False Hypos?

[ME_Valentijn]

I knew to expect I'd feel hypo when my blood sugar first got down to normal levels, as I wouldn't be used to normalcy and it would feel too low. But I've been down in the mid-4's several times now in the middle of the day, and I get weak and shaky every time. Half a glass of milk (6 carbs) seems to take care of it, though I'd rather just be able to stay around 4.5 and leave it alone

Am I not adapting to the normal glucose levels because I'm high all night? I'm usually between 8-11 at bedtime and during the night, regardless of what I eat, and 10-11 when I wake up.

 

[DaftThoughts]

I used to have that too. I was always around 10, so anytime I dipped below 5 my body got the shakes, sweats and weak knees. With time my range dropped, I rarely hit 10 or go over it anymore, so I can go to 4.5 and feel fine now. When I drop below 4 I have symptoms though.

If you can get leveled out and get into a better range where 9+ is the exception instead of the norm, your body won't send warning signals for dropping to the mid-4's. But for now I recommend treating the symptoms when they pop up. Once your averages settle you'll be fine, too!

 

[Bluetit1802]

I knew to expect I'd feel hypo when my blood sugar first got down to normal levels, as I wouldn't be used to normalcy and it would feel too low. But I've been down in the mid-4's several times now in the middle of the day, and I get weak and shaky every time. Half a glass of milk (6 carbs) seems to take care of it, though I'd rather just be able to stay around 4.5 and leave it alone

Am I not adapting to the normal glucose levels because I'm high all night? I'm usually between 8-11 at bedtime and during the night, regardless of what I eat, and 10-11 when I wake up.

Are you still on Gliclazide? If you are experiencing "lows" in the middle of the day but highs at bedtime and overnight no matter what you eat, I wonder if changing when you take it would help? I am diet only, and know very little about Gliclazide other than how it works, but I thought it may be worth looking in to.

 

[Lamont D]

I knew to expect I'd feel hypo when my blood sugar first got down to normal levels, as I wouldn't be used to normalcy and it would feel too low. But I've been down in the mid-4's several times now in the middle of the day, and I get weak and shaky every time. Half a glass of milk (6 carbs) seems to take care of it, though I'd rather just be able to stay around 4.5 and leave it alone

Am I not adapting to the normal glucose levels because I'm high all night? I'm usually between 8-11 at bedtime and during the night, regardless of what I eat, and 10-11 when I wake up.

Sometimes it can be awful just trying to stay around normal levels when first adopting a low carb diet, your body is not used to it! The symptoms are a warning that it doesn't want to be there, despite the efforts of your will power, of course treat the symptoms but keep it relatively low, otherwise you will be feeding it just what your body wants! Make sure if you're using milk to treat that it is full fat, as this slows the ensuing spike even if it's just a nudge up!

It will adjust, just don't let your body win!

 

[ME_Valentijn]

Are you still on Gliclazide? If you are experiencing "lows" in the middle of the day but highs at bedtime and overnight no matter what you eat, I wonder if changing when you take it would help? I am diet only, and know very little about Gliclazide other than how it works, but I thought it may be worth looking in to.

My GP had me try that for a week (I'd actually already started doing it a few days earlier), and it made no difference. I've not seen the Gliclazide have any impact on my numbers yet at all, despite raising the dose every week.

 

[Bluetit1802]

My GP had me try that for a week (I'd actually already started doing it a few days earlier), and it made no difference. I've not seen the Gliclazide have any impact on my numbers yet at all, despite raising the dose every week.

Gliclazide works by forcing the pancreas to produce extra insulin. However, if you are very insulin resistant, its effect will be minimal at best. No point in producing extra insulin if that insulin is being rejected by your cells! If that is the case, it is the IR that you have to combat, and from what I read, the best way to do this is a very low calorie diet along the lines of the Newcastle Diet, plus exercise. (800 calories a day for 8 weeks) But I believe you are unable to exercise, so it is going to be down to diet and weight loss, and getting rid of any visceral fat. What does your doctor think about that?

 

[ME_Valentijn]

But I believe you are unable to exercise, so it is going to be down to diet and weight loss, and getting rid of any visceral fat. What does your doctor think about that?

Weight loss has been slow but consistent. About 4 pounds in the past month, since I started counting calories. Again, no real change in blood sugars. The only thing that helps for that is keeping carbs at 20-25 per meal. But I also don't want to spend months at 8-11 every night, while waiting to lose enough wait in the hope that it might help.

Very low calorie is also probably not going to work for me, due to my chronic illness - and my GP would be completely opposed to trying such a non-standard diet. They only grudgingly accepted I was staying under 100 carbs per day because I was focused on getting plenty of fiber from lentils and avocados Haven't told them yet that I'm down to 65 carbs per day.

 

[Bluetit1802]

Weight loss has been slow but consistent. About 4 pounds in the past month, since I started counting calories. Again, no real change in blood sugars. The only thing that helps for that is keeping carbs at 20-25 per meal. But I also don't want to spend months at 8-11 every night, while waiting to lose enough wait in the hope that it might help.

Very low calorie is also probably not going to work for me, due to my chronic illness - and my GP would be completely opposed to trying such a non-standard diet. They only grudgingly accepted I was staying under 100 carbs per day because I was focused on getting plenty of fiber from lentils and avocados Haven't told them yet that I'm down to 65 carbs per day.

We all have different carb tolerances, and I suggest that 65g carbs is too much for you. Have you tried any fasting regimes, although I'm not sure how Gliclazide would fit in that. Otherwise, I can't think of anything to suggest.

What are you 2 hours after evening meal? When do you start to rise up to 8-11 ? Are you eating too much protein?

 

[ME_Valentijn]

We all have different carb tolerances, and I suggest that 65g carbs is too much for you. Have you tried any fasting regimes, although I'm not sure how Gliclazide would fit in that. Otherwise, I can't think of anything to suggest.

65 is the minimum I can handle. If I go under 20 per meal, I get weaker and exhausted. I think this is due to my ME/CFS, because I did Atkins in college at 20g per day for about a year with no problems. The general theory is that with ME/CFS we're pretty impaired in using glucose for energy, and might already be relying on the alternative metabolic pathways to a large extent.

What are you 2 hours after evening meal? When do you start to rise up to 8-11 ? Are you eating too much protein?

It's already getting a bit high then, but it shouldn't be due to what I'm eating. I typically make enough to have some leftovers for breakfast or lunch the next day, in the same amount that I had for dinner, and I don't get much of a rise then. But I typically have 100-150 grams of meat, which is around 30-35 grams of protein.

 

[ME_Valentijn]

Long story short, my GP is sending me to the endocrinologist in 2-3 weeks for diabetes management. Hopefully we can get my nighttime values down, and I'll stop having the false hypos as a result.

In the meantime, my plan is to raise my carbs slightly with lunch and breakfast (25 each?), and aim for blood glucose of 5-6, and avoid the 4-5 range while it's causing me problems. Not ideal, but good enough for the short term. I'm still going to aim for about 20 carbs with dinner, since going low is never a problem in the evening or overnight

 

[AndBreathe]

@ME_Valentijn - I'm not telling you what to do, as you have your own mind and views of your own. What I would do though is ask how long you tried with slightly lower carbs than your current 20-25 per meal?

The unfortunate thing about false hypos is that unless you break through the floor at which you feel you are triggering the false hypo (I am at all times assuming it is a false hypo; I can have no way of knowing for sure) you are merely reinforcing that routine into your body.

Our bodies like to work to routines and ranges. Your current comfort range is over 5. When you reach that, your body tells you it's getting uncomfortable, so you feed it to bring it up again. If you were able to work through that brief period of feeling low, your body would accept it's now comfort zone is a bit lower, and thereby work to protect that.

For false hypos by feeding the false hypo you are just ensuring it remains your norm. It won't go away on its own. I view it a bit like physio. When we start a new stretching regime it may feel a bit uncomfortable the first time the physio does "that" with our leg or whatever, but by the time he/she has done it a few times, it's much more comfortable.

With your Gliclazide you clearly have to ensure you're not driving yourself clinically too low.

Sadly, making changes will often, by its very nature lead to a period of discomfiture before the benefits are evident.

Good luck with it all.

 

[azure]

Long story short, my GP is sending me to the endocrinologist in 2-3 weeks for diabetes management. Hopefully we can get my nighttime values down, and I'll stop having the false hypos as a result.

In the meantime, my plan is to raise my carbs slightly with lunch and breakfast (25 each?), and aim for blood glucose of 5-6, and avoid the 4-5 range while it's causing me problems. Not ideal, but good enough for the short term. I'm still going to aim for about 20 carbs with dinner, since going low is never a problem in the evening or overnight

I seem to remember your diabetes type was complicated. It could well be that you need a basal insulin to help control your overnight levels. I think I might have mentioned that to you before?

I still feel that that is what I would pursue if my numbers stayed higher. Hopefully the Endo will be able to give you more information about your diabetes type and that will help too.

 

[ME_Valentijn]

Our bodies like to work to routines and ranges. Your current comfort range is over 5. When you reach that, your body tells you it's getting uncomfortable, so you feed it to bring it up again. If you were able to work through that brief period of feeling low, your body would accept it's now comfort zone is a bit lower, and thereby work to protect that.

Yes, I've made a point of not over-reacting to false hypos, in the hope that I would get used to being at that level and stop getting the false hypo reaction. But, it doesn't help. With yesterday's, I first measured 4.3 right before drinking my scheduled lunch carbs in the form of coffee with milk and a little maple syrup, feeling just slightly out of it, but then feeling fine with the coffee. Then a few hours later I was feeling very shaky and weak, and blood sugar tested 4.8. I first ate 30g of peanuts (3 carbs), but just kept feeling worse even though not in danger of a real hypo. Then I had half a cup of full-fat milk (6 carbs), and slowly started feeling a bit better. Though I remained weak and shaky for at least an hour afterward, and barely able to walk at dinner time.

It's been suggested that as long as I'm high at night, which is currently completely out of my control, I'll continue to have false hypo reactions. And since I can't afford to be unable to get off the couch for a couple hours to a greater extent than usual, I need to avoid those episodes, false hypo or not. It's also likely that my ME/CFS may be exacerbating the situation. My brain and muscles do not recover normally after exerting them, and they might have similar problems with recovering when glucose levels get lower than they like. I was also in a crash yesterday during the hypo, due to having over-exerted Saturday afternoon, by being taken on an outing to the garden center in my wheelchair for about an hour.

My level of functioning is already down to about 20%. I can't afford going down to 10% or lower while making an effort to push through symptoms which isn't even likely to work while I'm still high 12 hours of every day.

 

[AndBreathe]

Yes, I've made a point of not over-reacting to false hypos, in the hope that I would get used to being at that level and stop getting the false hypo reaction. But, it doesn't help. With yesterday's, I first measured 4.3 right before drinking my scheduled lunch carbs in the form of coffee with milk and a little maple syrup, feeling just slightly out of it, but then feeling fine with the coffee. Then a few hours later I was feeling very shaky and weak, and blood sugar tested 4.8. I first ate 30g of peanuts (3 carbs), but just kept feeling worse even though not in danger of a real hypo. Then I had half a cup of full-fat milk (6 carbs), and slowly started feeling a bit better. Though I remained weak and shaky for at least an hour afterward, and barely able to walk at dinner time.

It's been suggested that as long as I'm high at night, which is currently completely out of my control, I'll continue to have false hypo reactions. And since I can't afford to be unable to get off the couch for a couple hours to a greater extent than usual, I need to avoid those episodes, false hypo or not. It's also likely that my ME/CFS may be exacerbating the situation. My brain and muscles do not recover normally after exerting them, and they might have similar problems with recovering when glucose levels get lower than they like. I was also in a crash yesterday during the hypo, due to having over-exerted Saturday afternoon, by being taken on an outing to the garden center in my wheelchair for about an hour.

My level of functioning is already down to about 20%. I can't afford going down to 10% or lower while making an effort to push through symptoms which isn't even likely to work while I'm still high 12 hours of every day.

Have you considered that you could actually be feeling hungry, and not false hypo? In your shoes, I might try having a cube of cheese and see how I felt after that?

I'm fortunate in that I am unmedicated and can go pretty low, without issue. I have been known to feel a bit like a prowling wolf before a mealtime if I'm really hungry. I will also generally have fairly low numbers at that time, but I'm positive the feelings I have are hunger not hypo.

If that happens and a meal is imminent I wait it out, but if I'm some way form eating, I'll just have a cup of tea or coffee.

Again, I stress, I take no medications that could be implicated in driving numbers low.

 

[ME_Valentijn]

Have you considered that you could actually be feeling hungry, and not false hypo? In your shoes, I might try having a cube of cheese and see how I felt after that?

That's why I tried peanuts first. It didn't help, and the shakiness just got worse. I'd also had 50g of a dry sausage an hour before.

 

[azure]

That's why I tried peanuts first. It didn't help, and the shakiness just got worse. I'd also had 50g of a dry sausage an hour before.

With your complicated medical problems, it may be that a small amount of carbs is wise. Only you know how you feel.

i think you'll be able to make a better judgement about what food, if any, is necessary, after your night time sugars are in a better range.

 

[ME_Valentijn]

Keeping my carbs around 25 each for breakfast and lunch seemed to help in avoiding the 4.3-4.8 range and associated false hypos for a couple days (though I felt it creeping up on me once at 4.9). But now the same amount of carbs while eating the same foods is now sending me up to 10.4, at what is typically my lowest point of the day.

It just feels like my pancreas is constantly giving me the finger (or whatever the British equivalent is)

 

[DaftThoughts]

Keeping my carbs around 25 each for breakfast and lunch seemed to help in avoiding the 4.3-4.8 range and associated false hypos for a couple days (though I felt it creeping up on me once at 4.9). But now the same amount of carbs while eating the same foods is now sending me up to 10.4, at what is typically my lowest point of the day.

It just feels like my pancreas is constantly giving me the finger (or whatever the British equivalent is)

That sounds very likely. Gliclazide was doing that to me for a long time. Without it my pancreas has been a lot more consistent.

 

[ME_Valentijn]

That sounds very likely. Gliclazide was doing that to me for a long time. Without it my pancreas has been a lot more consistent.

I run out in a week, and it's two weeks until I see a diabetes specialist. I'm tempted to see what happens when I'm off it, instead of calling in for a refill

 

[ME_Valentijn]

11:30am - 10.4
2:00pm - 5.1

So now I need to eat, and am still feeling nauseated from the 10.4 :***: