Can a person suffer from both Reactive Hypoglycaemia and Postprandial hyperglycaemia?

[Glycemic]

Lately i'm finding that i'm getting the shakes at 6.5 6.6 and when i eat i also feel much better. This is also as well as when going down to 3.8 or below i get the other symptoms also.
Very confused right now.

 

[Lamont D]

Lately i'm finding that i'm getting the shakes at 6.5 6.6 and when i eat i also feel much better. This is also as well as when going down to 3.8 or below i get the other symptoms also.
Very confused right now.

The answer to your top line question is yes!
I think this is why I was misdiagnosed in 2009 with T2.
And also my current predicament, as because of my mental health issues, I tend to eat too much, and too much protein at once can cause a spike! And three months ago I was told I had just sneaked into diabetic levels, and needed to sort it out. Which I have. I have this week had my bloods done to see if I have. My fasting BG average is in prediabetic levels, around 6.2-6.6.
When someone has all the symptoms of T2, and having sugar crashes, but never get a true diagnosis of what is happening and they could be having hypos, it is common that doctors would miss this.
I think I have mentioned the person that helped me so much on here when I was first diagnosed. The doctors missed all of her symptoms, except the hyperglycaemia, and because of this her Diabetes became apparent.
She has T2 and also had RH.
That is inevitable unless you can control the RH. Because of the insulin resistance, then the high circulating insulin and in some cases including myself, I had hyperinsulinimia, hyperglycaemia and hypoglycaemia.
Madness I know, but that is how my weight ballooned.
The first couple of months lowering your carbs, is tough and the symptoms persist but this is possibly good news that you may becoming more sensitive to lower normal levels, hypo sensitivity is crucial to give a warning to avoiding the symptoms and the crash itself.
Beware the rebound effect, sometimes a low carb bite or two will minimise the symptoms and help your BG levels or stop the hypo. But too much will spike you too high and start the reaction again.
It is confusing and it is not easy, I know that and been through it, for me going low carb and intermittent fasting, helps me so much!
Hope you are feeling better now.
Best wishes.

 

[Glycemic]

The answer to your top line question is yes!
I think this is why I was misdiagnosed in 2009 with T2.
And also my current predicament, as because of my mental health issues, I tend to eat too much, and too much protein at once can cause a spike! And three months ago I was told I had just sneaked into diabetic levels, and needed to sort it out. Which I have. I have this week had my bloods done to see if I have. My fasting BG average is in prediabetic levels, around 6.2-6.6.
When someone has all the symptoms of T2, and having sugar crashes, but never get a true diagnosis of what is happening and they could be having hypos, it is common that doctors would miss this.
I think I have mentioned the person that helped me so much on here when I was first diagnosed. The doctors missed all of her symptoms, except the hyperglycaemia, and because of this her Diabetes became apparent.
She has T2 and also had RH.
That is inevitable unless you can control the RH. Because of the insulin resistance, then the high circulating insulin and in some cases including myself, I had hyperinsulinimia, hyperglycaemia and hypoglycaemia.
Madness I know, but that is how my weight ballooned.
The first couple of months lowering your carbs, is tough and the symptoms persist but this is possibly good news that you may becoming more sensitive to lower normal levels, hypo sensitivity is crucial to give a warning to avoiding the symptoms and the crash itself.
Beware the rebound effect, sometimes a low carb bite or two will minimise the symptoms and help your BG levels or stop the hypo. But too much will spike you too high and start the reaction again.
It is confusing and it is not easy, I know that and been through it, for me going low carb and intermittent fasting, helps me so much!
Hope you are feeling better now.
Best wishes.

Thank you for your reply, I have to admit that it's quit the struggle at the moment.

 

[Lamont D]

Thank you for your reply, I have to admit that it's quit the struggle at the moment.

It does get better soon.
Your body will still be adapting and that takes time.
Be safe. Take care. Best wishes.

 

[Glycemic]

Yesterday i saw my endocrinologist she wants me to go into hospital to a 78 plus hour glucose test where i will have nil by mouth and they will try to induce a hypo under clinical studies. She wants to rule out pancreatic cancer, adrenal and cortisol induced hypoglycaemia and other possible factors/reason for my hypos. She said that i was a complicated case that she's not seen before because my symptoms appear at both ends of the spectrum. (both low blood sugar and high blood sugar) I have to be honest she scared the living daylights out of me and has me a little concerned. I also have to go in this morning at 8am for a blood test to check my cortisol levels to make sure that my hypos are not related to stress via cortisol/adrenals. (fight or flight hormones) This is quite scary when you live alone. I'm trying to take all this under the chin and plod along as there's nothing much i can do until i get a proper diagnoses. And then try to live with it. At the moment it's been really hard trying to cope with all the symptoms and trying to live my life the best way i know how to.

 

[Lamont D]

Yesterday i saw my endocrinologist she wants me to go into hospital to a 78 plus hour glucose test where i will have nil by mouth and they will try to induce a hypo under clinical studies. She wants to rule out pancreatic cancer, adrenal and cortisol induced hypoglycaemia and other possible factors/reason for my hypos. She said that i was a complicated case that she's not seen before because my symptoms appear at both ends of the spectrum. (both low blood sugar and high blood sugar) I have to be honest she scared the living daylights out of me and has me a little concerned. I also have to go in this morning at 8am for a blood test to check my cortisol levels to make sure that my hypos are not related to stress via cortisol/adrenals. (fight or flight hormones) This is quite scary when you live alone. I'm trying to take all this under the chin and plod along as there's nothing much i can do until i get a proper diagnoses. And then try to live with it. At the moment it's been really hard trying to cope with all the symptoms and trying to live my life the best way i know how to.

I think I have mentioned that I spent more than 80 hours in hospital for my fasting test.
Do not worry the first eight hours or so are overnight at home, then around 8am, you arrive get tested, get your bed, then every two hours your blood gets tested, even during the night. You will get ice chips, told to do some walking, you have the rest of the time, to do what you please. I did a lot of reading, other than walking and sleeping. Also had a television.
Once the second day dawned I found it a bit relaxing and quiet, I was able to explore around and talk to people. And of course family visited.
They are looking to see if you go hypo, on a long fast.
And I agree, that the cortisol/adrenal are tested.
It is a succession of tests to rule out every condition other than Late Reactive Hypoglycaemia.
That is what happened to me!
I will say something stupid like don't worry, but I know you will, but it's a necessary progression of diagnosis.
If this results, like me, in a true diagnosis, getting the treatment right may be more important.

Do let us know, I believe they do have the internet down under in hospitals.

Best wishes.

 

[Glycemic]

I think I have mentioned that I spent more than 80 hours in hospital for my fasting test.
Do not worry the first eight hours or so are overnight at home, then around 8am, you arrive get tested, get your bed, then every two hours your blood gets tested, even during the night. You will get ice chips, told to do some walking, you have the rest of the time, to do what you please. I did a lot of reading, other than walking and sleeping. Also had a television.
Once the second day dawned I found it a bit relaxing and quiet, I was able to explore around and talk to people. And of course family visited.
They are looking to see if you go hypo, on a long fast.
And I agree, that the cortisol/adrenal are tested.
It is a succession of tests to rule out every condition other than Late Reactive Hypoglycaemia.
That is what happened to me!
I will say something stupid like don't worry, but I know you will, but it's a necessary progression of diagnosis.
If this results, like me, in a true diagnosis, getting the treatment right may be more important.

Do let us know, I believe they do have the internet down under in hospitals.

Best wishes.

Thank you. I'll keep you up to date with what happens and the final results. Just waiting to get the hospital invite. Again, very scary.

 

[Lamont D]

Thank you. I'll keep you up to date with what happens and the final results. Just waiting to get the hospital invite. Again, very scary.

One of the things I found interesting was the behind the scenes people and places in a hospital. I had never been a patient overnight in a ward. Yeah the kids in hospital when young and the wife in maternity. But it was different, and I couldn't help myself not to explore, experience what happens.
And even if, I could, I wouldn't or couldn't eat the food on offer! Trying to describe it, well, not for me! Never mind the carbs but everything steamed or boiled. Not a decent piece of meat, or a salad worthy of its name!
And I will repeat that the bacon and eggs after in the hospital restaurant was heaven on earth!
Try and enjoy the experience, you will probably get a room to yourself, but that doesn't mean you have to stay in there!!!!!
Best wishes.

 

[Glycemic]

Update:
Last Friday had a cortisol test. Something must have come up in the test because i am now booked in for a short synacthen test next Tuesday. I don't want to assume or get a head of myself but this either leads to Addison's disease or a problem with the pituitary gland/ adrenals.

 

[MarthaD]

I've been getting hypos for years and was also diagnosed with T2 a year ago. I've been shouting into a void for years about my hypos, but now that I self test, I can finally show evidence of them. At a recent hospital appointment, the doctor said I'm likely to have T2 and RH together, which is apparently quite unusual. They tested for LADA and MODY as a precaution. No results yet, but I've a referral to a dietician. Currently have a BMI of 22 and have lost a stone this year just from glucose running too high. Feels like a minefield right now.

 

[Glycemic]

I've been getting hypos for years and was also diagnosed with T2 a year ago. I've been shouting into a void for years about my hypos, but now that I self test, I can finally show evidence of them. At a recent hospital appointment, the doctor said I'm likely to have T2 and RH together, which is apparently quite unusual. They tested for LADA and MODY as a precaution. No results yet, but I've a referral to a dietician. Currently have a BMI of 22 and have lost a stone this year just from glucose running too high. Feels like a minefield right now.

Martha,
I'm so sorry that you are going through all this pain. I can sympathize. It's not easy at this stage to control especially when there's no rhyme or reason as to why our BC rises and falls with symptoms at both ends of the spectrum.

Sometimes it renders me so fatigued that i can't do anything and that alone frustrates me.

Good luck in finding answers.

 

[MarthaD]

Martha,
I'm so sorry that you are going through all this pain. I can sympathize. It's not easy at this stage to control especially when there's no rhyme or reason as to why our BC rises and falls with symptoms at both ends of the spectrum.

Sometimes it renders me so fatigued that i can't do anything and that alone frustrates me.

Good luck in finding answers.

Thank you. Same to you. It is exhausting swinging from high to low to high!

 

[Lamont D]

I've been getting hypos for years and was also diagnosed with T2 a year ago. I've been shouting into a void for years about my hypos, but now that I self test, I can finally show evidence of them. At a recent hospital appointment, the doctor said I'm likely to have T2 and RH together, which is apparently quite unusual. They tested for LADA and MODY as a precaution. No results yet, but I've a referral to a dietician. Currently have a BMI of 22 and have lost a stone this year just from glucose running too high. Feels like a minefield right now.

Hi and believe it or not, I have RH and also spells when because of many reasons had both RH and T2!
A person who taught me a lot about RH, has always had both.
There are those who have T2 and have symptoms of RH often or seldom.
The difference is that RH is a condition where the hypos will occur regardless after eating food that trigger the reaction and the body produces too much insulin.
You have done great showing your doctor. Is he a specialist endocrinologist? If not I would ask to be referred to one.
Only tests can give you a diagnosis, but in the meantime, I would advise looking at the RH forum, to get a sense of what you could be doing to help with your situation. I hope since your initial diagnosis of T2, that dietary changes are helping. And you mentioned a dietician. If in mind experience, you get one that maintains a carb laden diet, obviously doesn't understand the conditions of either T2 or RH.
The reason will be it is quite rare and the doctors, dsns and dietician follow the guidelines!
If I had followed that advise, I would be really ill with hypoglycaemia all the time.
Having RH, is really carb intolerance.
Keep asking questions, keep recording, use your food diary and I hope you get the tests you need.
Best wishes

 

[Lamont D]

Update:
Last Friday had a cortisol test. Something must have come up in the test because i am now booked in for a short synacthen test next Tuesday. I don't want to assume or get a head of myself but this either leads to Addison's disease or a problem with the pituitary gland/ adrenals.

But you are getting answers, and then you can move on and sort it out.
Hope things go well for you!
Best wishes.

 

[MarthaD]

Hi and believe it or not, I have RH and also spells when because of many reasons had both RH and T2!
A person who taught me a lot about RH, has always had both.
There are those who have T2 and have symptoms of RH often or seldom.
The difference is that RH is a condition where the hypos will occur regardless after eating food that trigger the reaction and the body produces too much insulin.
You have done great showing your doctor. Is he a specialist endocrinologist? If not I would ask to be referred to one.
Only tests can give you a diagnosis, but in the meantime, I would advise looking at the RH forum, to get a sense of what you could be doing to help with your situation. I hope since your initial diagnosis of T2, that dietary changes are helping. And you mentioned a dietician. If in mind experience, you get one that maintains a carb laden diet, obviously doesn't understand the conditions of either T2 or RH.
The reason will be it is quite rare and the doctors, dsns and dietician follow the guidelines!
If I had followed that advise, I would be really ill with hypoglycaemia all the time.
Having RH, is really carb intolerance.
Keep asking questions, keep recording, use your food diary and I hope you get the tests you need.
Best wishes

This is really helpful. Thank you. It's because of other posts of yours that I pursued looking at RH with the doctor. Haven't had a test though so I'll fight for one.

 

[Lamont D]

This is really helpful. Thank you. It's because of other posts of yours that I pursued looking at RH with the doctor. Haven't had a test though so I'll fight for one.

Thanks for that, and I do appreciate that I'm helping those who have ended up in like I did with RH.
I want to stress the use of a food diary.
If you write or keep a record of your meals, portion size, carb content and pre and 2 hour after blood glucose readings.
You can see which foods are causing the rollercoaster bloods readings!
As RH is nearly all about which foods you eat, the knowledge you can glean and learn about, will help. Not only that, as your meals are often repeated, you can see the trends, as your control starts and you start avoiding the foods.
And then of course, show your doctor, dsns, dietician the results, which will show, it is, why you go hypo and have an intolerance to certain foods.
Are you on other meds than metformin, which I was told by my endo, to stop?
I have just realised that we have already had a post or two, so if I have gone over things twice, I'm sorry!
Best wishes.
Let us know how you get on.

 

[MarthaD]

I'm only on metformin at the moment. Being brought back a follow-up in the next month or so... and happy to hear things more than once - more chance of me remembering!

 

[Lamont D]

I'm only on metformin at the moment. Being brought back a follow-up in the next month or so... and happy to hear things more than once - more chance of me remembering!

I would ask your GP, if the metformin has an effect on your insulin response. And could you lower the dosage with a view to stop.

I would imagine, if he doesn't know if it does (it did for me) th the advice will be to carry on.

 

[SJElsey]

The answer to your top line question is yes!
I think this is why I was misdiagnosed in 2009 with T2.
And also my current predicament, as because of my mental health issues, I tend to eat too much, and too much protein at once can cause a spike! And three months ago I was told I had just sneaked into diabetic levels, and needed to sort it out. Which I have. I have this week had my bloods done to see if I have. My fasting BG average is in prediabetic levels, around 6.2-6.6.
When someone has all the symptoms of T2, and having sugar crashes, but never get a true diagnosis of what is happening and they could be having hypos, it is common that doctors would miss this.
I think I have mentioned the person that helped me so much on here when I was first diagnosed. The doctors missed all of her symptoms, except the hyperglycaemia, and because of this her Diabetes became apparent.
She has T2 and also had RH.
That is inevitable unless you can control the RH. Because of the insulin resistance, then the high circulating insulin and in some cases including myself, I had hyperinsulinimia, hyperglycaemia and hypoglycaemia.
Madness I know, but that is how my weight ballooned.
The first couple of months lowering your carbs, is tough and the symptoms persist but this is possibly good news that you may becoming more sensitive to lower normal levels, hypo sensitivity is crucial to give a warning to avoiding the symptoms and the crash itself.
Beware the rebound effect, sometimes a low carb bite or two will minimise the symptoms and help your BG levels or stop the hypo. But too much will spike you too high and start the reaction again.
It is confusing and it is not easy, I know that and been through it, for me going low carb and intermittent fasting, helps me so much!
Hope you are feeling better now.
Best wishes.

Hi you sound like you also have been battling with low carbs, even with low carbs I cannot get my BS down, I have Steroid induced Type 2 so if I wasn’t on them I would not have it at all but after 40 years of Steroids I have it but was never told this could happen, I lost so I h weight and then it was diagnosed, so low weight and always hungry as I do get Hypoglycaemia as well and need to eat but then up go the BS again, fasting I am normal, as normal goes between 5 and 6 the take meds and by lunch time its up to 16to17 then comes back down late evening to around 9 to 11 it does a circle each day, I am always finger pricking but dont know why I bother, I do not know anyone else with Steroid inch Type 2 to chat to.

 

[MarthaD]

I would ask your GP, if the metformin has an effect on your insulin response. And could you lower the dosage with a view to stop.

I would imagine, if he doesn't know if it does (it did for me) th the advice will be to carry on.

I was taken off it as a test over the summer and my HBA1C jumped significantly without changes to my diet so I think it's doing something.