Conversation: The conversation between human and AI assistant.
[|Human|] I have diabetes type 2. In the afternoon I have no physical strength and an exhausted. My sure levels are under good control with metformin and sliding scale on insulin. I have had several lows lately in the low 40s without changing anything. This is new and am not sure what to think about this.
[|AI|]  Hello there, I can understand your concern about this fatigue due to diabetes. Fatigue in diabetes can be due to various reasons. In your case like you have already observed low sugars, that seems to be the reason why you are having less physical strength and exhausted feeling. It seems that the insulin doses you are on are higher than what you require as Metformin by itself does not cause low sugars, usually. There could be another reason for sudden low sugars while being on the same dose and that could be deterioration in your kidney functions. So I would suggest get an FBS, After breakfast, Before lunch, After lunch, Before dinner and After dinner reading for a week (one reading each day with changing timings every day) and then get kidney functions test, HbA1c to find the cause of your sudden low sugars. If there is no definite cause then there is a simple need to change your insulin doses and try to avoid low sugars. Your fatigue will get better once sugars start to be in normal range. Depending on your age and other problems like heart diseases (if any) or kidney problem (if any) your sugar level targets can be decided. Do discuss these things with your planetologist who will make the necessary changes after seeing the reports. Till then try to eat frequent small meals so that you do not get low sugars. Hope this helps. Take care.