Had My Diabetes Clinic Today Following The Low Blood Sugar Test

[Aldebaran]

So if she had a car accident and killed someone after being tested as 2.2 I would very much hope the DVLA and police would throw the book at her (or anyone else that did the same). DVLA advice is diabetics need to be 5 to drive regardless of type.

Hang on here!! Your posts have reached an uncomfortable tone. You are assuming way too much. I've been extremely descriptive of what has happened and how I've felt and for the record I'll say it again. I have never..never had the symptoms of Hypoglycemia. I have had no cause to react or repeatedly test. I have done what has been required of me and it is the medical team that have left me wondering what is happening. Would you want everyone tested before they touch the wheel? Am I supposed to test every time I get into a car? I don't appreciate anyone assuming that I'm a careless person who disregards the safety of myself and more importantly others out there. That is out of order and completely false. If you would like to fund the finances for me to buy innumerable test strips and lancets so that I could then dare to venture out in the car then go ahead. Your argument doesn't make any sense. You're personally attacking me when you clearly don't know the situation or who I am. I'm neither flippant or glib when I post but I am genuinely concerned and worried. If I didn't care, I wouldn't have asked in the first place. Assumptions solve nothing.

 

[Aldebaran]

Because its reckless that's why. The point is OP did know her supposed bg levels as did her HCP.

And honestly they probably should have them and know how to use them - how is it any different to driving drunk and they carry breathalysing equipment!

And again, I did NOT know my BG levels. It was the doctors surgery that informed me of the 2.2. I have acted on this and when I've tested myself, my bloods have been in the normal range..nowhere near the 2's. I am not sure how many times I've got to say this to you..I have never had the symptoms of Hypoglycemia!

 

[Aldebaran]

Sorry but you have no idea how the OP felt when her blood was that low. Mine will probably be in the mid to low 3's tomorrow after fasting for 3 days. I will be perfectly ok I will not be hypoing just having regular/"normal" blood sugar levels.

That is it bulkbiker. I have felt fine. If I hadn't, I would have asked the doctors about this as I know from others who've got Hypoglycemia, that it's frightening and when they're severe enough, you can't function properly. And because I'm at the Perimenopause age, I do get dizzy spells, etc, and when this has happened, I've tested my blood sugars and they've been normal. It seems that no matter how many times I say this, it's become a case of me finding more benefit in banging my head against a wall. Thank you for all your help. I really appreciate it.

 

[kokhongw]

We don't experience hypo during low glucose when there is adequate ketones because ketones are neuro protective.

This is a rather typical scenario

This is from a 1988 study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC329619/

And this 2009 study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671041/

 

[kokhongw]

Dr Keith Runyan (T1D on ketogenic diet) has just blog about hypoglycemia recently
https://ketogenicdiabeticathlete.wo...-diabetes-mechanisms-avoidance-and-treatment/

This section may be relevant:-

Can Nutritional Ketosis Provide An Alternate Brain Fuel And Protect Us From Hypoglycemia?

Another topic of research that needs to be done is to measure the degree to which ketones created by the liver by following a ketogenic diet can act as a brain fuel and lead to a reduction in or lack of symptoms of hypoglycemia in those with T1DM. We know from the study done by Drenick et. al. (ref 9) that in non-diabetic obese persons who fasted for 2 months and achieved blood beta-hydroxybutyrate (BHB) levels of 8 mM when given a single dose of insulin to induce severe hypoglycemia suffered no symptoms despite BG values as low as 9 mg/dl (0.5 mmol/l). However, the applicability of this study to those with diabetes following a ketogenic diet is questionable given that the BHB levels are typically in the 0.5 to 3 mM range from nutritional ketosis. Another study (ref 10) in rats found that the cerebral metabolic rate of glucose decreased by 9% for each 1 mmol/l increase in total plasma ketone body concentration in ketotic rats induced by 3 weeks of a ketogenic diet. “The brain’s ability to switch from glucose oxidation towards ketone bodies requires a type of ‘cerebral metabolic adaptation’. This process is not well understood but is thought to be highly associated with the duration and level of ketosis. Ketones are considered to supply up to 70% of the total energy demands once maximal metabolic adaptation occurs.” Another study (ref 11) of 8 healthy male students found that mental alertness was significantly reduced by moderate hypoglycemia (40 mg/dl or 2.2 mmol/l) after an overnight fast while similar hypoglycemia did not reduce mental alertness after a 72 hour fast. BHB levels were not reported in the abstract (I did not purchase the full article). Finally in this study (ref 12), the effect of hyperketonemia on counter-regulatory hormone responses to hypoglycemia was examined in six healthy subjects. The peak adrenaline (epinephrine) response to hypoglycemia fell from 7.97 to 2.6 nmol/l during ketone infusion and the peak noradrenaline, cortisol and growth hormone responses were also significantly lower during ketone infusion at a rate of 3 mg/min/kg body weight which resulted in a 0.58 mmol/l BHB concentration which as you know is achievable with nutritional ketosis. In addition, the study found that the BG required to elicit the counter-regulatory hormone response was lower during the ketone infusion (BG was 2.5 mmol/l (45 mg/dl) during ketone infusion compared to 3.0 (54 mg/dl) mmol/l without ketones).

 

[Aldebaran]

Dr Keith Runyan (T1D on ketogenic diet) has just blog about hypoglycemia recently
https://ketogenicdiabeticathlete.wo...-diabetes-mechanisms-avoidance-and-treatment/

This section may be relevant:-

Thank you for this kokhongw. Forgive my ignorance here as this is a whole new thing that I'm learning, but what could this mean in my case?

I've understood parts of it but not all of it. I've only been able to go on how I've felt and my home readings. I have read interesting blogs that a member here gave me and parts of the blogs struck a chord in my situation. I know you can't diagnose me, I'm just wanting to get a general picture of how this could apply to me.

 

[Lamont D]

Dr Keith Runyan (T1D on ketogenic diet) has just blog about hypoglycemia recently
https://ketogenicdiabeticathlete.wo...-diabetes-mechanisms-avoidance-and-treatment/

This section may be relevant:-

As usual @kokhongw , you have some great links and done some great research, which as usual mirrors my lifestyle.
The way I live my life, now, is relevant to what the op is going through, I am permanently in ketosis, no symptoms, no health setbacks, great energy levels and my GPs practice is amazed at what I've achieved by going as @bulkbiker would say as 'ultra' low carb!

I would advise @Aldebaran to get as many tests as possible, even if it is something else than T2! (As I was misdiagnosed!)
The great work done by her has been brilliant, she deserves praise and should consider continuing her lifestyle despite having no symptoms, understanding why, is important, finding a true diagnosis is enlightening.

Best wishes

 

[NoCrbs4Me]

@Aldebaran - you should insist on getting a printout of all your lab results (or, if available, on-line access). This will be very helpful to you.

 

[kokhongw]

Thank you for this kokhongw. Forgive my ignorance here as this is a whole new thing that I'm learning, but what could this mean in my case?

I've understood parts of it but not all of it. I've only been able to go on how I've felt and my home readings. I have read interesting blogs that a member here gave me and parts of the blogs struck a chord in my situation. I know you can't diagnose me, I'm just wanting to get a general picture of how this could apply to me.

My father, T2D for over 30 yrs, had 3 significant hypoglycemic episodes.
1 serious motor accident...crashed into a tree and required spinal surgery likely due to hypoglycemia. He crashed at a site rather far from home when he was supposed to have gone out for a foot massage nearby.

On 2 occasions he overdosed his insulin glucose was 2.0 mmol and went into shock, my mum had to call for ambulance. Unfortunately, back then we didn't understand much about glucose/ketones or ketogenic diet.

The dangers of low blood glucose is real. But that is only when we are on normal high carbs diet that results in our inability to produce sufficient ketones to provide alternative fuel for our brain. As we move towards a low carb ketogenic diet and lifestyle, the resulting stable low glucose, low insulin condition allows increasing production of ketones to compensate for the energy shortfall. That is why we don't experience hypo symptoms while on low carb or extended fasting. We have become keto adapted.

If you were to have your ketones measured while you have low glucose, you then be able to verify it that is the case. Unfortunately it is the researchers, not the health care providers who are aware of this. Current guidelines do not recognize ketones as safe alternative brain fuel.

 

[Aldebaran]

As usual @kokhongw , you have some great links and done some great research, which as usual mirrors my lifestyle.
The way I live my life, now, is relevant to what the op is going through, I am permanently in ketosis, no symptoms, no health setbacks, great energy levels and my GPs practice is amazed at what I've achieved by going as @bulkbiker would say as 'ultra' low carb!

I would advise @Aldebaran to get as many tests as possible, even if it is something else than T2! (As I was misdiagnosed!)
The great work done by her has been brilliant, she deserves praise and should consider continuing her lifestyle despite having no symptoms, understanding why, is important, finding a true diagnosis is enlightening.

Best wishes

Thank you for saying that Lamont. I read your blogs and was enlightened when it comes to Hypoglycemia. One thing that immediately stood out was the 'Hormonal Hypoglycemia' on there. My hormones are all over the place and even though I've not been diagnosed with this, it would make sense if it was a possibility.

I've learned even more about how it works in the last few days and I'm so grateful to have this forum here so I can ask about it. It's hard when you're not getting the answers elsewhere and reading blogs such as your's helps me to understand it. I do need this to be sorted out. I'm not happy that I didn't receive a phone call yesterday. They left my mind in a spin and haven't let me know anything else.

I tested my blood this morning before breakfast and it was 4.2. I'll just have to keep doing this so I can add to my diary and have something to show them. I appreciate everything that has been said in my threads and your information Lamont has been invaluable. Thank you

 

[Aldebaran]

@Aldebaran - you should insist on getting a printout of all your lab results (or, if available, on-line access). This will be very helpful to you.

I will do NoCrbs4Me. I understand the nurse was baffled but she should have gone through the rest of my results with me. I've had the print outs before so I need to request one now so I can read it to see what it says. Thank you.

 

[Aldebaran]

My father, T2D for over 30 yrs, had 3 significant hypoglycemic episodes.
1 serious motor accident...crashed into a tree and required spinal surgery likely due to hypoglycemia. He crashed at a site rather far from home when he was supposed to have gone out for a foot massage nearby.

On 2 occasions he overdosed his insulin glucose was 2.0 mmol and went into shock, my mum had to call for ambulance. Unfortunately, back then we didn't understand much about glucose/ketones or ketogenic diet.

The dangers of low blood glucose is real. But that is only when we are on normal high carbs diet that results in our inability to produce sufficient ketones to provide alternative fuel for our brain. As we move towards a low carb ketogenic diet and lifestyle, the resulting stable low glucose, low insulin condition allows increasing production of ketones to compensate for the energy shortfall. That is why we don't experience hypo symptoms while on low carb or extended fasting. We have become keto adapted.

If you were to have your ketones measured while you have low glucose, you then be able to verify it that is the case. Unfortunately it is the researchers, not the health care providers who are aware of this. Current guidelines do not recognize ketones as safe alternative brain fuel.

Wow, that is awful kokhongw and it's one reason why I'm grateful that our knowledge today is what it is. My uncle is now on insulin for his Type 2 and he sometimes has low blood sugars in the night while he finds the right balance of his medication.

Because I've asked here, this is all making more sense to me. My knowledge on Ketones, etc, would have left a space on a postage stamp so I'm pleased that now I understand why, (if I have it), I'm not having any symptoms. You guys have spurred me on to make sure the doctors take note of this properly and make sure that they help me as much as possible. Maybe the doctors surgery will suggest the test to measure my Ketones and if not, I could suggest it myself. Silly I know but I'm actually smiling a little because I'm understanding it a lot more. I really appreciate all the advice here.

 

[KK123]

I will do NoCrbs4Me. I understand the nurse was baffled but she should have gone through the rest of my results with me. I've had the print outs before so I need to request one now so I can read it to see what it says. Thank you.

Hi Aldebaran, this post is very interesting (thank you albeit it's not much fun for you!!), so that 2.2 was an hb1ac test then, ie where they have taken it in a vial and sent it off to the lab? No wonder they are astounded! Please keep us updated and please don't worry about some of the posts, I don't think they are meant to be personal but probably more to do with type 1's and their requirements for driving (it is a blooming nuisance having to check EVERY time I get in the car). I am sure that if they identify an 'issue' they will explain to you all about any driving concerns. x

 

[Aldebaran]

Hi Aldebaran, this post is very interesting (thank you albeit it's not much fun for you!!), so that 2.2 was an hb1ac test then, ie where they have taken it in a vial and sent it off to the lab? No wonder they are astounded! Please keep us updated and please don't worry about some of the posts, I don't think they are meant to be personal but probably more to do with type 1's and their requirements for driving (it is a blooming nuisance having to check EVERY time I get in the car). I am sure that if they identify an 'issue' they will explain to you all about any driving concerns. x

Hi KK, bless you and thank you for saying that. Yes it was the overall check that I now have just once a year because I'm now classed as not having Diabetes, (or whichever description it's given). Within a few hours, the doctor rang me to ask about the 2.2 reading and then I had my Diabetic Clinic appointment on Monday.

I've started the morning testing again. This morning before breakfast I was 4.2, two hours after it was 4.5. I genuinely haven't felt off or unwell thankfully and when I've had a dizzy spell, for example, I've tested my bloods, they've been fine. I've realised, in one respect, that I'm in some kind of limbo. I may be Hypoglycemic, but don't have Type 2 and no one seems to know why. And maybe, like Lamont, could I possibly have been misdiagnosed and now that I don't eat the rubbish anymore, is my body showing that I do have Hypoglycemia? It's a minefield of ifs, whats and hows at the moment. My poor bloods don't know whether they're coming or going but as I've said many times, we don't do 'normal' in our house lol.

The frustration with some of the posts KK comes from the fact that properly reading someone's thread would prevent anything heated. Because I can now say I don't have Diabetes, I wouldn't have even thought of testing myself before driving. As far as I know, I'm now classed as the average person who would never think of having to do this. I'm the kind of person who is, shall we say, overly cautious and I care about my family and others. I really have appreciated the support on here from the lovely members. I feel for people like you who have to test like that before driving. I understand the necessity for it but it must be very frustrating for you. I am going to double check the driving query just to be sure but no one has said anything to suggest otherwise.

I will keep you updated and thank you for taking the time to post to me xx.

 

[Lamont D]

Not having diabetes is great,
Not knowing what it is, is the reason you are searching for answers.
It doesn't surprise me in the least, that our health care providers don't have a clue or understand the process of how our insulin imbalance threatens that logic that having insulin resistance and high blood spikes couldn't possibly be anything else than type two! Despite the evidence of normal fasting Hba1c and normal blood glucose levels before eating. But as you rightly say, what is normal?
Keep battling, keep asking questions, keep up the great work you are doing to stay healthy.

 

[Aldebaran]

Not having diabetes is great,
Not knowing what it is, is the reason you are searching for answers.
It doesn't surprise me in the least, that our health care providers don't have a clue or understand the process of how our insulin imbalance threatens that logic that having insulin resistance and high blood spikes couldn't possibly be anything else than type two! Despite the evidence of normal fasting Hba1c and normal blood glucose levels before eating. But as you rightly say, what is normal?
Keep battling, keep asking questions, keep up the great work you are doing to stay healthy.

Absolutely Lamont and this is the best place to find answers, even just to point me in the right direction and to know what to ask. You would think that after all these years, not to mention the increase of Type 2, that our health care providers would be more intune and updated on what to do with certain cases such as mine and your's a few years ago, for example. Thankfully we have lovely doctors and nurses but it's still frustrating when they're at a loss when it comes to knowing why things are like this.

We're all different, with unique bodily functions. Some battle things better than others, some are an enigma and the best way to find out why is to look further to educate yourself. I'm not saying I'm an enigma but to say I've baffled our medical team, is no exaggeration. To say I'm so grateful to you and the other guys who've helped me can't be understated. As always Lamont, thank you so much xx.

 

[Aldebaran]

I got a phone call from the nurse a few hours ago. The doctor has said to leave my blood result with him. She wasn't sure if he would contact her or me so beyond that I'm still not sure what they want to do. My reading before dinner was 3.9 so just in the normal range. I will have to test quite frequently to add to my diary. I feel like a pin cushion but it's important to do this and record the readings.

I asked about my other results and the nurse said they were all okay, (liver, urine, etc). My Cholesterol was 5.7 and she said that was fine. I'm having to get used to my levels now being higher compared to when I was classed as Type 2. I'm pleased with those results anyway. I will let you know what the doctor decides. If he leaves this, I need to go and have a chat about further tests they can do for me.

 

[Lamont D]

I know I baffled quite a few doctors, dsns and even a specialist diabetic GP, then an endocrinologist. Even a few locums! (Ha!)
The training has always been lax, with the endocrine system, simply because of the lack of research.
It wasn't that long ago, that everybody wasn't aware and quite rare T2 was, the teaching has improved, but only about high blood glucose levels, which is a common cause of T2, but so is high insulin, or hyperinsulinaemia, there are so many new reasons for T2.
Hypoglycaemia has only ever been called idiopathic hypoglycaemia, because idiopathic means cause not known.
Only in the last ten years has it had its medical name changed to the different types of Hypoglycaemia. Who would have thought that people have too much insulin and how dangerous it can be, and in my experience, have high blood glucose levels as well!
And not be T1, it has to be T2, with high blood glucose levels, high insulin resistance and hyperinsulinaemia!
Then, when losing the weight, losing the insulin resistance, getting normal readings from the hba1c test, getting fasting levels in the normal range! It's still T2!
No it ain't!
Having produced too much insulin after food, is not T2, the doctors are not taught that!
You can't blame them!
But from reading the number of posts from people with the same symptoms I do believe that there is a lot more misdiagnosed patients out there and I'm not as weird or as rare as I was told over five years ago!

 

[Lamont D]

I got a phone call from the nurse a few hours ago. The doctor has said to leave my blood result with him. She wasn't sure if he would contact her or me so beyond that I'm still not sure what they want to do. My reading before dinner was 3.9 so just in the normal range. I will have to test quite frequently to add to my diary. I feel like a pin cushion but it's important to do this and record the readings.

I asked about my other results and the nurse said they were all okay, (liver, urine, etc). My Cholesterol was 5.7 and she said that was fine. I'm having to get used to my levels now being higher compared to when I was classed as Type 2. I'm pleased with those results anyway. I will let you know what the doctor decides. If he leaves this, I need to go and have a chat about further tests they can do for me.

Once again, you are in good control, you have helped your body be as healthy as you possibly can, the good results reflect that.
Knowing that if you start eating the wrong foods will make you ill.
Understanding the pitfalls and recognising what is healthy is the best treatment, for you!

 

[Bryce74]

Like EllieM said, propabably a measuring error. You had no symptoms, you never had it that low before, right? I would not worry. Just measure your blood sugar a few times more to be sure and reassured and then put it to rest.