Information for newbies and basic stuff.

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi and welcome to our forum.

Reactive Hypoglycaemia, the basics!

What is Hypoglycaemia?

Hypoglycaemia is in response to your blood glucose levels going below a certain percentage of blood sugar.
Usually depending on personal experience anything below 3.5 is a hypo and should be treated.
There are differing opinions and some hypoglycaemiacs can live comfortably as low as 3.0

Reactive Hypoglycaemia is a condition, where your pancreas over produces too much Insulin for the meal you have digested.
Reactive Hypoglycaemia or post prandial hypoglycaemia is a medical term describing recurrent episodes of symptomatic Hypoglycaemia occurring within four hours after a high carbohydrate meal or oral glucose load in people who do not have diabetes.
It is thought to represent a consequence of excessive insulin release triggered by the carb meal but continuing past the digestion and disposal of glucose derived from the meal.
So depending on what you eat, your blood glucose response and your body's ability to cope with carbs and sugars, the excess insulin and the very quick hyper (high blood sugar) within an hour. The drop to normal levels, but it continues to drop to a low blood sugar level (hypo).
The condition is unique because the hormonal response to carbs and glucose. We spike quickly, we do not have a lull in our spike, in others, the spike is interrupted in its climb, RH ers don't! We use up our glucose from the meal. Hence the speed of our hyper. When we treat our hypos, we fluctuate between highs and lows, hence the excessive symptoms and why our brain is bombarded with different psychological associated symptoms.
I didn't want to make this too scientific, there is a lot of science information on the internet. I did say this was basic!

Symptoms

Symptoms vary from Individuals hydration levels, according to Wikipedia!
The sensitivity of the rate and magnitude of decline of their blood glucose concentration.
They include;

Blurred vision.
Headaches.
Frequent urination.
Depression.
Unclear thinking.
Nervousness.
Sleep disruption or insomnia.
Muscle twitches.
Heart palpitations or fibrillation.
Irritability.
Fatigue.
Tremors.
Dizziness.
Flushing.
Lightheadedness.
Craving sweets.
Sweating.
Increased appetite.
Rhinitis.
Vomiting.
Nausea.
Panic attack.
Numbness.
Coldness in the extremities.
Confusion.
Irrational.
Bad tempered.
Disoriented.
Anxiety.
Anger.
Rage.
Coma. Can occur in extreme conditions in severe untreated episodes.

There are others, but it shows how diverse the symptoms are!

I personally did not have all the symptoms, but only missed out on a few!

Types of Hypoglycaemia.

Alimentary Hypoglycaemia. Or dumping syndrome. Prevalent after stomach surgery.
Hormonal Hypoglycaemia. Hypothyroidism.
Helicobacter Hypoglycaemia. Pylori induced gastritis. Bacteria in the gut and through digestion.
Congenital enzyme deficiencies. Fructose intolerance.
Late Reactive Hypoglycaemia. Used to be called idiopathic hypoglycaemia.
Because they have not found any known cause and is rare!
This is me! Naturally weird!

Causes.

As I've already said, I developed my condition naturally.
But usually it is prevalent after stomach surgery.
Trauma.
Fructose intolerance, usually hereditary.
I believe diet should be one of the causes, but there is nothing or research to back it up!
Also no way has been found to create insulin overshoot.

Treatment.

This is open to discussion.
However, a low carbohydrate intake is recommended by consensus on this forum.
No sugar.
Eating regularly. Depending on individual, seven to nine small meals per day. Small plate size is important because of protein and calorie intake.
Exercise is important. Walking does lower blood glucose levels. Anything strenuous will temporarily increase your blood glucose levels, exercise is good for you! Just don't overdo it!

In my experience of continuous hypos and hypers, one after another!
I have found the best way to avoid further hypers and hypos is to eat regularly throughout the day.
To treat a hypo, well, what I do is make a cuppa of tea, eat a biscuit, plain or something that is low carb, and sit and relax, this will raise your blood glucose levels slowly, then within a half hour, have a very small low carb meal.
Hopefully you won't hyper, so no hypo! No fluctuating blood glucose sugar levels.

Foods to avoid.

We recommend a low carbohydrate lifestyle.
Sugars and carbohydrates are the foods that you don't tolerate well. And you 'react' to them.
Obviously you cannot not eat carbs as they are everywhere, but avoid the starchy ones and the fructose sugars in fruit. As with all blood glucose disorders, there are some foods that you can eat very small amounts of, but the only way to know is to test and experiment.
Flour of all grains are to be avoided.
Factory made food is full of what is known as production sugars and ingredients such as corn syrup.
Tinned products such as soups.
Rice.
Pasta.
Fast food. Even the meat is processed.
Some RH ers can be tolerant to dairy products and lactose, which is a sugar.
Low, reduced or no fat products! Such as yoghurt! The full fat is replaced by processed sugars.
Confectionery.


Some patients who have Reactive Hypoglycaemia, can also have T2 diabetes, but not the other way around.
Diabetic hypoglycaemia can be caused by drugs or by not eating regularly.
This does not include T1 or T2 diabetics who regularly hypo because they have to have insulin injections because of insulin resistance.
Most RH ers are not diabetic.
If your fasting hba1c level is normal, then you are not diabetic.There is always those who can attain normal levels through diet but are susceptible to diabetic levels.

There are no medication that have yet to recognised just for RH. But there are trials and research.
There is no known cure for Reactive Hypoglycaemia!

As I've said, this is the basics, from a layman who has the condition.
I've been through hypo hell, done the tests and experimentation and found myself fit and healthy again after a lot of years.

Hope this helps, those who find themselves in need of information.

Welcome to the forum.
 
Last edited:

leslie10152

Well-Known Member
Messages
1,110
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Ignorance
For me, the onset of a hypo starts with a peculiar chill in my spine, followed by clumsyness and confusion. The feeling closely resembles a serious panic attack. Depending on the severity of the attack, it can take as long as 30 minutes for me to get back on track.
 

pogoplum

Member
Messages
6
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
I know we are all different, but my own (symptom unaware) RH manifests itself with micro-blackouts whilst conscious. This happens around 60 seconds before collapse (medical emergency). After 25 years, only VLC diet prevents incidents. Not had one for c 1 year now!
 

ickihun

Master
Messages
13,698
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Bullies
Hi and welcome to our forum.

Reactive Hypoglycaemia, the basics!

What is Hypoglycaemia?

Hypoglycaemia is in response to your blood glucose levels going below a certain percentage of blood sugar.
Usually depending on personal experience anything below 3.5 is a hypo and should be treated.
There are differing opinions and some hypoglycaemiacs can live comfortably as low as 3.0

Reactive Hypoglycaemia is a condition, where your pancreas over produces too much Insulin for the meal you have digested.
Reactive Hypoglycaemia or post prandial hypoglycaemia is a medical term describing recurrent episodes of symptomatic Hypoglycaemia occurring within four hours after a high carbohydrate meal or oral glucose load in people who do not have diabetes.
It is thought to represent a consequence of excessive insulin release triggered by the carb meal but continuing past the digestion and disposal of glucose derived from the meal.
So depending on what you eat, your blood glucose response and your body's ability to cope with carbs and sugars, the excess insulin and the very quick hyper (high blood sugar) within an hour. The drop to normal levels, but it continues to drop to a low blood sugar level (hypo).
The condition is unique because the hormonal response to carbs and glucose. We spike quickly, we do not have a lull in our spike, in others, the spike is interrupted in its climb, RH ers don't! We use up our glucose from the meal. Hence the speed of our hyper. When we treat our hypos, we fluctuate between highs and lows, hence the excessive symptoms and why our brain is bombarded with different psychological associated symptoms.
I didn't want to make this too scientific, there is a lot of science information on the internet. I did say this was basic!

Symptoms

Symptoms vary from Individuals hydration levels, according to Wikipedia!
The sensitivity of the rate and magnitude of decline of their blood glucose concentration.
They include;

Blurred vision.
Headaches.
Frequent urination.
Depression.
Unclear thinking.
Nervousness.
Sleep disruption or insomnia.
Muscle twitches.
Heart palpitations or fibrillation.
Irritability.
Fatigue.
Tremors.
Dizziness.
Flushing.
Lightheadedness.
Craving sweets.
Sweating.
Increased appetite.
Rhinitis.
Vomiting.
Nausea.
Panic attack.
Numbness.
Coldness in the extremities.
Confusion.
Irrational.
Bad tempered.
Disoriented.
Anxiety.
Anger.
Rage.
Coma. Can occur in extreme conditions in severe untreated episodes.

There are others, but it shows how diverse the symptoms are!

I personally did not have all the symptoms, but only missed out on a few!

Types of Hypoglycaemia.

Alimentary Hypoglycaemia. Or dumping syndrome. Prevalent after stomach surgery.
Hormonal Hypoglycaemia. Hypothyroidism.
Helicobacter Hypoglycaemia. Pylori induced gastritis. Bacteria in the gut and through digestion.
Congenital enzyme deficiencies. Fructose intolerance.
Late Reactive Hypoglycaemia. Used to be called idiopathic hypoglycaemia.
Because they have not found any known cause and is rare!
This is me! Naturally weird!

Causes.

As I've already said, I developed my condition naturally.
But usually it is prevalent after stomach surgery.
Trauma.
Fructose intolerance, usually hereditary.
I believe diet should be one of the causes, but there is nothing or research to back it up!
Also no way has been found to create insulin overshoot.

Treatment.

This is open to discussion.
However, a low carbohydrate intake is usually recommended.
No sugar.
Eating regularly. Depending on individual, seven to nine small meals per day. Small plate size is important because of protein and calorie intake.
Exercise is important. Walking does lower blood glucose levels. Anything strenuous will temporarily increase your blood glucose levels, exercise is good for you! Just don't overdo it!

In my experience of continuous hypos and hypers, one after another!
I have found the best way to avoid further hypers and hypos is to eat regularly throughout the day.
To treat a hypo, well, what I do is make a cuppa of tea, eat a biscuit, plain or something that is low carb, and sit and relax, this will raise your blood glucose levels slowly, then within a half hour, have a very small low carb meal.
Hopefully you won't hyper, so no hypo! No fluctuating blood glucose sugar levels.

Foods to avoid.

We recommend a low carbohydrate lifestyle.
Sugars and carbohydrates are the foods that you don't tolerate well. And you 'react' to them.
Obviously you cannot not eat carbs as they are everywhere, but avoid the starchy ones and the fructose sugars in fruit. As with all blood glucose disorders, there are some foods that you can eat very small amounts of, but the only way to know is to test and experiment.
Flour of all grains are to be avoided.
Factory made food is full of what is known as production sugars and ingredients such as corn syrup.
Tinned products such as soups.
Rice.
Pasta.
Fast food. Even the meat is processed.
Some RH ers can be tolerant to dairy products and lactose, which is a sugar.
Low, reduced or no fat products! Such as yoghurt! The full fat is replaced by processed sugars.
Confectionery.


Some patients who have Reactive Hypoglycaemia, can also have T2 diabetes, but not the other way around.
Diabetic hypoglycaemia can be caused by drugs or by not eating regularly.
This does not include T1 or T2 diabetics who regularly hypo because they have to have insulin injections because of insulin resistance.
Most RH ers are not diabetic.
If your fasting hba1c level is normal, then you are not diabetic.There is always those who can attain normal levels through diet but are susceptible to diabetic levels.

There are no medication that have yet to recognised just for RH. But there are trials and research.
There is no known cure for Reactive Hypoglycaemia!

As I've said, this is the basics, from a layman who has the condition.
I've been through hypo hell, done the tests and experimentation and found myself fit and healthy again after a lot of years.

Hope this helps, those who find themselves in need of information.

Welcome to the forum.
Did I see it somewhere that bariatric surgery can bring it on?
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Did I see it somewhere that bariatric surgery can bring it on?

You are correct!

It is a different type of RH, but definitely RH!
It has been called rebound Hypoglycaemia, gastric dumping, or just hypoglycaemia depending on how it affects the patient!

Because of the changes in digestion, the process is quickened and can't eat a lot!
The change in how the glucose, insulin levels balance can cause Hypoglycaemia.
It has a lot to do with alpha and beta cells interact in the glucogenesis stage of ingestion!

Hope that makes sense!
 
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doriandun

Newbie
Messages
2
The issue is not that the pancreas creates to much insulin, the problem is the glucose and insulin, combination have no where to go as your cells have closed it doors and will not let next to nothing in, as a result of the impending threat of sugar.

If the walls come down, the sugar, enters your organs and damages them,in it's current state, so the focus should be on, initially removing sugar from the diet, thus lowering the glucose levels in the blood stream, and finding a way to open the cells.....once the cells are open, and if you continue to eat properly, the body will heal it self and regain a self of equilibrium.


also what you will find is that tea, as well as cigarettes do have an effect on blood sugar [try smoking two cigarettes within a few minutes of each other], the food list above is correct, but i would add increase your omega 3, from linseed, and fish like sardines and salmon, today i eat two to three times a day, i can wake up in the morning 6am, take a handful of linseed, don't eat nothing till 10 to 11am, or even mid day sometimes, morning is usually spent taxing the brain, maybe if i was exerting myself more physically, i would be inclined to eat earlier, the tip about the exercise i agree with.

if i am indulging in meat, lamb and beef seem to balance blood sugar, better than chicken
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
It is different for each of us but the underlying result is Hyperinsulinaemia.
Wether it's excessive or just an imbalance caused by the first insulin response, glucose dumping or the second insulin response which is Late RH.
Then there is T2s who have RH because of the high insulin resistance. And then the pancreas tries to balance in high glucose levels by swamping the amount of glucose with insulin.
The bodies chemistry alters during digestion, the necessary glucagon is imbalanced. The gut brain trigger system alters the bodies response to food that we have an intolerance to.

I agree with your suggestions, as this was posted quite some time ago.
I could include certain fasting regimes that some RH ers have had great success and also some recipes that are great for allowing you not to spike.
I could also mention ketosis.
I could also mention the recent discussions on how me and @Brunneria have discussed how we have changed our lifestyle since the time of writing.

But isn't that what threads are for?

Anyway, welcome to our forum. Someone else's opinion and how they deal with the condition is always worth reading. You never stop learning.

Best wishes.
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Oh yeah!
Since being in total control, I don't have the insulin problems.
I don't have insulin resistance.

You stop the pancreas creating the insulin, no hyper.
You stop the hyper, you don't get the hypo!

But, even if I didn't have insulin resistance, I would still hypo, the last this happened was during an eOGTT. I didn't have insulin resistance then or no glucose insulin imbalance. My second insulin response is still there despite being in ketosis for more than three years.
 

Tarajeano

Newbie
Messages
3
Type of diabetes
Other
Treatment type
Other
My 15 month old has been displaying every single warning symptom of type 1 diabetes. ..except I preformed a random glucose the other evening and she was 82. But shes been consistently ill, fatigued (which I attributed to being under the weather) she's either got little to know appetite, but drinks constantly, or she wants to eat everything in site 24/7. She's got a yeast diaper rash. She no longer has been sleeping through the night--she used to go to bed 7-8p, wake once maybe to have a bottle or breast, and return to sleep until 630a. Now she's been up every couple hours, begging for a bottle, also nursing, and then wanting another bottle...appearing a bit out of it (for example she freaked out one night about her bottle, it was in front of her, but she acted as though she wasn't able to see it). She's been EXTREMELY moody and easily irritable, and it comes out of nowhere. She's restless, tossing and turning. She used to MAYBE need her diaper changed once thru the night, if she woke. Shes now been urinating thru her diapers, or I'm changing a full diaper every time she wakes.
She had what I think was a moderate reaction to eggs the other day, and then almond milk the next, where she got flushed in the face, disoriented, off balance, itchy, lethargic, wheezy, but yet wanting to eat. her hand are like ice more than not, shes been congested and having cold symptoms for almost a month. She has been taken off dairy due to chronic ear infections (shes had ten now, three of which happend AFTER having tubes placed.
She had what I think was a moderate reaction to eggs the other day, and then almond milk the next, where she got flushed in the face, disoriented, off balance, itchy, lethargic, wheezy, but yet wanting to eat. I keep mentioning to my mother that I think it's a possibility of diabetes (she's an RN). She tells me I'm overreacting and reading too far into things. And then the glucose test of 82 sealed the deal for her.
My question is, how soon after symptoms present that you'll see the telltale glucose reading? Is it possible to have a "normal" reading during the beginning onset of symptoms? How did those diagnosed at a young age present that made your parents or physician test for diabetes?d keep mentioning to my mother that I think it's a possibility of diabetes (she's an RN). She tells me I'm overreacting and reading too far into things. And then the glucose test of 82 sealed the deal for her.
My question is, how soon after symptoms present that you'll see the telltale glucose reading? Is it possible to have a "normal" reading during the beginning onset of symptoms? How did those diagnosed at a young age present that made your parents or physician test for diabetes? Could RH be the culprit?
 

Juicyj

Expert
Retired Moderator
Messages
9,018
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
Hypos, rude people, ignorance and grey days.
Hello @Tarajeano You are replying to an old thread here, can I post a new thread for you ? BTW your reading is non diabetic, it's equivalent to 4.5mmol/l here in the UK which is nothing to worry about - however she should be seen by a doctor to rule out other causes.
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
The issue is not that the pancreas creates to much insulin, the problem is the glucose and insulin, combination have no where to go as your cells have closed it doors and will not let next to nothing in, as a result of the impending threat of sugar.

If the walls come down, the sugar, enters your organs and damages them,in it's current state, so the focus should be on, initially removing sugar from the diet, thus lowering the glucose levels in the blood stream, and finding a way to open the cells.....once the cells are open, and if you continue to eat properly, the body will heal it self and regain a self of equilibrium.


also what you will find is that tea, as well as cigarettes do have an effect on blood sugar [try smoking two cigarettes within a few minutes of each other], the food list above is correct, but i would add increase your omega 3, from linseed, and fish like sardines and salmon, today i eat two to three times a day, i can wake up in the morning 6am, take a handful of linseed, don't eat nothing till 10 to 11am, or even mid day sometimes, morning is usually spent taxing the brain, maybe if i was exerting myself more physically, i would be inclined to eat earlier, the tip about the exercise i agree with.

if i am indulging in meat, lamb and beef seem to balance blood sugar, better than chicken

Hi, I agree with the last post, you must take your little one to your GP or paediatric specialist.
I have heard of childhood hypoglycaemia and you do get big fluctuations from normal blood sugar levels. They mostly grow out of the condition.

Do see someone about your worries.

Best wishes
 

Ian_Laye

Well-Known Member
Messages
296
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
I don't see how she could have a diabetic reaction to unsweetened Almond milk because it is zero carb.
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
I don't see how she could have a diabetic reaction to unsweetened Almond milk because it is zero carb.
Even some zero carb foods produce insulin.
Not sure about almond milk tho!
 
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi everyone, i have been having type 2 diabetic for 6 years, my average a1c is around 6.5, although recently 6 months being 7.2, my main problem is since i hav depression and anxiety besides diabetes, sometimes i worry if i can take a job because of hypoglycemia, although i know i can take some snacks to work, but i still sometimes worry, does anyone has similar situations
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi everyone, i have been having type 2 diabetic for 6 years, my average a1c is around 6.5, although recently 6 months being 7.2, my main problem is since i hav depression and anxiety besides diabetes, sometimes i worry if i can take a job because of hypoglycemia, although i know i can take some snacks to work, but i still sometimes worry, does anyone has similar situations

I would ask your GP to refer you to a councillor with your anxiety and depression.
Have you tested your blood glucose levels and found that you are low?

My anxiety was a severe symptom of my Hypoglycaemia and my glucose levels were in fluctuating levels at that time, the more I didn't have blood glucose levels control the worse the anxiety.
Since then, I have not had the symptoms because of being in ketosis and not having the fluctuations in blood glucose levels.

Best wishes
 
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Thank you for your comments and I am already seeing a psychiatrist for the depression and anxiety, i think sometimes it does help me when I test my blood sugar on a regular basis. When the results are staying in the regular or high end, i tend to think i don't have hypoglycemia, but those are at home results. When i walk outside i think i need to carry the testing pouch too to check the blood sugar too, and carry some kind of candy or snack just to be on the safe side. Thanks for sharing your story and it helps when i know i am not the only one dealing with diabetes and anxiety
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
I started a thread in the Emotional and Mental health forum.
It gives an explanation of why anxiety and depression is associated with diabetes.

Patients with a high level of circulating insulin, can have symptoms described by you.
Fluctuating blood glucose levels can trigger insulin when too many carbs and sugars are eaten. Having high spikes is not recommended.
If you are on meds, that could be causing the lows, or you could be having false hypos, which is the awful symptoms you can get, when you have a sudden drops in blood glucose levels.

Use your glucometer when you feel low again, any level above four and six mmols is in normal range. Any reading below 3.5 is definitely a hypo. And then you treat it properly. Try and avoid to not spike to high or you will get a rebound effect.

Best wishes
 
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Thank you ,Lamont, For all the knowledge and kind words, i will definitely check my blood sugar with the glucometer on a regular basis and check the numbers, you are right if i have too much carbs, as i eat white rice on a regular basis, which I shouldn't, it will cause high spikes, and then drop down , thank you for everything.
 
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Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Thank you ,Lamont, For all the knowledge and kind words, i will definitely check my blood sugar with the glucometer on a regular basis and check the numbers, you are right if i have too much carbs, as i eat white rice on a regular basis, which I shouldn't, it will cause high spikes, and then drop down , thank you for everything.
No worries,
If you start a food diary, recording as much as possible, for instance. What you eat and when, drink, portion size, exercise, then your blood glucose levels before meals, then after two hours. And anything pertinent to how you are doing.
Any tests, hba1c levels, fasting levels.
Anything that is relevant.

I have had one for over six years, it helped with my diagnosis, and how much my doctors, dsns didn't know about what was going on.

It helps with seeing trends and improvements in your results, it also gives you a reminder if you don't control your diabetes.

Things will improve if you follow the advice on how to control your blood glucose levels.

Best wishes
 
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi Lamont, thanks again for everything, i am taking a training course for hha, home health aid, right now. This morning I only had a small bowl of oatmeal, then dueing class time, i got hungry by 11 o'clock, I guess i should have eaten more. Then i had a huge lunch today, i am afraid that i might get hungry again later before class ended, anyway, i measured my blood sugar before lunch at 11, it was 135, but i was already feeling hungry. I will bring snacks during meals to offset the before meal hungrynrss