Hypo type episode on Dapaglaflozin/Forxiga, and Spironolactone, while waiting for a pacemaker upgrade. Advice anyone?

[Coco51]

I felt sweaty and shaky after skipping breakfast this morning, and looking at the leaflet for Dapaglaflozin, I see one of the side effects is to cause low blood sugar levels. It's a diabetes drug which has been found to help with Heart Failure patients. It makes you pee away blood sugar. So I ate some prunes and fruit and honey which helped immediately, thank goodness.But has anyone got any tips to share on this?

The context for me is this. At a routine echo scan a month ago I was diagnosed with Heart Failure. I have a dual lead pacemaker for bradycardia (36 bpm when discovered). I have had two Ablations for AF, 6 and 7 yrs ago, and after some problems the AF has settled. Even so I have remained on Flecainide and Bisoprolol. I also take BP meds Lisinopril and Indapamide, plus Apixaban and a Statin.

I was definitely feeling breathless and having trouble with stairs and hills. At the Rapid Referral Heart Failure Clinic (a month after the scan, but let's not go there...!) the lovely Consultant said my condition was reversible and not strictly speaking HF (yippee!). It's Pacemaker Dissynchrony.

The way I understand it is that my Left Ventricle, which has no pacing lead, is not beating in time with the Right Ventricle which has got a pacing lead. Another CRT pacemaker with an extra lead should solve it. Meantime stroke and MI are an increased risk.

To tide me over, the HF specialist has prescribed Spironolactone potassium sparing diuretic (no more Indapamide) and Dapaglaflozin. This is a diabetes drug that tests have shown helps HF patients. He says I can come off it when the new pacemaker is fitted.

Now the waiting begins. I had already emailed my AF specialist and he had put me on the priority list for a pacemaker upgrade even before I got to the HF clinic. He also told me to stop Flecainide and continue Bisprolol. The HF man thought dropping the Flecainide was "very cautious", but deferred to the EP. So a little confusion there!

Apologies forTMI. But if anyone is still reading I would love some advice about these meds. I'm meantime fretting and hoping the AF won't return before the new pacemaker is fitted. The headlines about growing waiting lists don't help.

[JessicaRed]

Hi Coco

Im awaiting valve replacement but Im type 2 diabetic and take a similar med empagliflozin that has been very good at helping my blood sugar control but yes you need to eat regularly

Best of luck

[Coco51 in reply to JessicaRed]

Thank you. Must not eat a late breakfast!

[Knockmore]

When I was diagnosed as pre-diabetic I started to take a daily chromium supplement. This regulates blood sugar and I am off the list for the GP check now after two years ( and no more Mr Kiplings sugar fancies! ). It took me at least three months to get used to bisoprolol and the breathlessness but it has settled down now and I have been on it for ten years. I am on Amiodarone and came off Indapamide due to a clash. So far I have not needed a replacement. However the biggest improvement to my AF has come after my sleep apnia diagnosis and the use of the CPAP machine. I think years of bad sleep and me ignoring it caused many problems.

[Coco51 in reply to Knockmore]

Thank you. I had not heard of chromium supplementation before. Being pre diabetic I should give it a go. But the diabetes med I am now on is to benefit the heart failure symptoms. It's one of those drugs that is licensed for two different purposes. When i get the new pacemaker they might take me off it.What is causing your breathlessness? Is it the Bisoprolol? Or do you have AF?With me it is the pacemaker dissynchrony creating heart failure symptoms.

I'm glad you found help with the CPAP machine. How did you discover you had sleep panes?

[Knockmore]

apologies for the late reply,

The AF was the cause of my breathlessness but before this was discovered I thought it was the fault of the bisoprolol. I have AF and take Amiodorone and all is good .

The sleep diagnosis was via my cardio consultant . He strongly believes sleep , or lack of it ,causes many issues he deals with.