Type 2 Reactive hypoglycaemia

[Mete90]

Hello about 4 weeks ago I started getting really bad episodes of hypo after eating lunch especially, it was so bad that I stopped being active cause even 5 mins of excercice would cause a hypo. Sadly this has pushed my hbac1 numbers to 50 from 47 within 4 weeks.
Can anyone experiencing RH please help as this is afftecting my day to day life!

 

[Antje77]

Hello about 4 weeks ago I started getting really bad episodes of hypo after eating lunch especially, it was so bad that I stopped being active cause even 5 mins of excercice would cause a hypo. Sadly this has pushed my hbac1 numbers to 50 from 47 within 4 weeks.
Can anyone experiencing RH please help as this is afftecting my day to day life!

Hi @Mete90 , and welcome to the forum!

Could you tell us a bit more about yourself? Do you have a diabetes diagnosis? Are you on medication, and if so, what medication?
Do you use a glucose meter, and what numbers do you see when you're having a hypo?
Perhaps we can help you out a bit!

Wish you all the best!

 

[HSSS]

And what typically is lunch?

Hb1ac twice in 4 weeks is unusual. Any reason why it was done again so soon?

Hb1ac at 47 isn’t a problem, it’s only 1 point below diabetic and could safely go lower. That said doing so by hypo isn’t the way you’d want to get there.

 

[Brunneria]

Hello about 4 weeks ago I started getting really bad episodes of hypo after eating lunch especially, it was so bad that I stopped being active cause even 5 mins of excercice would cause a hypo. Sadly this has pushed my hbac1 numbers to 50 from 47 within 4 weeks.
Can anyone experiencing RH please help as this is afftecting my day to day life!

hi and welcome

I am afraid that until you give more details - type of diabetes, medications, etc. There isn’t much we can offer by way of suggestions.

 

[JoKalsbeek]

Hello about 4 weeks ago I started getting really bad episodes of hypo after eating lunch especially, it was so bad that I stopped being active cause even 5 mins of excercice would cause a hypo. Sadly this has pushed my hbac1 numbers to 50 from 47 within 4 weeks.
Can anyone experiencing RH please help as this is afftecting my day to day life!

RH is an overreaction of the pancreas to a carb-filled meal, turning a glucose spike into a hypo. You're only mentioning exercise. We'll need a bit more to go on, your numbers, meals, medication etc... We're not just being nosy, but the more we know, the more we can help.

 

[Mete90]

Hi @Mete90 , and welcome to the forum!

Could you tell us a bit more about yourself? Do you have a diabetes diagnosis? Are you on medication, and if so, what medication?
Do you use a glucose meter, and what numbers do you see when you're having a hypo?
Perhaps we can help you out a bit!

Wish you all the best!

Hi
I was diagnosed with type 2,6 years ago when I had my daughter been on 500g Metformin a day.
The medication was stopped 4 weeks ago when I started getting hypos,yes I use a meter and my hypos can get as low as 5 very quickly sometimes within minutes. Dr have said 5 isn’t too low but it is for me cause I get the hypos symptoms from 6.

 

[Mete90]

And what typically is lunch?

Hb1ac twice in 4 weeks is unusual. Any reason why it was done again so soon?

Hb1ac at 47 isn’t a problem, it’s only 1 point below diabetic and could safely go lower. That said doing so by hypo isn’t the way you’d want to get there.

Hi
I normally have a whole meal sandwich or sometimes just a salad with avocados,a banana still my hypos occur.
They done my hbac1 on June 18 as I was going hypo and again on the 14 July as there was no improvement.

 

[Mete90]

And yes that’s what I thought that 47 will only go down more but it went up very quickly

 

[JoKalsbeek]

Hi
I was diagnosed with type 2,6 years ago when I had my daughter been on 500g Metformin a day.
The medication was stopped 4 weeks ago when I started getting hypos,yes I use a meter and my hypos can get as low as 5 very quickly sometimes within minutes. Dr have said 5 isn’t too low but it is for me cause I get the hypos symptoms from 6.

Hi again @Mete90 ,

What a perfectly useless doctor: telling you a 5 isn't a hypo, which I have to admit is true, but not telling you what you ARE experiencing... It's not RH, they're false hypo's. Yeah, that's an actual thing. Your body's been used to being higher than fives (a 4 or 5 would be a perfectly normal blood sugar), so any time it drops lower than what it is used to, it completely and totally panics. You feel like you're having a hypo, because as far as your body is concerned, you are. All the hallmarks are there, except for the actual low blood sugars. They're scary, they're real, not imagined, and you are actually in no danger whatsoever. But your heart races, your legs feel like jelly, you sweat, hairs stand on end, tremors etc...

The thing is, your body needs to get used to normal numbers, like fives, even fours. So you'll have to stop treating the false hypo's with sugar. That sound really terrifying, but your body has to realise, and it can only do that by going through it, that your blood sugars are actually at a healthy level, not at a waaaaah-we're-going-to-die-! level. What you can do when you feel like this is have something to eat that is high in fats and protein. have a boiled egg, cheese, olives... That sort of thing. Your body'll calm down and you won't spike your blood sugars with any of that.

I've had RH, long before I developed T2, and I had false hypo's. I've also had actual hypo's. So there's some experience speaking here. They really do feel the same as the real thing. And they go away once you're used to lower blood sugars. Don't treat them, keep blood sugars low-ish, and they'll be gone with about a week. Keep treating them and it could go on forever.

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- just in case, this might help control your blood sugars. You'd get your HbA1c into the normal range with it too.

The take away from all this: What you're doing is working, your body just doesn't know what to do with it yet. But it'll learn.
Hugs,
Jo

 

[JohnEGreen]

When the nurse came to my home to draw bloods the other day in the course of conversation I happened to say it was thought that T2's don't get hypos her immediate reaction was oh yes they do so not all medics are ignorant of the facts mind you she has been treating diabetics for many years.

 

[JoKalsbeek]

When the nurse came to my home to draw bloods the other day in the course of conversation I happened to say it was thought that T2's don't get hypos her immediate reaction was oh yes they do so not all medics are ignorant of the facts mind you she has been treating diabetics for many years.

Got the same response from my endo. You'd expect an endo of all people, to know that gliclazide can indeed cause hypo's in T2's. (The OP's describing a 5 as a hypo though... That's not hypo. Feels like it though, if you've been high long enough).

 

[Brunneria]

Thank you for the further info @Mete90

I would suggest that you cut the carbs a bit, and raise the fat and protein a bit in your meals. That will ease the transition and stop your blood glucose swinging high then lower.

As @JoKalsbeek has said, the feelings of a false hypo are very real, even if it doesn't actually count as being a hypo.
If your blood glucose has been running high enough to get an HbA1c of 50, then you have been running too high for so long that your body now expects those unnaturally high levels.

Many T2s on the forum aim for HbA1cs below 42, and some achieve HbA1cs in the 20s and low 30s, while feeling perfectly well. Non diabetics usually have HbA1cs in that range too.

 

[Mete90]

Hi again @Mete90 ,

What a perfectly useless doctor: telling you a 5 isn't a hypo, which I have to admit is true, but not telling you what you ARE experiencing... It's not RH, they're false hypo's. Yeah, that's an actual thing. Your body's been used to being higher than fives (a 4 or 5 would be a perfectly normal blood sugar), so any time it drops lower than what it is used to, it completely and totally panics. You feel like you're having a hypo, because as far as your body is concerned, you are. All the hallmarks are there, except for the actual low blood sugars. They're scary, they're real, not imagined, and you are actually in no danger whatsoever. But your heart races, your legs feel like jelly, you sweat, hairs stand on end, tremors etc...

The thing is, your body needs to get used to normal numbers, like fives, even fours. So you'll have to stop treating the false hypo's with sugar. That sound really terrifying, but your body has to realise, and it can only do that by going through it, that your blood sugars are actually at a healthy level, not at a waaaaah-we're-going-to-die-! level. What you can do when you feel like this is have something to eat that is high in fats and protein. have a boiled egg, cheese, olives... That sort of thing. Your body'll calm down and you won't spike your blood sugars with any of that.

I've had RH, long before I developed T2, and I had false hypo's. I've also had actual hypo's. So there's some experience speaking here. They really do feel the same as the real thing. And they go away once you're used to lower blood sugars. Don't treat them, keep blood sugars low-ish, and they'll be gone with about a week. Keep treating them and it could go on forever.

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- just in case, this might help control your blood sugars. You'd get your HbA1c into the normal range with it too.

The take away from all this: What you're doing is working, your body just doesn't know what to do with it yet. But it'll learn.
Hugs,
Jo

Thank you jo

 

[Mete90]

Hi again @Mete90 ,

What a perfectly useless doctor: telling you a 5 isn't a hypo, which I have to admit is true, but not telling you what you ARE experiencing... It's not RH, they're false hypo's. Yeah, that's an actual thing. Your body's been used to being higher than fives (a 4 or 5 would be a perfectly normal blood sugar), so any time it drops lower than what it is used to, it completely and totally panics. You feel like you're having a hypo, because as far as your body is concerned, you are. All the hallmarks are there, except for the actual low blood sugars. They're scary, they're real, not imagined, and you are actually in no danger whatsoever. But your heart races, your legs feel like jelly, you sweat, hairs stand on end, tremors etc...

The thing is, your body needs to get used to normal numbers, like fives, even fours. So you'll have to stop treating the false hypo's with sugar. That sound really terrifying, but your body has to realise, and it can only do that by going through it, that your blood sugars are actually at a healthy level, not at a waaaaah-we're-going-to-die-! level. What you can do when you feel like this is have something to eat that is high in fats and protein. have a boiled egg, cheese, olives... That sort of thing. Your body'll calm down and you won't spike your blood sugars with any of that.

I've had RH, long before I developed T2, and I had false hypo's. I've also had actual hypo's. So there's some experience speaking here. They really do feel the same as the real thing. And they go away once you're used to lower blood sugars. Don't treat them, keep blood sugars low-ish, and they'll be gone with about a week. Keep treating them and it could go on forever.

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- just in case, this might help control your blood sugars. You'd get your HbA1c into the normal range with it too.

The take away from all this: What you're doing is working, your body just doesn't know what to do with it yet. But it'll learn.
Hugs,
Jo

Hi jo
Ok let’s assume they false hypos and yes might be I’ve been on high for too long body is used to it. Cause I only feel great when my numbers are 7-9 sometimes after breakfast it can skyrocket to 12 and won’t feel much difference.
My other worry is more of the numbers dropping after a meal which I than lack energy.
Spoke to the gp this morning (a different one )
He encouraged me to have more carbs for lunch to not get a hypo

 

[JoKalsbeek]

Hi jo
Ok let’s assume they false hypos and yes might be I’ve been on high for too long body is used to it. Cause I only feel great when my numbers are 7-9 sometimes after breakfast it can skyrocket to 12 and won’t feel much difference.
My other worry is more of the numbers dropping after a meal which I than lack energy.
Spoke to the gp this morning (a different one )
He encouraged me to have more carbs for lunch to not get a hypo

Sigh. Wonderful advice. But you're not hypo. You're not under a 4.0. If you were having hypo's carbs would indeed be the solution. But you're not. You're not on any medication that can cause a hypo, and you're not on insulin unless I missed something. You're experiencing hypo symptoms while you're not actually hypo. That happens, that's real, and it is a nightmare to go through, but tossing more carbs in will only make it worse. Take it from someone who used to feel perfectly fine when she was seeing 22,0's. Once I hit a 7 or 6 I'd be ready to faceplant, weak, trembling, a right mess. It felt like dying. It was misery, and I kept taking Dextro Energy tabs to fix it until I found out what was going on. It let up soon after. Much to my relief.

It's entirely up to you where you go from here, but keep in mind, if you're not seeing numbers under a 4.0, you're okay. Even if you don't feel like it. You really, really are. Have fats, have protein. It'll calm your body down and get it out of the panic.

Jo

 

[Mete90]

Sigh. Wonderful advice. But you're not hypo. You're not under a 4.0. If you were having hypo's carbs would indeed be the solution. But you're not. You're not on any medication that can cause a hypo, and you're not on insulin unless I missed something. You're experiencing hypo symptoms while you're not actually hypo. That happens, that's real, and it is a nightmare to go through, but tossing more carbs in will only make it worse. Take it from someone who used to feel perfectly fine when she was seeing 22,0's. Once I hit a 7 or 6 I'd be ready to faceplant, weak, trembling, a right mess. It felt like dying. It was misery, and I kept taking Dextro Energy tabs to fix it until I found out what was going on. It let up soon after. Much to my relief.

It's entirely up to you where you go from here, but keep in mind, if you're not seeing numbers under a 4.0, you're okay. Even if you don't feel like it. You really, really are. Have fats, have protein. It'll calm your body down and get it out of the panic.

Jo

Thank you jo I’ll defo try it this week, may I ask if you’ve ever experienced numbers dropped at all from 6 to 4 within minutes of being active ?

 

[JoKalsbeek]

Thank you jo I’ll defo try it this week, may I ask if you’ve ever experienced numbers dropped at all from 6 to 4 within minutes of being active ?

There's a 15% margin of deviation on a meter, so that could explain the difference between measurements. Sometimes you'll get a different measurement on the same drop of blood. But blood sugars can drop rapidly, depending on what you're doing, and that also, just like a sharp rise, can make you feel off. (Dizzy, wobbly, nausea).

 

[Brunneria]

@Mete90

I had a rather unfortunate incident with a burger and fries from a motorway services, once.
Started with bg around 6, rose to a little over 12, and then took less than half an hour to drop down to below 5mmol/l
Rather an unpleasant experience, and I very nearly fell asleep at the wheel driving through the Peak District.
Not something I will EVER repeat.

Moral of the story: I ate too many carbs, my body dealt with the sudden rise by pumping out a lot of insulin which drove my bg down quickly too. I didn't hypo, although it felt horrible.
Easily avoided in future by avoiding the carb overload that set the up>down process off.
What I should have done was have a low carb meal, perhaps meat and salad, or crustless quiche and coleslaw, or egg mayo with a spoon. That would have kept my bg nice and low and steady, with no sudden rises or drops, and no nasty symptoms. I would have also felt a lot less tired, and arrived at my destination feeling great, instead of like a limp dishrag.

(I do have RH, and have recorded a number of well below 4 RH hypos, but the example given above didn't take me down to below 4, so wasn't a hypo)

 

[Lamont D]

Hi @Mete90
I'll just tell you about my experience with my RH and how carbs have a direct effect on your blood levels. The same symptoms effect both RH and T2.

Depending on your insulin response, the amount of carbs dictate how quickly you spike, if because of insulin resistance and hyperinsulinaemia which does happen to some T2s. This means that your blood levels rise quickly. If I did this, I would get hyper symptoms, starting with headache and eyes blur a lot. Once I've spiked probably in double figures from normal within an hour, my blood levels would start falling steadily because of a secondary insulin response, this is when I get more symptoms as you describe, when you say you are having a hypo, it's a false hypo.
But because my insulin continues, I go hypo!
Most T2s, only go hypo when meds are involved. Unless they have T2 with RH. Or have another condition which will cause Hypoglycaemia.
A lot of doctors are not trained in the way to treat diabetic conditions and follow NHS guidelines. Which are not tailored to everyone.
I would if I were you would keep a food diary and record the readings you are getting.
I would also limit my carb intake, and persevere with getting good control of your blood levels.

Keep safe

 

[Mete90]

Hi @Mete90
I'll just tell you about my experience with my RH and how carbs have a direct effect on your blood levels. The same symptoms effect both RH and T2.

Depending on your insulin response, the amount of carbs dictate how quickly you spike, if because of insulin resistance and hyperinsulinaemia which does happen to some T2s. This means that your blood levels rise quickly. If I did this, I would get hyper symptoms, starting with headache and eyes blur a lot. Once I've spiked probably in double figures from normal within an hour, my blood levels would start falling steadily because of a secondary insulin response, this is when I get more symptoms as you describe, when you say you are having a hypo, it's a false hypo.
But because my insulin continues, I go hypo!
Most T2s, only go hypo when meds are involved. Unless they have T2 with RH. Or have another condition which will cause Hypoglycaemia.
A lot of doctors are not trained in the way to treat diabetic conditions and follow NHS guidelines. Which are not tailored to everyone.
I would if I were you would keep a food diary and record the readings you are getting.
I would also limit my carb intake, and persevere with getting good control of your blood levels.

Keep safe

Thanks for the advice I have been noting down numbers and food,still trying to figure it all out.
I really appreciate your comments and advices