe me when I say I can feel it coming on).

I spoke to my doctor this morning and we agreed for me to stop taking glipizide, just my insulin shots (20 units after breakfast, 20 units before bed).

I do owe my doctor an A1C blood test but I haven't had urinalysis for a few months.

Thank you for your response Screeling

Author:  Screeling [ Wed Sep 27, 2017 8:09 pm ]
Post subject: 

Seems kind of odd you would be on anything else for your sugars if you are on insulin. Did he indicate why he had you on insulin and a sulfonylurea? That's a recipe for hypoglycemia. Usually you adjust you units of insulin (basals and post-prandials) to control your sugars. The glipizide would stimulate further insulin release and probably make it harder to dial in your range control with insulin.

The guidelines say insulin is basically your last resort if other meds fail - usually docs have you go off all other meds and just use insulin. Before getting to that point, you're usually started on Metformin, then add another med if you can't gain control, and usually a 3rd med if it seems likely to be successful and avoid resorting to insulin.

Here's the link for current treatment guidelines from the American College of Endocrinology. I've seen all Family Med residents (so not just Endocrinologists) have the notecards of this algorithm in their pocket or on their desk. I promise, it's not dense at all. Page 6 has the meat of what I mentioned above:

If you had a UA a few months ago, then your kidney function is probably not the issue. Your doc is probably on the right track with stopping the dual-therapy.

Author:  Jasmy [ Wed Sep 27, 2017 10:30 pm ]
Post subject:  Re: Correct Me If I'm Wrong?

My original doctor is the one who put me on glipizide when I was first diagnosed. After years of being under control, I started having problems with glucose levels and my then doctor increased the glipizide and then added insulin. He retired over a year ago and my new doctor and I have been able to work together a lot better than my original doctor, who only lectured instead of listening. This morning my doctor took me off of glipizide and we will talk again in two weeks to see how my glucose levels are.

Author:  Screeling [ Thu Sep 28, 2017 2:13 pm ]
Post subject: 

Good deal. I'm sure you will be successful. Good luck and good health!

Author:  darksiege [ Fri Sep 29, 2017 4:45 pm ]
Post subject: 

When I went to the dietician a few months ago... I was under the impression that drinking alchohol would raise my blood sugar. She corrected me. I was told to make sure I am eating when I drink. Beer will count as a carb serving and an alcohol... but stuff like whiskey is not treated as a carb and it just an alcohol, so unless I eat with the drinking... I can hurt myself.

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