A sweet elderly aunt of ours has recently been experiencing frequent episodes of low sugar. She has been taking diamicron mr 2×1 and diaformin 1 g tablet 2×1 for about 3 years.
Despite her doctor’s insistence on the dose, she reduced the diamicron mr tablet to once a day. But hypoglycaemia, i.e. sugar drop, continued again. He explained that his doctor did not want to reduce his medication according to the three-month average sugar value. At first it was 7.5, then it decreased to 6.2. On the last night before the patient came to us, her blood sugar dropped to 30 and she was rushed to hospital by ambulance. Her daughter also told us that they were constantly taking b12 injections and iron pills and the iron did not improve.
We say that the beginning of every healing is to get the right anamnesis (information about the patient).
Of course, this was like that.
During the conversation, the aunt’s daughter explained that her mother’s stomach and large intestine were removed 20 years ago. It was understood that the sugar of this aunt, who obeyed her diet regularly, was a sugar condition in which the rapidly falling sugar increased reactively due to dumping syndrome secondary to postgastrectomy (ie an operation in which half of the stomach and the duodenum were removed together with the remaining parts of the stomach). In these cases, there is a sudden insulin discharge from the pancreas in response to the high satiety sugar passing rapidly to the jejunum part of the small intestine. However, since the group of drugs we call diamicron mr (sulfonylurea) are preparations that act by releasing insulin from the pancreas, they created an extra insulin load on this patient and made hypoglycaemia more frequent.
We switched to the acarbose group, which adjusts the sugar treatment to the increased postprandial glucose level, discontinued diamicrone and halved the dose of diaformin. We continued to give iron intravenously and b12 intramuscularly once a month, since iron and b12 could not be absorbed since there was no stomach and duodenum by mouth. Vitamin D was also added by controlling.
The result?
I never had hypoglycaemia again. His iron, b12 and blood counts were perfect. In terms of his health, the happiness and smile on his face was worth seeing when he stated that he had never felt so good in the last 20 years.
Now… What was the curve? What was the truth?
I am waiting for your comments on what you understand.
Those who make the correct comment will be announced separately.
