Am I suffering from Reactive Hypo?

[MancJules]

Hi, I was diagnosed type 2 diabetic back in April and so far I've been trying to tackle it with diet only as per doc's instructions. I've lost nearly a stone in weight, am not on meds and don't monitor my blood sugar at all. I've not got the greatest diet really but I'm trying to get healthy.

The last couple of months I've been getting night time hypos. Or at least that's what I thought they might be. The first time I hadn't eaten a proper evening meal and woke up in the early hours after a couple of nasty nightmares. I felt really woozy and shaky. Fortunately I had some chocolate pretzels lying around so I ate those. A couple of people advised me to keep some lucozade in and to have about 100ml if I was having a hypo.

I had another, milder one a few weeks later and treated it with the lucozade.

Last night I had the worst one. Woke up from a really horrible dream about 2am and felt woozy and shaky again. Had some lucozade and peanut butter. I'd eaten fairly normally the day before (didn't miss any meals) though possibly a little carb heavy. I had a crumpet and butter about 11pm as I felt hungry. I felt fairly fragile this morning so had a couple of crumpets for breakfast. Diet again today has been a bit carb-heavy as I've been feeling dizzy all day so I thought my blood sugar was still low. I still feel dizzy now.

So I've been looking around online for causes & how to prevent night time hypos and the general gist seems to be that its very unusual for me to be having a normal hypo as I'm not on meds. I've looked at a couple of threads about Reactive Hypo which I'd never heard of before. Needless to say I'm rather bombarded with info and not sure what to do next.

Given that I'm feeling dizzy right now, what do I do? I've just had my evening meal which was some veg tagine which has approx 1/2 dessertspoon of honey and 1/2 tsp of sugar in as well as chopped tomatoes, butternut squash (or sweet potato? - I didn't make it)

Does it sound like I'm suffering from reactive hypo? How do I stop it happening again? I was going to try cutting down on bread but should I cut down on all carbs? Should I be speaking to my doc/ diabetic nurse about it? (Is that a stupid question?)

I don't want to have another one. Last night was awful.

 

[AndBreathe]

Hi, I was diagnosed type 2 diabetic back in April and so far I've been trying to tackle it with diet only as per doc's instructions. I've lost nearly a stone in weight, am not on meds and don't monitor my blood sugar at all. I've not got the greatest diet really but I'm trying to get healthy.

The last couple of months I've been getting night time hypos. Or at least that's what I thought they might be. The first time I hadn't eaten a proper evening meal and woke up in the early hours after a couple of nasty nightmares. I felt really woozy and shaky. Fortunately I had some chocolate pretzels lying around so I ate those. A couple of people advised me to keep some lucozade in and to have about 100ml if I was having a hypo.

I had another, milder one a few weeks later and treated it with the lucozade.

Last night I had the worst one. Woke up from a really horrible dream about 2am and felt woozy and shaky again. Had some lucozade and peanut butter. I'd eaten fairly normally the day before (didn't miss any meals) though possibly a little carb heavy. I had a crumpet and butter about 11pm as I felt hungry. I felt fairly fragile this morning so had a couple of crumpets for breakfast. Diet again today has been a bit carb-heavy as I've been feeling dizzy all day so I thought my blood sugar was still low. I still feel dizzy now.

So I've been looking around online for causes & how to prevent night time hypos and the general gist seems to be that its very unusual for me to be having a normal hypo as I'm not on meds. I've looked at a couple of threads about Reactive Hypo which I'd never heard of before. Needless to say I'm rather bombarded with info and not sure what to do next.

Given that I'm feeling dizzy right now, what do I do? I've just had my evening meal which was some veg tagine which has approx 1/2 dessertspoon of honey and 1/2 tsp of sugar in as well as chopped tomatoes, butternut squash (or sweet potato? - I didn't make it)

Does it sound like I'm suffering from reactive hypo? How do I stop it happening again? I was going to try cutting down on bread but should I cut down on all carbs? Should I be speaking to my doc/ diabetic nurse about it? (Is that a stupid question?)

I don't want to have another one. Last night was awful.

You need to test, as what you describe could be due to lots of things, including high sugars.

I started testing, almost as soon as I was diagnosed, but in your shoes, I'd be heading back to my Doc, so that he/she is aware of your symptoms. With luck, on the basis of your symptoms, he/she may prescribe you a meter and strips.

Either way, control of diabetes, and reactive hypoglycaemia is best achieved by adopting a diet with fewer carbs than your common or garden non-diabetic person.

I'll tag @Brunneria as he does have reactive hypoglycaemia, and may have something insightful to add. Good luck with it all.

 

[Brunneria]

Hi, and welcome.

As you know, we cant diagnose anything on here. And it could be a lot of things, at this stage, including panic attacks and hot flushes But there are a couple of quick and easy ways to test the RH theory.

Evening 1: have a high protein meal with veg and fat, but no carbs. Something like steak, salad and mayo. Or baked salmon, low carb cauli cheese and green beans.
(Are you vegetarian? If so, low carb cauli cheese with veg) no pud. If you need a snack before bed, then have a spoon of peanut butter, cold meat, nuts, cheese.

Evening 2: repeat your carb heavy evening, ending with the crumpet.

If you are fine with 1 and have a repeat of your shaking and weirdness with 2, then it is definitely worth investigating the RH avenue. Although if you have read any of the RH threads you will probably realise that it can be a bit of a struggle to get your doc on board.

Either way, i would suggest is that you get yourself a meter (SD Codefree is the cheapest to run that I've seen) and start testing blood glucose. I would advise it for any type 2, because it is the best way to hammer out a personal diet that you have designed perfectly for your body.

Congrats on the weight loss by the way!

 

[Brunneria]

Oh, and one more thing.
Speaking as an established reactive hypoglycaemic, that 100ml lucozade is the WORST thing to take.

It is marvellous for type 1diabetics, and type 2s on strong meds.
For RHers, all it achieves is a quick high then a plunge back into hypo-land, with the beginnings of a vicious cycle.

If you stick with the lucozade, then have 50 mls - no more - and follow with something slow release. Nuts, cheese, cold meat. So that you get a quick rise, but it wont be high enough to trigger a big insulin release. Then the slow release from the food will catch you if you start to drop again.

My personal recommendation for anyone hypoing is to not rely on glucose for the full cure. Just get out of the hypo and eat proper food. A meal. Protein and fat. But (as you can tell) I'm a low carber, so it makes no sense to me to bounce around with highs and lows when you can stay level and steady.

Hope that helps.

 

[MancJules]

Thanks ever so much to both of you. That info is great. I've been trying to reduce my carb intake anyway recently. I'll try the test you suggested Brunneria. I did have some peanut butter with the lucozade last night to prevent another hypo. I might get some more if its a good general snack to have to keep my blood sugar levels steady. I meant to ask about snacks so thanks for those suggestions too.

And I will speak to the doc and get myself a testing kit.

 

[Lamont D]

If you really do think you are having hypos and are hypoglycaemic, then you need to eat little and often all through the day, with as few carbs as possible, portion size is really important.
As eating just a bite or two every two to three hours will prevent them.
I wouldn't use so much carbs to treat a hypo!

 

[Brunneria]

When you buy your peanut butter, have a look at the nutrition on the label.
You are looking for the brand with the lowest carb levels. Don't look at the sugar, just focus on the carbs.

Glad we could help.

 

[AndBreathe]

Thanks ever so much to both of you. That info is great. I've been trying to reduce my carb intake anyway recently. I'll try the test you suggested Brunneria. I did have some peanut butter with the lucozade last night to prevent another hypo. I might get some more if its a good general snack to have to keep my blood sugar levels steady. I meant to ask about snacks so thanks for those suggestions too.

And I will speak to the doc and get myself a testing kit.

I think you've had great advice here, but in reality, you have no real idea what's going on, and in my view, you won't until you know what your bloods are doing at these times.

Many people, when reducing their carbs get false hypos, which are hypo-type symptoms, but when their actual blood scores are not in the hypoglycaemic range. Usually, this is something the individual has to learn to work through, to get the carbs/bloods ratios into an acceptable place.

In my view, just carbing up, when you feel a bit iffy is potentially just confusing matters, and may not be helping your longer term health. Again, in my view, you need to acquire a meter, and maybe even a blood pressure monitor, in order to properly assess what's going on.

Please do see your doc or nurse.