Medication, chocolate and testing

[62Rose]

Is anyone else using Acarbose to try to help them stabilise their blood sugars?
Do people with RH get test strips etc on the NHS?

 

[Brunneria]

Did you include chocolate in the title just to grab my attention?

Sorry, no experience of Acarbose, although I know it is a starch blocker, and has different reputations for effectiveness in different parts of the world. I believe (but am happy to be corrected) that it would only be effective if the patient is eating carbs, since it prevents their digestion, and therefore blocks the glucose release from the carbs. The blocking action may cause digestive side effects.

As for the test strips... if you have an official diagnosis of RH then you can request strips - I don't know whether they are obliged to provide them. If you drive and have a look at the DVLA website, and the medical conditions that require reporting, then hypoglycaemia is on the list. So the DVLA needs to be aware of your condition. And if it is a condition that needs reporting for the same reasons as for diabetes, then you could use the diabetic hypo driving rules to press your argument with the doc. After all, if people with diabetes who are at risk of hypos need to test before driving, then it is logical that the same rules should apply to people with RH.

Don't know whether your doc will accept that argument though.

 

[Lamont D]

I got my specialist endocrinologist to write to my GP to get test strips and he obliged.

If you don't ask, you don't get.

Get your GP to understand how important testing and finding your intolerance to certain foods, if you are going to get complete control of the condition.

I've replied about acerbose in your other thread.

Let us know how you get on.

Best wishes

 

[62Rose]

@ Brunnaria, sorry I changed my mind about the chocolate question!
Thanks both for your replies. I’m glad you said that about the tablets it’s puzzling me as to how they can help since I eat low carb meals anyway, I’ve had a difficult couple of weeks, but when I test my readings are not that low? I’m ringing the consultant’s secretary tomorrow on my pharmacists advice, she said I shouldn’t be feeling like this. I will ask about strips then too.

 

[Lamont D]

Chocolate!

I'm into dark chocolate. The higher the cocoa content the better.

A couple of pieces with full fat yoghurt and some frozen berries. Yum!

All very low carb!

 

[kokhongw]

I use 72% dark chocolate to handle my reactive hypoglycemic events.

 

[62Rose]

Still waiting to hear about when I can go to the consultant again, hopefully Nov 13. Have had a few really bad nights, It’s taken half the day to feel ok again. When I do get an appointment should I ask if they will give me a 24hr blood sugar monitor first, I know he is going to suggest the 72 hour fast again which I really don’t want to do. But what’s happening when I don’t fast seems more useful to me. Are there any questions that you can suggest that I could ask? I’m desperate for answers and need to get some quality sleep. Thanks

 

[Lamont D]

Still waiting to hear about when I can go to the consultant again, hopefully Nov 13. Have had a few really bad nights, It’s taken half the day to feel ok again. When I do get an appointment should I ask if they will give me a 24hr blood sugar monitor first, I know he is going to suggest the 72 hour fast again which I really don’t want to do. But what’s happening when I don’t fast seems more useful to me. Are there any questions that you can suggest that I could ask? I’m desperate for answers and need to get some quality sleep. Thanks

As you are low carbing already, it can only be a diagnosis to know what you need to do more.
More tests and your symptoms should be wrote down and recorded. Use a food diary.
Ask for any tests to try and confirm diagnosis.
Ask for a blood glucose monitor and test strips. Insist that you need to see how controlling your blood levels is integral to getting healthier.
The 72 hour fasting test is used to discount other conditions, that will lead to a definitive diagnosis. I would recommend it!
Other tests are the breakfast test, insulin levels, c-peptide and tolerance tests.
Being intolerant or allergic to certain foods can have an impact on your health.

Keep asking, keep learning, keep posting.

Best wishes

 

[62Rose]

Had another blood test looking at stress hormones today, had to lay down for 30 mins first. Does anyone know what that might diagnose please?Consultant agreed to 24 hour glucose monitor for a week, waiting for an appointment to get it also said I can get strips on prescription. I didn’t ask all my questions but at least something is being done. I avoided the 72 hour test again!
Been trying a bit of homemade low carb choc, coconut oil and peanut butter bar before bed and sometimes get a 4 hour stretch of sleep!
He said I am getting an insulin overshoot and may be having false hypos?
Im still low carbing and praying that my body will adapt soon. He denied that food allergies could be causing anything!

 

[Lamont D]

It's good that you are getting sorted and doing tests.
The glucometer will give you the whole story of what is going on.

Stress will effect all your hormones and known to raise blood glucose levels. But I haven't a clue about which hormones your endo is testing for.

The overshoot of insulin does mean that it will be essential to go low carb to not trigger the overshoot, did your endo mention anything about what you are eating.

I do have food allergies such as dairy, but I have intolerance to other carbs or starchy vegetables. It is this intolerance that causes the trigger to overshoot.

If we avoid them, no trigger, no overshoot!

Keep asking, keep learning, keep letting us know how you are doing.

Best wishes

 

[lindisfel]

Had another blood test looking at stress hormones today, had to lay down for 30 mins first. Does anyone know what that might diagnose please?Consultant agreed to 24 hour glucose monitor for a week, waiting for an appointment to get it also said I can get strips on prescription. I didn’t ask all my questions but at least something is being done. I avoided the 72 hour test again!
Been trying a bit of homemade low carb choc, coconut oil and peanut butter bar before bed and sometimes get a 4 hour stretch of sleep!
He said I am getting an insulin overshoot and may be having false hypos?
Im still low carbing and praying that my body will adapt soon. He denied that food allergies could be causing anything!

Hi Rose, they could be measuring cortisol? But they need to measure output from the pituitary gland as well as the cortisol from the adrenal.
The pituitary should control the adrenal output. High cortisol raises b.g.
regards
Derek

 

[SimonCrox]

I have prescribed a fair bit of acarbose in my time, but practically zero in last 10 years.
UK residents cannot take the flatulence that goes with it - so my few patients on it have been single (before starting acarbose).
A small dose eg 25 mg might be quite useful, but it is a pain breaking the tablets in two.
For some reason, the datasheet says avoid in significant renal impairment
The other useful point is that it delays the breakdown of complex CHO inot absorbable CHO; so if someone is hypo, you need to give pure glucose to be on safe side and not comlex CHO (although lucozade which is partially hydrolysed maize starch seems to treat the hypos OK)
Best wishes

 

[Lamont D]

I have prescribed a fair bit of acarbose in my time, but practically zero in last 10 years.
UK residents cannot take the flatulence that goes with it - so my few patients on it have been single (before starting acarbose).
A small dose eg 25 mg might be quite useful, but it is a pain breaking the tablets in two.
For some reason, the datasheet says avoid in significant renal impairment
The other useful point is that it delays the breakdown of complex CHO inot absorbable CHO; so if someone is hypo, you need to give pure glucose to be on safe side and not comlex CHO (although lucozade which is partially hydrolysed maize starch seems to treat the hypos OK)
Best wishes

Hi, @SimonCrox

I remember someone posting about acerbose and was eventually taken off it for similar reasons and then finding out the drug was helping speed up the conversion to glucose helping the breakdown of carbs quickly, even though the poster was glucose dumping already.
For the symptoms above described, I would have thought that a new diabetic drug that lowers the hyper initially increasing first insulin response would have been a better choice such as a Gliptin.

With Hypoglycaemia, the need for something like lucozade is unnecessary because this would accentuate the rebound effect of going hyper then hypo again.
It is better to eat a small amount of carbs say a plain biscuit to nudge your blood glucose levels up back into normal levels, then eat a little while later and testing to regulate your levels.
I have been in this position in hospital and they were trying to force glucose, sandwiches and the likes down me to stop the hypo.
I learned my lessons on my extended OGTT, which to date all went to hypo and successfully restored normal levels within half an hour and allowed home because of the normalisation of my blood, under an hour after going hypo.

I still felt dreadful though!

 

[62Rose]

It's good that you are getting sorted and doing tests.
The glucometer will give you the whole story of what is going on.

Stress will effect all your hormones and known to raise blood glucose levels. But I haven't a clue about which hormones your endo is testing for.

The overshoot of insulin does mean that it will be essential to go low carb to not trigger the overshoot, did your endo mention anything about what you are eating.

I do have food allergies such as dairy, but I have intolerance to other carbs or starchy vegetables. It is this intolerance that causes the trigger to overshoot.

If we avoid them, no trigger, no overshoot!

Keep asking, keep learning, keep letting us know how you are doing.

Best wishes

I am already low carbing, i did ask if I should cut them completely which he felt wasn’t necessary. I have very small amounts of starchy veg if any and stick to above ground veg. I think how much energy I use may be a factor too as after a busy day I will often have a worse night. I read that taking exercise in the morning may help, but life doesn’t always allow that luxury.

I’m not entirely sure how to test different foods, as I eat at least every two hours now? I’m not even sure of the spike time, still getting my head round things. Thanks again for your help.

 

[62Rose]

I have prescribed a fair bit of acarbose in my time, but practically zero in last 10 years.
UK residents cannot take the flatulence that goes with it - so my few patients on it have been single (before starting acarbose).
A small dose eg 25 mg might be quite useful, but it is a pain breaking the tablets in two.
For some reason, the datasheet says avoid in significant renal impairment
The other useful point is that it delays the breakdown of complex CHO inot absorbable CHO; so if someone is hypo, you need to give pure glucose to be on safe side and not comlex CHO (although lucozade which is partially hydrolysed maize starch seems to treat the hypos OK)
Best wishes

I found it made me go low in the day more often and made things far worse at night, that was the issue for me. I am satisfied with the monitoring plan and maybe then trying another tablet, he said maybe Metformin, but I think I am very sensitive to medication so will wait to see what the results will show hopefully.
Thanks for your help.

 

[SimonCrox]

Yes - I gave acarbose once for reactive hypoglycaemia on the premise that it would reduce the glucose load hitting the system - definately did not help.

 

[Lamont D]

Yes - I gave acarbose once for reactive hypoglycaemia on the premise that it would reduce the glucose load hitting the system - definately did not help.

It is heart warming that a doctor has actually heard of reactive hypoglycaemia!

In my experience of traveling around the grounds of the football world, I always ask the resident doctor!

I have had replys of, 'what is that',
' hypo what?',
'Yeah, that's when you don't eat properly',
'diabetes you mean!',
'Lots of fluids to fix the hypos'
and the best,
'You must eat lots of fruit (and vegetables) with that!

God bless their patients!

 

[bulkbiker]

God bless their patients!

More like god help them surely...!

 

[62Rose]

I now have a date for a scan to my abdomen as I have had a pain for a few weeks now, another issue entirely hopefully? My problem is I need to fast for 6 Hours beforehand and the appointment is at 9am. I am not supposed to have fats for my last intake as that may affect the results. I asked what I could eat bearing in mind I am dairy free and wouldn’t eat carbs and it seems eggs would be ok.
I usually have eaten two if not three times by 9am. Any other suggestions anybody as to what they have had? Last night I was awake at 1.30, 3.30 and 5.30 having hypos, now by 9am I would be feeling very unwell if I hadn’t eaten at 5.30; 7 and 8.30, I’m only just starting to function now!
Thanks for reading and helping me get my head round things.

 

[Brunneria]

I now have a date for a scan to my abdomen as I have had a pain for a few weeks now, another issue entirely hopefully? My problem is I need to fast for 6 Hours beforehand and the appointment is at 9am. I am not supposed to have fats for my last intake as that may affect the results. I asked what I could eat bearing in mind I am dairy free and wouldn’t eat carbs and it seems eggs would be ok.
I usually have eaten two if not three times by 9am. Any other suggestions anybody as to what they have had? Last night I was awake at 1.30, 3.30 and 5.30 having hypos, now by 9am I would be feeling very unwell if I hadn’t eaten at 5.30; 7 and 8.30, I’m only just starting to function now!
Thanks for reading and helping me get my head round things.

I would contact them and explain the situation in detail, and say basically, I HAVE to eat, so please let me know what you suggest will affect the scan the LEAST.

Goodness, I do not envy you with all this. I really hope you get the answers you need!