Dealing with reactive hypos when due to go to bed

Messages
5
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
I had hypo symptoms and scarfed some sugary treats until I could get my glucose meter, tested and was 4.4. Then as I was pale and trembling, sweating and slurring words my colleagues made me eat 4 biscuits and sugary tea plus 3 dextrose tablets over 30 mins. My sugars went up to 5.8 so I drove home from work, sugars were at 8.2. It was time for my evening meal so I ate a balanced protein/carb/fat meal. Following this I felt really jittery so I tested and was 9.2. I drunk lots of water as I felt really odd and wanted to reduce my sugar. Less than 20 mins after the 9.2 I am now 7.6. And it’s time for me to go to bed. I’m 99% sure that I will hypo in my sleep. But because it’s reactive I know my body will probably get to 3.8 and rise on its own so I’m not going to be unconscious like a true diabetic but I know I’ll have a **** sleep and wake up sweaty.

Should I have a little glucose before bed to offset the hypo I know will come?
 

Melgar

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Staff Member
Moderator
Messages
1,334
Type of diabetes
Other
Treatment type
Tablets (oral)
Hi and welcome to the forum @coolcombination . We cannot diagnose or suggest prescriptions on the forum. However, in general, Reactive hypoglycaemia responds well to low carb diets, it sounds counter intuitive. I believe it’s the consumption of carbs that sets off the over production of insulin, causing the hypos In RH. Indeed people who manage their RH symptoms tend to go low carb to manage their symptoms. I am going to tag @Lamont D as my knowledge is limited. He is very knowledgeable on RH and may be able to make some suggestions.

Ed grammar.
 
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Messages
5
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi and welcome to the forum @coolcombination . We cannot diagnose or suggest prescriptions on the forum. However, in general, Reactive hypoglycaemia responds well to low carb diets, it sounds counter intuitive. I believe it’s the consumption of carbs that sets off the over production of insulin, causing the hypos In RH. People who manage their RH symptoms tend to go low carb to manage their symptoms. I am going to tag @Lamont D as my knowledge is limited. He is very knowledgeable on RH and may be able to make some suggestions.
Thanks for your response, I managed my RH for year on a low carb high fat diet but my gallstones and cholesterol has forced me to lower my fat intake so I operate now on fasting till lunch and then eating every 3 hours till bedtime
 
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Melgar

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Messages
1,334
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Tablets (oral)
I cannot eat fats either @coolcombination . It’s under investigation. They have ruled out my gall bladder. It sucks doesn’t it. Are they going to remove your gall bladder?
 
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Lamont D

Oracle
Messages
17,606
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi and welcome to the forum @coolcombination . We cannot diagnose or suggest prescriptions on the forum. However, in general, Reactive hypoglycaemia responds well to low carb diets, it sounds counter intuitive. I believe it’s the consumption of carbs that sets off the over production of insulin, causing the hypos In RH. Indeed people who manage their RH symptoms tend to go low carb to manage their symptoms. I am going to tag @Lamont D as my knowledge is limited. He is very knowledgeable on RH and may be able to make some suggestions.

Ed grammar.
Thanks @Melgar and welcome @coolcombination to our forum.
With RH it is very difficult to really know what triggers the highs and lows.
So we have to discover through trial and error know what to eat and obviously to avoid.
I have been where you are now. I called this period my hypo hell. Not until I found that eating didn't help me at all. But before you say, I have to eat, of course, that is what you have to find out.
The dietary advice for your gall bladder etc is to have a meal with carbs, protein and a little fat.
I had hypo symptoms and scarfed some sugary treats until I could get my glucose meter, tested and was 4.4. Then as I was pale and trembling, sweating and slurring words my colleagues made me eat 4 biscuits and sugary tea plus 3 dextrose tablets over 30 mins. My sugars went up to 5.8 so I drove home from work, sugars were at 8.2. It was time for my evening meal so I ate a balanced protein/carb/fat meal. Following this I felt really jittery so I tested and was 9.2. I drunk lots of water as I felt really odd and wanted to reduce my sugar. Less than 20 mins after the 9.2 I am now 7.6. And it’s time for me to go to bed. I’m 99% sure that I will hypo in my sleep. But because it’s reactive I know my body will probably get to 3.8 and rise on its own so I’m not going to be unconscious like a true diabetic but I know I’ll have a **** sleep and wake up sweaty.

Should I have a little glucose before bed to offset the hypo I know will come?
So of course, RH is triggered by how much carbs you can tolerate. I will go through the science of you wish.
So the advice would be mixed wouldn't it?

From my experience, which included a lot of discovery of how to treat RH. The medical books are full of just eat carbs etc. Eat well plate, eat every three hours and so on.
When I had a fasting test in hospital.. I found that as long as I didn't eat, I would not trigger the symptoms!
So how do I deal with having to eat and stay healthy without continuous hypos?
By not triggering the spike of high BG levels (over 7-8 mmols for me)
So finding the carbs that send you over your trigger BG levels and continuing in or around normal levels, you avoid the symptoms.

As you fast until afternoon, you should not get the symptoms.
But you do get the symptoms within ran your of eating, and that is when the rollercoaster ride of BG levels, for the rest of the day. And as you say, now you are reading a hypos you sleep?
So, from around 7pm, I don't eat, so I know, I won't go hypo when I go to bed.
And if you do suffer a hypo, you need to nudge it back into normal with a little carb, testing every fifteen minutes. And walking helps so much with BG levels.
Glucose tablets will cause more high blood glucose levels, known as the rebound effect.
And yes, I know about the awful sleep.
But as you get used to the dietary restrictions, the symptoms will reduce.

I'm my experience, what I would do is.......Stop eating now, ride out the symptoms and it you are still going hypo, just eat little cheese, something that has good natural fats. Keep texting until you feel ok to go bed

Best wishes
Keep asking.
Stay safe.
 
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Reactions: Pipp
Messages
5
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Thanks @Melgar and welcome @coolcombination to our forum.
With RH it is very difficult to really know what triggers the highs and lows.
So we have to discover through trial and error know what to eat and obviously to avoid.
I have been where you are now. I called this period my hypo hell. Not until I found that eating didn't help me at all. But before you say, I have to eat, of course, that is what you have to find out.
The dietary advice for your gall bladder etc is to have a meal with carbs, protein and a little fat.

So of course, RH is triggered by how much carbs you can tolerate. I will go through the science of you wish.
So the advice would be mixed wouldn't it?

From my experience, which included a lot of discovery of how to treat RH. The medical books are full of just eat carbs etc. Eat well plate, eat every three hours and so on.
When I had a fasting test in hospital.. I found that as long as I didn't eat, I would not trigger the symptoms!
So how do I deal with having to eat and stay healthy without continuous hypos?
By not triggering the spike of high BG levels (over 7-8 mmols for me)
So finding the carbs that send you over your trigger BG levels and continuing in or around normal levels, you avoid the symptoms.

As you fast until afternoon, you should not get the symptoms.
But you do get the symptoms within ran your of eating, and that is when the rollercoaster ride of BG levels, for the rest of the day. And as you say, now you are reading a hypos you sleep?
So, from around 7pm, I don't eat, so I know, I won't go hypo when I go to bed.
And if you do suffer a hypo, you need to nudge it back into normal with a little carb, testing every fifteen minutes. And walking helps so much with BG levels.
Glucose tablets will cause more high blood glucose levels, known as the rebound effect.
And yes, I know about the awful sleep.
But as you get used to the dietary restrictions, the symptoms will reduce.

I'm my experience, what I would do is.......Stop eating now, ride out the symptoms and it you are still going hypo, just eat little cheese, something that has good natural fats. Keep texting until you feel ok to go bed

Best wishes
Keep asking.
Stay safe.
I’ve had some nuts as I don’t like cheese and whatever happens happens
 

Lamont D

Oracle
Messages
17,606
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Have you had any advice from doctors about lactose intolerance or wheat or gluten intolerance?
I have been lactose intolerant since very young.
I’ve had some nuts as I don’t like cheese and whatever happens happens
That is good, keep testing your BG levels. And try and take it easy on yourself.
Keep safe.
Best wishes.
 

AndBreathe

Master
Retired Moderator
Messages
11,517
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
@coolcombination - I don't have RH, thankfully, but have been around a long time and observed several who have.

My strongest steer to you would be to invest in a creating yourself a food diary, of everything you eat and drink, and your matching blood sugar scores. Some of us with slightly wonky metabolisms have sensitivities to foods that can result in unusual blood sugar responses, versus a "normal" person. For me, I found that foods with wheat raised my blood sugar a bit, but it remained raised for a long time - much longer than for other foodstuffs. Some find they have kryptonite foods (or drinks) that just send their numbers stratospheric.

The thing about RH is that following these elevations you can have the crashing low. I have observed that by finding what causes the rise can be a real, real help finding the crash triggers too. Once you know that, you can ditch or reduce the triggering foods.

Your situation is a bit more complicated by having gallbladder challenges at the moment, so it might make sense to have a protein heavy diet for a while - provided your kidneys are good and no problems there.

Unfortunately, with very personalised conditions, like RK and diabetes, we have to do our own homework, because whilst others might carry the same label (I hate labels), their conditions can differ and the management requirements will likely differ too.
 
Messages
5
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
@coolcombination - I don't have RH, thankfully, but have been around a long time and observed several who have.

My strongest steer to you would be to invest in a creating yourself a food diary, of everything you eat and drink, and your matching blood sugar scores. Some of us with slightly wonky metabolisms have sensitivities to foods that can result in unusual blood sugar responses, versus a "normal" person. For me, I found that foods with wheat raised my blood sugar a bit, but it remained raised for a long time - much longer than for other foodstuffs. Some find they have kryptonite foods (or drinks) that just send their numbers stratospheric.

The thing about RH is that following these elevations you can have the crashing low. I have observed that by finding what causes the rise can be a real, real help finding the crash triggers too. Once you know that, you can ditch or reduce the triggering foods.

Your situation is a bit more complicated by having gallbladder challenges at the moment, so it might make sense to have a protein heavy diet for a while - provided your kidneys are good and no problems there.

Unfortunately, with very personalised conditions, like RK and diabetes, we have to do our own homework, because whilst others might carry the same label (I hate labels), their conditions can differ and the management requirements will likely differ too.
Thanks for the advice on a food diary. Should I do my blood sugar immediately after the meal to gauge the effect or wait two hours etc.

A food intolerance has never been mentioned or investigated so that is interesting to me. What intolerances should I watch for? Wheat and what else? Lactose?
 
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Lamont D

Oracle
Messages
17,606
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Thanks for the advice on a food diary. Should I do my blood sugar immediately after the meal to gauge the effect or wait two hours etc.

A food intolerance has never been mentioned or investigated so that is interesting to me. What intolerances should I watch for? Wheat and what else? Lactose?
Intolerance such as lactose intolerance means you get a reaction to some parts of your body, it can be mild, it can cause a more severe reaction. It is not as lethal as an allergy. But it is still something to wonder about.
I found out very young, cos I couldn't drink dairy, had troubles with other dairy products, the worst being butter, I would vomit if I put it in my mouth. And I did.
I found that before and after my diagnosis, my body reacted to the majority of carbs, sugars, etc, to spike my BG levels really high, my body reacted to this with excess amounts of insulin. So too much glucose and insulin in my blood at the same time, and because my body was obese, because of the excess insulin, which have me a fatty liver, kidney, and of course the symptoms of both high and lows.
So you could say, I had an intolerance to carbs and sugars.
And hence the name of the condition, Reactive Hypoglycaemia. Because my body 'reacts' to the carbs and sugars.
over time our bodies have become susceptible and imbalanced to the food we have grown up with.
The supposed healthy carbs.
I stopped and lost originally six stone, and became healthier.
healthy foods were killing me.
Well, as I said I was obese. Well nearly nineteen stone!
my endocrinologist told me, I was very ill and if I don't get healthier, well you can guess the rest.
So, there are many intolerant foods.
it is about finding out about them, which foods you can tolerate.
My worst and highest spike was a potato! Huh! Starchy veg! Go figure.
But wheat is also up there, as is oats.
I was told ten years before to have a 'healthy ' breakfast. So I enjoyed porridge, no milk and sugar, but that was also causing my symptoms, hypos etc. M hypo hell.
Hence one of the first supervised tests (in hospital) is an extended oral glucose tolerance test (eOGTT) a five hours test to drink 75g of glucose, and take bloods and readings to see how high you spike against a normal non diabetic response. Then to see if and when you drop below hypoglycaemia levels.
Bloods are taken to labs to see if there is anything else causing the hypos.
According to a university paper I read a couple of years ago. It is significant that twenty (ish) percent of the population are affected by either gluten or actual wheat intolerance. And it is or something similar is in every manufactured food. And the reason it is in bold letters on the food label.

Testing is usually, pre meal. Then two hours after first bite. The two hours reading should be no more than 2mmols higher than the pre meal reading. If it is within, that is ok. If higher, then something in that meal is not recommended.
However, the portion size, what is eaten within that meal, the protein and fat content.
So you will get different readings.
However over time, testing individually foods, should give you an idea what is good and bad. Hate the baddies!
and you will see the trends as you gain control of your BG levels.
In my experience, as your health and symptoms improve, you will notice trends, and maybe just maybe ( not me) you could have a few carbs.
Last thing, I have not said, eat this, eat that.
That is because we are different to each other in what we eat.
I can't eat dairy, but you might be able to.
our favourite foods are different. Religion, availability, affordability and more.
I eat a lot of eggs, meat mainly pork or gammon, bacon. Found me a butcher, found a fresh food outlet for my salad veg. Mushrooms etc.
I have found my balance of nutrition. That keeps me fit and healthy.
That I rarely get hypos, intermittent fasting helps.
But knowing that I don't need to eat much, is so beneficial.
I hope this helps.
Keep asking, keep safe.
Best wishes.
 
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DEM1988

Member
Messages
17
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
I saw a Dietitian who recommended you book end your days with a cereal. It has worked wonders for night time hypos for me having only one night time hypo every fortnight or so.

I use Rice Krispies, Cornflakes or Weetabix with a some sweetener and Lacto-free milk (proper milk causes my sugars to spike).
 

Lamont D

Oracle
Messages
17,606
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
I saw a Dietitian who recommended you book end your days with a cereal. It has worked wonders for night time hypos for me having only one night time hypo every fortnight or so.

I use Rice Krispies, Cornflakes or Weetabix with a some sweetener and Lacto-free milk (proper milk causes my sugars to spike).
Are you testing before and after the cereal?
Let us know the results.
Also be careful with the milk, as there is oat milk out there which is in my experience worse with a high carb count.
Good luck with the high GI cereals.
 

DEM1988

Member
Messages
17
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
Hi Lamont,

I use a Libre 2 so can keep an eye on my glucose levels. The cereals usually do spike a little bit at around 8 mmol (from around 4.6mmol starting level) but they seem to slowly decrease from this level so my glucose levels stay stable for longer. The Lacto-free milk is proper milk without the lactose sugar in, I can't get away with vegan milks as they play havoc with my IBS. If I use normal milk my glucose levels spike in the 11mmol range which scared me seeing as I had a starting glucose of 4.6mmol. But like I'm figuring out, this condition seems to react differently from person to person - I suppose it's quite an individual illness in that each person seems to have unique triggers and coping mechanisms.
 
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Lamont D

Oracle
Messages
17,606
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi Lamont,

I use a Libre 2 so can keep an eye on my glucose levels. The cereals usually do spike a little bit at around 8 mmol (from around 4.6mmol starting level) but they seem to slowly decrease from this level so my glucose levels stay stable for longer. The Lacto-free milk is proper milk without the lactose sugar in, I can't get away with vegan milks as they play havoc with my IBS. If I use normal milk my glucose levels spike in the 11mmol range which scared me seeing as I had a starting glucose of 4.6mmol. But like I'm figuring out, this condition seems to react differently from person to person - I suppose it's quite an individual illness in that each person seems to have unique triggers and coping mechanisms.
my trigger is somewhere between 7-8 mmols. This is obviously from just above normal levels.
so I tend to stay more in this area by avoiding anything that will cause it.
your trigger may be higher.