Dapagliflozin - Blood sugar problem.

[HeartyJames]

Hi folks. Firstly thanks for listening and hopefully replying.

Had a difficult week. Been on Dapagliflozin 10mg (Forxiga) since April 2021 without issues. I am not diabetic and it is used as a drug for heart failure. It does take glucose out of blood into urine. Cardiology always tell me how great it is.

This week for past 5 days I have been waking up very yucky, nauseous, fainty feeling , dizzy, sweating and not being able to do my work. I have had low BP and heart rate , so I thought it was that. Then I thought I would check my blood sugar as I have a kit and a long way from expiry dates.

Blood sugar read 2.3 mmol hypo . My wife had to remind me to eat biscuit and some bread as was not thinking straight. I did and within a hour went to 8.8mmol and felt fine. Short time after went to 2.6. I did not measure again that day but felt bad.

Next day same again but started at 2.1mmol. I had breakfast, went to 2.5. No matter what I ate it kept below 3 and with symptoms. Spoke to a nurse but she was a bit hopeless and just told me to eat more carbs. Did not work.

Same next day and 1.9. I phoned GP. He has told me to reduce to 5mg Dapagliflozin and that was it.

I am worried as I think that low blood sugar is dangerous. I am also concerned I have to reduce a drug that is supposed to be important for my heart failure.

Just been to 1.9 again this evening and very drowsy until I had some carbs

Any info appreciated.... I am not diabetic. I am pre with hba1c recently measured at 46

Take care everyone

[Sljp0000]

Hi HeatyJames

I really feel for you. Having low blood glucose levels is definitely whats giving you your awful symptons. I'm on Empaflaglozin which does the same as your drug although I take it for type 2 diabetes not for my heart problem. (Although its neant to protect avainst heart disease.....it hasnt me but thats another story!) I am surprised it effects you so dramatically but everyone is different.

How are you getting on since you reduced your dosage? I would make sure you eat a healthy breakfast before you take it each morning. Porridge and fruit would be ideal to help with heart and blood sugars. Then measure blood before lunch and dinner to see how many carbs you need to pack away. Its ridiculous really, a pre diabetic you're meant to be cutting down on carbs not I creasing them to keep up with your drug. Maybe this drug simply doesn't suit you and they need to look at it her options?

However, I can understand why you are worried about your heart health reducing the drug. Can you ask to speak to the person who prescribed it again? It's a sad fact but I'm afraid that GPs/practice nurses don't understand the work the hospital are doing and vice versa. I would ring the hospital and ask to speak to a cardiologist.

Let me know how you get on. Good luck, Susie.

[HeartyJames in reply to Sljp0000]

Thanks for replying Sljp0000. Not convinced something isn't going on as most agree the drug should not have such a drastic effect. I am on lower dose starting today. Woke up this morning feeling funny again so will have my oats and fruit, but I always have that for breakfast, for years. This is my problem, rest of day trying to lose weight so cutting out my carbs, other than breakfast. Clearly not working . I only have to eat a bit of bread and I put on weight. So difficult.

Going walking next week so I getting rather concerned that I won't be able to do it. It feels terrible when blood sugar goes down and disables you. I did ask consultant and secretary left note on desk. He is away two weeks but have an appt on 31st, so will iron it out. Been on this drug since April 2021. No side effects. The GP and nurses seem very ignorant. I have to teach them. They say Why are you taking a diabetic drug? They also wanted to stop my losarten and carvedilol because I had low bp and heart rate. not understanding they are for the heart. So its very hard to know what to do. I plummmeted to 1.9mmol last night, felt like I would go unconscious. Had no choice had to have a plate of low fat chips after some sugar. so counterproductive but I recovered to 6.1 mmol hour later. I then felt like I could see again and everything was clear. I did not realise how bad I was feeling until it suddenly went.

Will measure now as I type after fasting all night. Oh surpising it is 6.3 so that is great. Chips still working.. So will keep checking. Should be ok as having a small amount of oats and see what it is like before lunch, unless I start feeling funny again. Looks like I will need to keep a close eye on this. No effect from drug yet as only start new dose this morning... Its only 5mg lower dose. take care Sljp0000

[Hidden]

Dear HeartyJames

I am also on this amazing drug and had very similar side effects as you { and many others } after talking with my Cardiologist and nurse they agreed to move taking it in my evening medication slot. { 10mg }

That and having porridge in the morning { small bowel quite plain } seems to have done the trick.

But you can only try this after having it passed by your DR/Cardiologist/Nurse etc

Hope it helps

[HeartyJames in reply to Hidden]

Well as you know, I already love my porridge in the morning

[Hidden in reply to HeartyJames]

Yes I do!, it seems that its more important with Dapagliflozin to take it religiously at the same time so I was told, but then when you read the dreaded “ all the things that can happen to you” leaflet, it says that there’s a 6 hour window !

[HeartyJames in reply to Hidden]

Thanks for replying.. Not sure if I should do what GP says and go down to 5mg or wait until 31st august when I can then speak to cardiology. They left a note on his desk. Suppose I will do what GP says, better than being hypo. Take care Blue1958

[HeartyJames in reply to Hidden]

Thanks Blue1958.... I usually take Dapagliflozin before any food, first thing along with all my other 10 meds. Been having the hypo before taking it though, so thats rather strange. take care

[andrea_waffle7]

Do you not have a heart failure nurse rather than any general nurse, when I was prescribed this drug I was given a heart failure nurse, luckily I haven’t needed to contact her. Also my cardiologist has said to have a bit of salt when I feel faint rather than carbs, so he recommended electrolyte tablets, (salt tablets) as I also have very low BP but if I increased my carbs I too would start to put weight on which I don’t want to put with heart failure. Let me know how you get on and good luck for your next appointment. Exercise also helps increase BP but then it tends to drop again. Andrea

[HeartyJames in reply to andrea_waffle7]

Thanks for replying .I had a cardiac rehab nurse but suddenly vanished and referred me back to hospital nurse. Contacted me twice but also vanished. I write emails but no response until yesterday when a secretary said they put message on the consultant desk, but away on holiday. Interesting about electolytes. I did have a sachet thing when 1.9 mmol that I used to use if drained when cycling which is electrolyte loaded. I will mention that to cardiologist on 31st aug. I will be doing plenty of walking exercise next week as away in Cumbria so was very concerned nothing happens then. My bp usually 80/60 range, so low too. Often lower but never goes above 90 when resting. Although at gp nurse I reached 110 but probably due to being there and after walking. So they took a unusual reading for their records. Useless. Take care andrea_waffle7

[Callista in reply to HeartyJames]

I was interested about disappearing cardiac nurses who no longer wish to help you. I had the same experience although others on this forum seem to be able to get continued help. Here in West Cumbria it seems they are all over you for a short period and then happily abandon you. I feel I have no one to go to for advice except transient GPs who are not really bothered.

[HeartyJames in reply to Callista]

Yes just the same.....

[Geoff51 Heart Star]

I have been on Dapagliflozin 10mg since last Christmas on recommendation of my Cardiologist as well as Amolopidine, Bisoprolol, Atorvastatin, Ramipril, Aspirin and Sukkarto SR(Metformin) plus Omeprazole to counteract the affect on my stomach of the NSAIDs. To be perfectly honest I am feeling better now than I have done for the 12 years since my Heart attack. I have had a bit of thrush which is easily treated with 1 Canestan tablet but apart from that I have had no side affects at all. I seem to pee a lot more, but I always peed a lot anyway, I have very borderline diabetes and only take 1 Metformin daily as a maintainance dose. I have lost the angina I often got after exercise and am very happy with the affect on my health.

[HeartyJames in reply to Geoff51]

its a great drug. I think my issue will be temporary. Been ok since reduced, but probably go back to 10mg once I have the crt pacemaker when drugs will be reviewed. Just got to keep an eye on it. Maybe some other non diabetic thing going on in my body. Time will tellThanks for your reply. Your drugs are all similar to mine..

[Prestwick]

I read your post with great interest. I have DCM and have been well on Bisoprolol, Entresto and Eplerenone. 3 weeks ago I was started on 10mg Dapagliflozin and I have felt increasingly ill. Many of the symptoms you describe. I put many of these down to low BP but I did wonder about hypoglycaemia too.I have stopped the Dapagliflozin and am waiting to speak to my Heart Nurse. I will be interested to hear how you get on.

Best wishes with the walking

[HeartyJames in reply to Prestwick]

I reduced to 5mg and a bit of an improvement...