Does your sugar drop while your stomach is still full, or is it once you're starting to feel hungry?

[Coolifornia]

I've made an observation that my hypo symptoms begin about 4 hours after eating, which is the time it takes for my stomach to feel actually empty again. This is when I've measured lows with my monitor. But there have been at least a few occasions where I felt symptoms while my stomach still felt full and I wasn't hungry at all, but it's possible that what I feel during those times isn't hypoglycemia (haven't been able to measure those).

Anyways, my question - does your stomach actually have to be "hungry" for you to experience a hypo during reactive hypoglycemia? And if someone's hypos start four hours after eating, does that mean that insulin is highest at that hour? Why wouldn't it be highest at the moment you start to eat, in accompanying the rise of blood sugar?

Maybe a question for my endocrinologist, but I'm interested in others' experiences.

 

[DCUKMod]

I've made an observation that my hypo symptoms begin about 4 hours after eating, which is the time it takes for my stomach to feel actually empty again. This is when I've measured lows with my monitor. But there have been at least a few occasions where I felt symptoms while my stomach still felt full and I wasn't hungry at all, but it's possible that what I feel during those times isn't hypoglycemia (haven't been able to measure those).

Anyways, my question - does your stomach actually have to be "hungry" for you to experience a hypo during reactive hypoglycemia? And if someone's hypos start four hours after eating, does that mean that insulin is highest at that hour? Why wouldn't it be highest at the moment you start to eat, in accompanying the rise of blood sugar?

Maybe a question for my endocrinologist, but I'm interested in others' experiences.

Hello Coolifornia - I don't suffer from reactive hypoglycaemia (RH) but I'll respond a little and tag a couple of knowledgeable folks for you.

For many people with RH, they have their hypo, following a usually significant rise in blood sugars. I liken it to throwing a tennis ball upwards indoors. The tennis ball hits the ceiling, then descends very fast, due to hitting that ceiling. That's sort of what happens with the bloods - a spike up, then a fast crash down. The fast crash down is what you feel.

Many folks on here find at least part of the answer to this problem is modifying what they eat to prevent that's sharp upward movement. Without the sharp upward movement, the crash is gentler, or indeed in many cases eliminated.

In order to see how that might fit your needs, it could be helpful if you could describe the sorts of things you eat and drink, and in particular around your uncomfortable episodes. Hopefully in a while, @Brunneria or @Lamont D might be able to drop in and comment, however, both are in UK, so it could be a few hours, as it's the middle of the night in UK.

 

[Lamont D]

I've made an observation that my hypo symptoms begin about 4 hours after eating, which is the time it takes for my stomach to feel actually empty again. This is when I've measured lows with my monitor. But there have been at least a few occasions where I felt symptoms while my stomach still felt full and I wasn't hungry at all, but it's possible that what I feel during those times isn't hypoglycemia (haven't been able to measure those).

Anyways, my question - does your stomach actually have to be "hungry" for you to experience a hypo during reactive hypoglycemia? And if someone's hypos start four hours after eating, does that mean that insulin is highest at that hour? Why wouldn't it be highest at the moment you start to eat, in accompanying the rise of blood sugar?

Maybe a question for my endocrinologist, but I'm interested in others' experiences.

You may not like most of my answer because I've yet to hear from someone who has the same symptoms and when they actually feel the hypo or aware of the hyper then hypo. Firstly because of the stage of development of RH, then diagnosis and of course treatment and control.
Secondly, The spike and how quickly you dump glucose because of the insulin response, then of course the overshoot. Quantifying the when, and how and why, it reacts is individual. The amount of carbs in a meal is important as well, if I have over five percent of certain foods then I trigger the hyper/hypo. It could be more with other carbs.
Your question is an interesting one, but in my experience, it is unlikely that you will hypo on an empty stomach with RH! That is why one of the tests is a 72hour fasting test. Your insulin response is likely to be higher at the point of highest spike, I am assuming that the pancreas would still produce insulin, because that is what my endocrinologist said about me. Because of the secondary insulin response, the overshoot, this is what causes the hyperinsulinaemia in a lot of RH ers! It did for me and increased my weight so much!
What you are describing are the symptoms and you are still learning how to cope with the different symptoms during the process from pre meal to the actual hypo, if, of course you trigger the overshoot by consuming too many carbs.
In my experience, you are describing ' Late Reactive Hypoglycaemia'! This is what my endocrinologist has diagnosed me.
The period between the spike is within the first hour, I hyper around forty minutes, then the overshoot happens during this period and continues until I eat or sleep, but and it is a big but, if I continue to eat carbs, the rebound effect will happen. The experience of having hypers and hypos, gives your brain the excuse to keep telling you to eat more, hence the hunger and craving, I was literally looking for non existent foods to appease my trawling the food cupboards, fridge, freezer, fruit bowl and anywhere including the shop, just to eat something!
Since I have changed my dietary regime to Keto, this hunger, craving has abated and if I behave myself, doing intermittent fasting, the need to continually feed myself has gone away (ish). I still could gladly eat too much but that is habit rather than hunger!
I hope that helps you understand what happens!

Best wishes

 

[Coolifornia]

You may not like most of my answer because I've yet to hear from someone who has the same symptoms and when they actually feel the hypo or aware of the hyper then hypo. Firstly because of the stage of development of RH, then diagnosis and of course treatment and control.
Secondly, The spike and how quickly you dump glucose because of the insulin response, then of course the overshoot. Quantifying the when, and how and why, it reacts is individual. The amount of carbs in a meal is important as well, if I have over five percent of certain foods then I trigger the hyper/hypo. It could be more with other carbs.
Your question is an interesting one, but in my experience, it is unlikely that you will hypo on an empty stomach with RH! That is why one of the tests is a 72hour fasting test. Your insulin response is likely to be higher at the point of highest spike, I am assuming that the pancreas would still produce insulin, because that is what my endocrinologist said about me. Because of the secondary insulin response, the overshoot, this is what causes the hyperinsulinaemia in a lot of RH ers! It did for me and increased my weight so much!
What you are describing are the symptoms and you are still learning how to cope with the different symptoms during the process from pre meal to the actual hypo, if, of course you trigger the overshoot by consuming too many carbs.
In my experience, you are describing ' Late Reactive Hypoglycaemia'! This is what my endocrinologist has diagnosed me.
The period between the spike is within the first hour, I hyper around forty minutes, then the overshoot happens during this period and continues until I eat or sleep, but and it is a big but, if I continue to eat carbs, the rebound effect will happen. The experience of having hypers and hypos, gives your brain the excuse to keep telling you to eat more, hence the hunger and craving, I was literally looking for non existent foods to appease my trawling the food cupboards, fridge, freezer, fruit bowl and anywhere including the shop, just to eat something!
Since I have changed my dietary regime to Keto, this hunger, craving has abated and if I behave myself, doing intermittent fasting, the need to continually feed myself has gone away (ish). I still could gladly eat too much but that is habit rather than hunger!
I hope that helps you understand what happens!

Best wishes

As always, thank you for your response Lamont!