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24, New diagnosis Reactive Hypoglycemia Questions

Discussion in 'Reactive Hypoglycemia' started by keewd7, May 4, 2021.

  1. keewd7

    keewd7 · Newbie

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    So I'm 24 years old, male. Finally got an answer to all my dizziness and terrible symptoms.
    So after trial and error, and the terrifying error of hitting 45 and feeling like I was dying, I've got my diet almost wired tight.
    I mainly eat eggs, bacon, daves killer bread, with natural peanut butter, protein bars, chicken salads, and black coffee/snus.

    My questions to you guys are:
    1.) Is this forever? Like do you know anyone who's body has stopped producing too much insulin?
    2.) What is your lowest level?
    3.) Have you passed out? If you did, did you wake up on your own or have to to injected with glucose?
    4.) Going on a backpacking/camping trip, any protein/fat suggestions? (No dairy)
    5.) What does your diet look like? Healthy fats ideas?
    6.) Have you tried keto/intermittent fasting? Did it help?
    7.) Do you drink alcohol? My body will respond well somedays and others it won't.
  2. Brunneria

    Brunneria Other · Guru

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    1) for me, yes, it seems to be
    2) lowest recorded level was 1.6mmol/l but meters are notoriously unreliable at v low and v high levels
    3) have never ‘keeled over’ but have fallen suspiciously deeply asleep on several occasions. Waking up after a hypo sleep can be really rough.
    4) i used to take jerky for snacks, a wok and cook real food, buying fresh food incl bags of salad and bacon and eggs, buying daily. Don’t know what location and shopping availability you will have.
    5) I'm approx 80% carnivore, keto, and cook almost all my own food, which I enjoy. This evening was a stir fry, with chicken, onion, garlic, mushroom, butter, fresh lemon and freshly picked thyme.
    6) yes and yes. I naturally gravitate to approx 2 meals a day, at 1pm and around 6-7pm
    7) very occasionally, and usually dry spirits with low carb mixers. Made by own sloe gin, sloe vodka and strawberry vodka a couple of years ago. Still enjoying them.
    #2 Brunneria, May 4, 2021 at 9:22 PM
    Last edited: May 5, 2021
  3. optimist1

    optimist1 · Well-Known Member

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    Depending on your severity, some meds including just probiotics can help.

    From a part of a paper on RH.
    Alpha Glucosidase Inhibitors
    Inhibitors of α-glucosidase (acarbose and miglitol) can reduce the levels of GIP, which is released from K cells in the duodenum, which can be stimulated through the absorption of carbohydrates and fat. GIP increases significantly after the excessive ingestion of nutrients. There are studies that showed that he GIP and glucagon levels decreased after a mixed meal in patients with new diagnosed type 2 diabetics by treatment with single-dose acarbose[36, 37] and acarbose decreased GIP and glucagon only in a mixed meal test rather than OGTT.[38]

    Low-dose glitazones given to patients with reactive hypoglycemia associated with IGT are also considered to be effective in the symptoms of reactive hypoglycaemia and the prevention of diabetes.[39, 40] As a matter of fact, hyperinsulinemia and IGT were found in OGTT in 2 cases with hypoglycemic symptoms, and it has been shown that hyperinsulinemic clamp reduces the insulin sensitivity. In these cases, hypoglycaemic symptoms of IGT improved after the use of 15 mg pioglitazone. It has been reported that low dose of 15 mg pioglitazone prevents reactive hypoglycemia in impaired glucose tolerance.[41]

    DPP-IV inhibitors have been suggested to be involved in the treatment of prediabetes.[43] Glucagon levels decreased in GLP-1 compared to placebo and with a 32% reduction in postprandial glucose excursions no evidence of hypoglycemia or weight gain was seen in studies with single dose 50 mg vildagliptin. This effect suggests that it may be used in the treatment of reactive hypoglycaemia, possibly in prediabetic patients, and may prevent both the symptoms of hypoglycaemia and diabetes.[44]

    Dipeptidyl peptidase-4 (DPP-4) inhibitors improve insulin secretion and reduces glucagon secretion, thereby reducing hyperglycaemia. These incretin effects are glucose-dependent, thus minimize the risk of hypoglycaemia. Incretin-based therapies are of interest in subjects with mild postprandial glycaemic excursions but without overt T2DM. Sitagliptin treatment for 7–8 weeks resulted in reductions in post-challenge glucose excursions during both an MTT and an OGTT, in Japanese subjects with IGT. The observation that treatment with sitagliptin increased the early insulin response to the glucose load during the OGTT, and reduced circulating glucagon levels during the MTT.[45]

    It is suggested that the incretin-based treatments are promising in both IFG and IGT treatment, and we think that DPP-IV inhibitors may be useful in prediabetic patients, especially in postprandial reactive hypoglycaemia.[50] Also, GLP-1 receptor agonist is likely to have a preventive effect on postprandial reactive hypoglycemia with prediabetes, especially in overweight people. It has been suggested that pathophysiologic- based therapy is associated with marked improvement in glucose tolerance and reversion of prediabetes to normal glucose tolerance in more than 50% of patients.[44-47]

    Gut Microbiome
    Recently, the gut microbiota has been discussed as a potential target for the control of diabetes and reactive hypoglycaemia, and the possibility to correct gut microbiota dysbioses through diet. The macrobiotic Ma-Pi 2 diet, with its high fibre load, was effective in increasing the production of SCFAs by the gut microbiota. The macrobiotic Ma-Pi 2 diet reduced blood glucose excursions during the day, thereby facilitating glycemic control in subjects with RH.[48, 49] Thus, these SCFA metabolites are preventive, reactive hypoglycemia.
  4. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    The first part of the paper clearly distinguishes the difference between a prediabetic with symptoms of RH and the actual condition.
    We have had quite a few sufferers that have been given such meds, especially acerbose, by their own accounts, it doesn't help with symptoms or help if like me, you have the condition.
    The second and third parts of the paper, I have been involved in research into using sitagliptin to help with initial insulin response. Those with the condition will probably have hyperinsulinaemia, that is why I was misdiagnosed with T2. Again piglotazone did not work for me, maybe again, it was prediabetic with RH symptoms.
    The tests done for diagnosis are mainly tests for other conditions depending on the outcome, a mixed meal test is one I endured, and no diagnosis was apparent because the result was skewed with the amount of carbs derived from the meal. I am carb intolerant, as is most RH ers, it is the carbs that trigger the reaction.
    I tend to agree with most of the next part.
    The final part is particularly interesting to me, because I have had heliocobacter pylori in my gut and have had the antibiotics to get rid of the bacteria, this is seven years before actual diagnosis, and a couple before diagnosis. Heliocobacter pylori is known to be a precursor and cause as is hyperinsulinaemia to RH.
    I have taken a special biotic and I'm trying to remember the name, it was no carbs, no sugar, a health sports drink for athletes with lactose intolerance. I do believe that that I have mentioned the gut, brain trigger before as part of creating the second insulin response called an overshoot, which drives blood sugar down.
    This paper is similar to some that I have read that believe that RH is not a food orientated condition, and we need carbs to have normal brain function, and the only consideration is for RH symptoms, rather than the difference between symptoms and conditions, there is also the individuality of the condition, also there are other types of Hypoglycaemia that is not considered.
    Basically, in my experience with RH for eight years plus and prior to the battles I had to get a true diagnosis for over a decade. It is a major factor that you have to look at your dietary intake and find a balanced dietary approach that is healthy for you.
    Every 'expert' that produces this research, does tend to perceive that RH condition that can be labelled the same as glucose tolerance rather than an insulin overshoot and a precursor to diabetes. It is not!
    If you are wondering why there is not much research, it is because it is rare to have the condition and there is only a few specialist endocrinologist who can recognise RH, but even less that really know the condition and how to treat it.

    But it is really good that you are looking at the knowledge out there, because it is important to know how and why you are hypoglycaemic.

    My best wishes, keep safe.
  5. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    1. Management of blood glucose levels and dietary intake is important, there is no cure. So yes.
    2. I have had many times 'lo' reading on my glucometer. The lowest in numbers is 1.9mmols. But quite often I have tested again and got a higher reading but still in hypo levels.
    3. I think I have, like Brun, have had episodes of conking out and waking up with symptoms. And feeling really awful. I have never slept during the day, I have regular good sleep since diagnosis, but I have had sleep problems for many years before.
    4. Similar to Brun, meat and salad, eggs, some other vegetables like mushrooms, I cook everything from fresh. I would watch out for the protein bars and the like, there are lower carb bars that are ok, but anything processed is not for me. They use such things as Palm oil, and the like, which I believe don't do you any good.
    5. I go by having the fat off meat and using animal fats for cooking. No veg oils.
    6. I have been Keto since diagnosis (exceptions now and again, through different reasons) I have been intermittent fasting for about five or more years. My window is between 3pm and 7pm (ish)
    7. I stopped drinking alcohol about fifteen years ago, because I couldn't handle it, there are some wines or spirits that you could try, I remember drinking straight Bacardi, and not affecting me greatly, but most alcoholic drinks are made from grains, and grains will spike you and trigger the overshoot.
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