by Okilkhan
(Bangalore)
QUESTION: I have had diabetes for two years and take GlyNASE-MF and Cobadex CZS, but I do not feel that I am benefiting. I feel unwell, insecure, and very angry. What should I do?
Feeling angry, anxious, or generally unwell should not be dismissed as “just diabetes.” Check glucose during an episode because low glucose can cause irritability, anxiety, sweating, dizziness, and confusion. GlyNASE-MF commonly contains glipizide plus metformin, and glipizide can cause hypoglycemia. High glucose, medication effects, poor sleep, diabetes distress, anxiety, or depression may also contribute. Arrange a prompt diabetes and mental-health review rather than adding vitamins or changing tablets yourself.
Answer by Dr. Albana Greca, MD, MMedSc
Hi Okilkhan,
Whether treatment is working must be judged from HbA1c, glucose patterns, side effects, organ health, and daily functioning—not from vitamins or symptoms alone.
Brand names can vary, so take the packages to your doctor or pharmacist. GlyNASE-MF sold in India commonly contains glipizide and metformin. Glipizide stimulates insulin release and can cause low glucose; metformin reduces liver glucose production and improves insulin sensitivity.
Cobadex CZS is a vitamin and mineral supplement intended for documented or suspected nutritional deficiency. It is not a primary glucose-lowering medicine and is not a proven treatment for anger, anxiety, or diabetes distress.
Yes. Hypoglycemia can cause irritability, nervousness, sweating, shaking, hunger, dizziness, headache, confusion, or unusual behavior. It is more likely with glipizide if meals are delayed or missed, activity increases, alcohol is used, kidney function declines, or the dose is too strong.
Check glucose when the anger or unwell feeling begins and record the result, meal, medicine, and symptoms in a blood sugar log. Read the causes of low blood glucose and how to decide whether blood sugar is too high or too low.
If glucose is below 70 mg/dL and you are awake and can swallow, take about 15 grams of fast-acting carbohydrate, recheck after 15 minutes, and repeat if it remains below 70. Examples include glucose tablets or a small amount of regular juice.
Repeated lows mean the medicine plan needs prompt review. Do not simply eat extra food every day to compensate for an excessive glipizide dose.
High glucose may cause thirst, frequent urination, blurred vision, fatigue, dehydration, and poor concentration. Anger alone cannot identify the glucose level.
Ask for your actual HbA1c result, fasting and after-meal patterns, and individualized targets. Occasional readings are not enough to decide whether treatment works.
Diabetes distress is the emotional burden of medicines, monitoring, costs, and fear of complications. It can occur with depression or anxiety. Persistent anger, insecurity, hopelessness, loss of enjoyment, or poor sleep deserves direct assessment.
Ask the clinician to screen for diabetes distress, depression, anxiety, sleep problems, alcohol or substance use, and thoughts of self-harm. A counselor or psychologist familiar with diabetes may help. Read our overview of diabetes and changes in mood or thinking.
Long-term metformin can contribute to vitamin B12 deficiency in some people, but a multivitamin should not replace testing when deficiency is suspected.
Possibly, but only after review. If HbA1c remains above target, treatment should be adjusted according to hypoglycemia, weight, cost, and heart, kidney, or liver conditions.
Because glipizide can cause low glucose and weight gain, the clinician may decide to adjust it or select another class. Do not stop GlyNASE-MF suddenly or double it. Review the benefits and side effects of diabetes medicines and the medicine safety guide.
Use a sustainable meal pattern rather than skipping meals or severely restricting carbohydrate while taking glipizide. The plate-method meal plan can help. Regular activity can improve health and mood, but the plan should account for hypoglycemia risk; see exercise and diabetes safety.
Seek emergency help for unconsciousness, seizure, inability to swallow, severe confusion, violent or unsafe behavior, or thoughts of harming yourself or another person. Obtain prompt medical review for repeated glucose below 70 mg/dL, any reading below 54 mg/dL, persistent glucose around 300 mg/dL or higher, severe weakness, vomiting, difficult breathing, dehydration, or rapidly worsening mood.
The most immediate practical step is to check glucose during the angry or insecure feeling. GlyNASE-MF may contain a sulfonylurea that can cause hypoglycemia, while Cobadex CZS is a deficiency supplement rather than diabetes treatment. At the same time, persistent emotional symptoms deserve proper mental-health screening even when glucose is normal.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical or mental-health care. Do not stop, double, or change GlyNASE-MF, vitamins, other medicines, food intake, alcohol use, or exercise without speaking with your healthcare provider.
Last reviewed: July 2026.
Click here to post comments or follow up
Ask the Doctor now? Simply click here to return to Type 1 diabetes information.