Not Sure Where I belong RH or PreDiabetes

[MrPenguin]

Hi all, I have symptoms of both RH and PreDiabetes.. Are they joined at the hip? Or completely different?

I crash if I eat carbs for breakfast, even porridge.. And I will get the shakes, sweating, palpitations, dizziness and the only way to correct that is to obviously grab whatever you can find in your zombie state and wait for it to kick in.. When in this state I always know what my blood sugar is going to be.. In the 60s (3.3) ish.. To avoid this issue I just skip breakfast most days and my blood sugar remains stable and I feel better..

Dinner tonight I thought I'd take a more detailed look at what my blood sugar is doing and it is like this..

22:00 96 mg/dl (5.3) - Before Dinner..
22:00 - 22:10 Dinner (Rice with meatballs and chopped toms and lentils and onions)
22:30 135 mg/dl (7.5)
23:10 139 mg/dl (7.7)
00:10 144 mg/dl (8.0) Two hours after eating
00:30 Got fed up with the high readings so I lifted some weights for 15 minutes..
01:10 115 mg/dl (6.4)

Does anybody recognise this pattern? I was a stable weight up until my mid 30s always 10 stone, I was naturally muscular .. For the last 2 years I had bowel and digestive issues which I overcame by giving up gluten.. Before giving up gluten it was like my body was consuming itself, I was losing muscle in places you wouldn't usually and got down to 7.7 stone (49kg). I have been struggling to gain the weight I lost back and I eat easily double what I did when I was 10st and I now lift weights daily for the past 8 months yet I can't seem to get back up to it. Currently 8.9 stone (57kg).

I would love to hear from anybody with some advice on what I should do.. The last time I brought this up with the doctor they took my reading and as it was a morning app I hadn't eaten yet and it was 85 mg/dl (4.7) so that was a waste of time.

 

[DevonVee]

@Brunneria She is very knowledgeable about RH.
I have not yet worked out how to tag. Look up some of her posts you will learn loads.

 

[Brunneria]

you tagged perfectly @DevonVee

Hi and welcome @MrPenguin

I have seen some enlightened writers and studies that suggest that mild RH is extremely common, and often crops up before pre-diabetes does - the kind of thing where you snack on carbs, and feel hungry really quickly afterwards, leading to constant grazing. Also very common in pre-menstrual women, when their hormones are at certain stages of the cycle.

As to whether it is common enough to be classed as joined at the hip... boy, that would take some study. Most people have no idea at all about their blood glucose at any time - until their doc has already diagnosed diabetes, and the stronger D medications.

I would love to see a proper study.
The nearest I have found are these:

This study (from 2010)
http://www.ncbi.nlm.nih.gov/pubmed/20509823
Took 362 people 'without a diagnosis of abnormal glucose metabolism through an oral glucose tolerance test (OGTT)' and tested them.
12.4% had idiopathic reactive hypoglycaemia !!!
And curiously, that only 54% of them had a normal glucose tolerance (but that is a discussion for another thread)
The study then went on to see if switching to a high fibre diet helped.
It did.
They concluded that: A reactive glucose pattern following intake of a high glycaemic load is relatively prevalent and this phenomenon could be modulated by dietary fibre supplementation.

This study (2005)
found that idiopathic RH is prevalent in 50% of lean young women with PCOS.
http://www.ncbi.nlm.nih.gov/pubmed/15808380
That actually blows my mind.
50%!!!
And bearing in mind that PCOS tends to lead to weight gain, presumably over weight PCOSers have an even higher incidence of RH (that is just my speculation)
Plus the fact that women with PCOS are statistically much more likely to develop Type 2

This study (2008)
http://clinicaltrials.gov/show/NCT00802971
Shows RH to be astonishingly widespread:
'The prevalence of IRH is not fully known. A British trial among 1136 random chosen women aged 17-50, reported that 37.9% experienced symptomatic hypoglycemia four times every month (mean value). However, not all reported symptoms attributed to a low blood glucose (BG) correlates with measured low levels of BG and a "true" hypoglycaemic episode, i.e., as defined by American Diabetes Association (ADA) when plasma BG value is < 3,9 mmol/l with or without accompanying symptoms. This was underscored in three studies from England, Canada and Denmark, in whom all reported hypoglycaemic symptoms, but in whom accompanying plasma glucose values < 3,3 mmol/l during hypoglycaemic symptoms only occurred in 23, 47 and 0% of the study subjects, respectively. The majority of those with symptoms related to IRH hence are having these symptoms without being classified as hypoglycemic according to conventional interpretations. However, a new (2005) ADA definition; relative hypoglycemia, also comprise these symptomatic cases of hypoglycemia following a plasma glucose > 3,9 mmol/l.'

So, my reading of these studies suggests that RH may affect
12.4% of the population
At least 50% of women with PCOS
And 37.9% of women of reproductive age may experience symptoms 4x a month

Sorry if these imply that RH is a girly thing. It isn't. It is just that these are the studies I found.

 

[Brunneria]

Re your blood glucose readings...

To be honest, that evening meal (gosh you eat late!) showed fairly typical numbers for a mixed protein, fat and carbs meal. The fibre from the lentils will have slowed things down a bit. I would be interested to know what happens every hour for a few more hours. I often get a dip at around 3.5-6 hours (depends on what I ate, because protein, fat and fibre always slow digestion) then my blood glucose rises back up to its starting point.

For a meal like yours, my body would only have an RH response if I ate too much rice. So it would all come down to portion size.

You mentioned that you get RH after breakfast. That was exactly my experience. But only when I ate carbs for breakfast.
Switching to protein and fat breakfasts (eggs, bacon, no carbs like toast, or coffee with cream, or ham and cheese, or even kippers) made the breakfast RH problem go away completely.

 

[azure]

@MrPenguin Reading that, I'd be more concerned about your weight loss/inability to,gain weight. Has your doctor given you a diagnosis for that or suggested any treatment?

Your fasting blood sugar isn't in the prediabetic range. Have you had any other tests eg an HbA1C or a glucose tolerance test?

Was it your doctor who suggested the fasting blood glucose test or did you ask for it?

What particular symptoms of prediabetes do you have?

 

[Brunneria]

Sorry for the serial postings
But I wanted to break up the wall of words a bit!

Re your desire to gain some weight, this can be difficult for some people when they low carb.
The general advice on the forum is to up protein, not carbs. So bigger meat, fish, eggs portions. Also nuts seem to be a great thing for weight gain.

Hope these help.

 

[Alison Campbell]

I had really bad symptoms of RH for 10 years before being diagnosed with prediabetes. The symptoms stopped around the time of diagnosis for prediabetes.

 

[MrPenguin]

Before evening meal I was at a normal 4.5.. An hour after tonight's evening meal I got 11.1 when I tested which is the highest reading i've ever seen in the 6 months i've been testing.. All I had was battered chicken breasts, fried egg and bake beans.

After seeing it was 11.1 (200) I ate some raw garlic, had a spoon of coconut oil and drank a load of water and walked around for a while.

2 and a half hours after my evening meal it's at 10.

Lifted some weights for 15 minutes and did 30 pushups

3 and a half hours after evening meal 7.2.

How would you say these numbers look?

 

[chalup]

I would say that looks a bit high. 4.5 to 11 is a big jump. Try the same meal without the batter and beans and see what happens to your levels. You could ask your doctor for some proper testing as well. A c-peptide test will tell you if you are producing a normal amount of insulin and an OGGT test will tell you how your body is responding to carbs.

 

[Brunneria]

Before evening meal I was at a normal 4.5.. An hour after tonight's evening meal I got 11.1 when I tested which is the highest reading i've ever seen in the 6 months i've been testing.. All I had was battered chicken breasts, fried egg and bake beans.

After seeing it was 11.1 (200) I ate some raw garlic, had a spoon of coconut oil and drank a load of water and walked around for a while.

2 and a half hours after my evening meal it's at 10.

Lifted some weights for 15 minutes and did 30 pushups

3 and a half hours after evening meal 7.2.

How would you say these numbers look?

Thanks for giving the info about what happened after the meal.

The initial rise to 11 may well have been the batter and the beans. Beans do that to me, especially if they have sugar in the sauce. And portion size will affect that too. I shudder to remember those days when I used to think a half tin of beans on toast were a healthy breakfast! Nowadays, I wouldn't even have half that in an otherwise all protein breakfast.

As for the blood glucose staying so high for so long, protein digests slowly - and some protein can be broken down to glucose, so depending on how many chicken breasts and eggs you ate, that may explain it. Glad it fell to 7 by 3.5 hours.

How are you feeling now?

 

[MrPenguin]

@MrPenguin Reading that, I'd be more concerned about your weight loss/inability to,gain weight. Has your doctor given you a diagnosis for that or suggested any treatment?

Your fasting blood sugar isn't in the prediabetic range. Have you had any other tests eg an HbA1C or a glucose tolerance test?

Was it your doctor who suggested the fasting blood glucose test or did you ask for it?

What particular symptoms of prediabetes do you have?

I was given a fasting blood sugar test and since it was normal.. Around 4.5, I was sent packing.. In my mind it was a pointless test as it's always around there 1st thing when I haven't yet eaten.

Thanks for giving the info about what happened after the meal.

The initial rise to 11 may well have been the batter and the beans. Beans do that to me, especially if they have sugar in the sauce. And portion size will affect that too. I shudder to remember those days when I used to think a half tin of beans on toast were a healthy breakfast! Nowadays, I wouldn't even have half that in an otherwise all protein breakfast.

As for the blood glucose staying so high for so long, protein digests slowly - and some protein can be broken down to glucose, so depending on how many chicken breasts and eggs you ate, that may explain it. Glad it fell to 7 by 3.5 hours.

How are you feeling now?

It's the morning now and I initially felt a little rough. I took my reading a soon as I woke up and it's 5.6. I had RLS all night and jumped out of bed twice thinking about hitting my foot with a hammer! I feel a little dehydrated and my vision is a little blurry this morning which is pretty normal as I usually have dry eyes when I wake up.. My feet feel like they are very mildly buzzing? I don't seem to sweat anymore so I tend to overheat when I'm asleep. I drink plenty throughout the space of a day (4-5 litres).

What I ate for dinner last night, If I'd eaten that for lunch I would have had a much lower spike which would have returned to normal after a few hours. Is there a reason why it's much worse later on in the day?

I wanted to ask whether having only 1 kidney puts me at greater risk? I know my doctor told me to watch my salt intake but he didn't say anything at all about sugar and in fact told me to stuff my face with cakes and biscuits which I didn't do because I'm not an idiot! I also have Gilbert's syndrome if that matters.

Thanks for taking the time to respond.

 

[azure]

I was given a fasting blood sugar test and since it was normal.. Around 4.5, I was sent packing.. In my mind it was a pointless test as it's always around there 1st thing when I haven't yet eaten.


It's the morning now and I initially felt a little rough. I took my reading a soon as I woke up and it's 5.6. I had RLS all night and jumped out of bed twice thinking about hitting my foot with a hammer! I feel a little dehydrated and my vision is a little blurry this morning which is pretty normal as I usually have dry eyes when I wake up.. My feet feel like they are very mildly buzzing? I don't seem to sweat anymore so I tend to overheat when I'm asleep. I drink plenty throughout the space of a day (4-5 litres).

What I ate for dinner last night, If I'd eaten that for lunch I would have had a much lower spike which would have returned to normal after a few hours. Is there a reason why it's much worse later on in the day?

I wanted to ask whether having only 1 kidney puts me at greater risk? I know my doctor told me to watch my salt intake but he didn't say anything at all about sugar and in fact told me to stuff my face with cakes and biscuits which I didn't do because I'm not an idiot! I also have Gilbert's syndrome if that matters.

Thanks for taking the time to respond.

@MrPenguin A fasting blood test isn't pointless at all. It can help diagnose diabetes and prediabetes. It might not be the only test needed, but it still contributes to the overall picture.

Apart from your rise to 11 after a specific meal, your blood sugars (in your first post) look pretty normal. I'm a little confused as to why you're testing at home. Is this someyhing you started before your doctor's appointment or after? If it was before, what made you start testing, if it was after you got the normal fasting blood sugar result, again, what made you start doing your own tests?

Did you see a doctor in the UK or was it in the US? You're giving your results in US measures first, but I assumed you were in the UK - is that right?

My advice is to go back to the doctor, explain your symptoms and ask for further tests eg thyroid, coeliac screen, liver function, etc, etc in the hope that that will explain your weight loss. You could also ask for an HbA1C which will show your blood sugars over the last 3 months (approx).

As you have one kidney and Gilbert's Syndrome along with the unexplained weight loss, I think it's very unwise to assume the issue is with your blood sugar. You need some general screening tests and input from a doctor.