Diabetes Resolved - What Does This Mean?

[Lamont D]

When I googled “diabetes resolved” to try and find out what that meant in terms of ongoing monitoring, one of the pages mentioned about a low carb diet can result in hypos. I clicked on that many pages I don’t know where it was now! Also I take a tablet called Nortriptyline which can cause hypos. So maybe a mixture of the two might be to blame?

Hi, and welcome to the forum.
I have reactive hypoglycaemia.
Going below, 3.5mmols is an actual hypoglycaemic episode. Every now and then people without diabetes or a metabolic condition, will get that low naturally.
However if the lows are frequent and you get symptoms of diabetes like you describe. There is a reason for it.
Nortriptyline causes hypotension in rare cases as a side effect, I couldn't find that it causes hypos.
The reading that took my interest, was the double figures after five hours.
Unless it was a false reading or true, that is unusual for a non diabetic.Unless your liver dumped glucose into your system because your body required it.
I am non diabetic and my last Hba1c was 37.
I have hypos because of my pancreas creates too much insulin, because I am carb intolerant.
I'm not diagnosing you, just giving you an idea that something is not right, if I fast and I do every day now, my readings are always in normal range. It is only if I have carbs do I get the reaction.

Why do you go hypo infrequently?
Why do I get double figures after five hours of fasting?

Over this period, it's a pity you didn't keep a food diary, with readings and what particular food you have had.
Have you been tested for allergies?

I would go along with the others, you need a referral to a specialist endocrinologist who has experience with Hypoglycaemia, but not T1.
When I was diagnosed, my GP refused to supply me with testing strips and take me off the diabetic register.
I got into the reasons why I needed them and the eye appointments, hba1c test and so on. He buckled when I mentioned my endo would be getting in touch with him.
Even after nearly eight years from diagnosis, I get the lot. Including free prescriptions.
Don't let your doctor take away your greatest tool for your health. You need test strips, you need to record them and you will see what is happening to you. I have been on a very low carb diet since diagnosis and it does not cause Hypoglycaemic episodes. I should know.
The best diagnostic test you can have is an extended oral glucose tolerance test. It has to be over five hours, yes, not two, which is the standard diabetes test. An extended test can give your doctors so much information and the reason it is five hours is to see if you do go hypo. A specialist would do this test if you tell him you go hypo from a normal diet which includes carbs.

I would definitely not recommend the eat well diet, even if you are trying to prove something, this diet doesn't help with anything if you have an imbalance of any hormones, glucose/insulin even thyroid the carbs will effect your organs and your blood glucose levels and the symptoms caused by fluctuating blood levels.

Stay on 50g of carbs and test, test, test pre meal, two hours and maybe three hours and four. Just to satisfy your curiosity.

Have you anxiety and/or depression?

Let us know how you get on.

Stay safe, keep battling, I have had twenty years of getting the right balance of food and treatment.

 

[Eurobuff]

Hypos on low carb are almost always only because of medications also taken. If you are low carb without medication hypos are extremely unlikely. Effectively it is because the medication is now stronger in the blood glucose lowering effects than your new diet needs it to be. You might however experience false hypos where you feel horribly low even though you’re not, a product of becoming accustomed to high levels and being shocked by more normal ones all of a sudden.

I think it’s the meds. I’ve managed to reduced my sugar levels for the last 5 years, although the last year it’s crept up a bit .

 

[Eurobuff]

Hi, and welcome to the forum.
I have reactive hypoglycaemia.
Going below, 3.5mmols is an actual hypoglycaemic episode. Every now and then people without diabetes or a metabolic condition, will get that low naturally.
However if the lows are frequent and you get symptoms of diabetes like you describe. There is a reason for it.
Nortriptyline causes hypotension in rare cases as a side effect, I couldn't find that it causes hypos.
The reading that took my interest, was the double figures after five hours.
Unless it was a false reading or true, that is unusual for a non diabetic.Unless your liver dumped glucose into your system because your body required it.
I am non diabetic and my last Hba1c was 37.
I have hypos because of my pancreas creates too much insulin, because I am carb intolerant.
I'm not diagnosing you, just giving you an idea that something is not right, if I fast and I do every day now, my readings are always in normal range. It is only if I have carbs do I get the reaction.

Why do you go hypo infrequently?
Why do I get double figures after five hours of fasting?

Over this period, it's a pity you didn't keep a food diary, with readings and what particular food you have had.
Have you been tested for allergies?

I would go along with the others, you need a referral to a specialist endocrinologist who has experience with Hypoglycaemia, but not T1.
When I was diagnosed, my GP refused to supply me with testing strips and take me off the diabetic register.
I got into the reasons why I needed them and the eye appointments, hba1c test and so on. He buckled when I mentioned my endo would be getting in touch with him.
Even after nearly eight years from diagnosis, I get the lot. Including free prescriptions.
Don't let your doctor take away your greatest tool for your health. You need test strips, you need to record them and you will see what is happening to you. I have been on a very low carb diet since diagnosis and it does not cause Hypoglycaemic episodes. I should know.
The best diagnostic test you can have is an extended oral glucose tolerance test. It has to be over five hours, yes, not two, which is the standard diabetes test. An extended test can give your doctors so much information and the reason it is five hours is to see if you do go hypo. A specialist would do this test if you tell him you go hypo from a normal diet which includes carbs.

I would definitely not recommend the eat well diet, even if you are trying to prove something, this diet doesn't help with anything if you have an imbalance of any hormones, glucose/insulin even thyroid the carbs will effect your organs and your blood glucose levels and the symptoms caused by fluctuating blood levels.

Stay on 50g of carbs and test, test, test pre meal, two hours and maybe three hours and four. Just to satisfy your curiosity.

Have you anxiety and/or depression?

Let us know how you get on.

Stay safe, keep battling, I have had twenty years of getting the right balance of food and treatment.

In the nortriptyline leaflet it said to monitor your blood sugar for highs and lows. I contacted the drug company who emailed me and advised that you can have lows or highs. That is the reason that my GP prescribed the strips as the diabetic nurse refused. I have TMJ which gives me severe “toothache” although it’s not toothache. I had an operation and it came back. The Gp then prescribed Amitriptyline. After which I had, diabetes, and later copper wiring in my eye and was suffering irregular heart beat. It was the amitriptyline that was causing it. So after trying just about every other med that exists ended up on nortriptyline which works. Had no trouble with “toothache”, swollen mouth, etc etc. I couldn’t eat when it flared up.

I’ve been doing some tests since yesterday (sssh don’t tel my doctor!) I’ve been testing 2 hours after each meal.

10.6 after Cod (no batter) , 2 potato scallops (thin sliced potato with batter) & 50ml gin with diet lemonade, it was 8.2 3 hours after

Today lunch 9.2 (I was going out) so could only test 1 hour after- I plain pancake, with cheese, and low sugar yoghurt with carb killa milkshake and some walnuts. (25g carbs)

Tea - 8.2 2 hours after - 3 high fibre crackers, cheese, Diet Pepsi (20g carbs)

 

[Mrs T 123]

That’s what’s worrying me. Part of me (and I know this is stupid) thinks is it worth following the NHS Eat Well Plate for 3 months, which would give me a diabetic HBA1C. I don’t want to risk my health, but if I’m going to stop getting the checks, isn’t that worse, than 3 months of “normal” carbs. Can I ask if you are coded as Resolved or In Remission?

I wouldn't do anything to risk your health - you want to improve it - I had been getting yearly checks with everything and it was only because of COVID that I had to request my last HbA1c - my DN didn't really want me to get it at all but I persuaded her. I am not sure what I am coded as but she has referred to me as "in remission" a few times now. You mentioned you were diagnosed in 2014 so you should have been getting at least yearly checks since then and once you are in remission/resolved imo you/I should still get these checks/reviews done.

 

[Eurobuff]

I wouldn't do anything to risk your health - you want to improve it - I had been getting yearly checks with everything and it was only with COVID that I had to request my last HbA1c - my DN didn't really want me to get it at all but I persuaded her. I am not sure what I am coded as but she has referred to me as "in remission" a few times now. You mentioned you were diagnosed in 2014 so you should have been getting at least yearly checks since then and once you are in remission/resolved imo you/I should still get these checks/reviews done.

I’ve been coded as “resolved” so far I have had my eye screening yearly, hba1c twice a year, and my cholesterol, liver & kidney function twice a year. My eyes tested at an opticians once a year, free. Just wondered what would change. I was thinking of the freestyle libre just for 2 weeks to see what it showed. It won’t work with my phone though so would have to buy a reader as well which would double the cost I don’t know if my doctor would look at the results though as he’s too arrogant and knows it all.

 

[Lamont D]

In the nortriptyline leaflet it said to monitor your blood sugar for highs and lows. I contacted the drug company who emailed me and advised that you can have lows or highs. That is the reason that my GP prescribed the strips as the diabetic nurse refused. I have TMJ which gives me severe “toothache” although it’s not toothache. I had an operation and it came back. The Gp then prescribed Amitriptyline. After which I had, diabetes, and later copper wiring in my eye and was suffering irregular heart beat. It was the amitriptyline that was causing it. So after trying just about every other med that exists ended up on nortriptyline which works. Had no trouble with “toothache”, swollen mouth, etc etc. I couldn’t eat when it flared up.

I’ve been doing some tests since yesterday (sssh don’t tel my doctor!) I’ve been testing 2 hours after each meal.

10.6 after Cod (no batter) , 2 potato scallops (thin sliced potato with batter) & 50ml gin with diet lemonade, it was 8.2 3 hours after

Today lunch 9.2 (I was going out) so could only test 1 hour after- I plain pancake, with cheese, and low sugar yoghurt with carb killa milkshake and some walnuts. (25g carbs)

Tea - 8.2 2 hours after - 3 high fibre crackers, cheese, Diet Pepsi (20g carbs)

I would recommend testing pre meal, as you need a baseline to see if it 2mmols above the pre meal reading. Have you tested when you get up and an hour after getting up before breakfast?

If you looking for readings that are abnormal, the regimen of doing it as I have suggested, will be obvious when they occur and if it is carbs that will show up.

Keep safe

 

[Eurobuff]

I would recommend testing pre meal, as you need a baseline to see if it 2mmols above the pre meal reading. Have you tested when you get up and an hour after getting up before breakfast?

If you looking for readings that are abnormal, the regimen of doing it as I have suggested, will be obvious when they occur and if it is carbs that will show up.

Keep safe

I can test before and after. I was thinking that if I’m getting 10.6, 9 etc that they are diabetic readings and that a non diabetic wouldn’t see those readings at all?

I haven’t tested on getting up, I can do. I normally eat more or less as soon as I get up. When I was first diagnosed and started on the low carb diet, I was trying to do what I used to do in my non diabetic days. I could get up and if needed I could go down to the supermarket do my shopping and come back and then have breakfast. I’ve tried to do that since and can’t, as I start feeling dizzy, clammy, and can’t stay in my feet. I couldn’t go for an hour before eating when getting up.

 

[HSSS]

I can test before and after. I was thinking that if I’m getting 10.6, 9 etc that they are diabetic readings and that a non diabetic wouldn’t see those readings at all?

I haven’t tested on getting up, I can do. I normally eat more or less as soon as I get up. When I was first diagnosed and started on the low carb diet, I was trying to do what I used to do in my non diabetic days. I could get up and if needed I could go down to the supermarket do my shopping and come back and then have breakfast. I’ve tried to do that since and can’t, as I start feeling dizzy, clammy, and can’t stay in my feet. I couldn’t go for an hour before eating when getting up.

Whilst your figures are suggestive of diabetes for the post meal readings, having a pre meal will show you the effects of that particular meal. So if the difference between pre and 2hrs post barely rises it’s a good meal for you. If it goes up by more then 2mmol not so much.

 

[Eurobuff]

I would recommend testing pre meal, as you need a baseline to see if it 2mmols above the pre meal reading. Have you tested when you get up and an hour after getting up before breakfast?

If you looking for readings that are abnormal, the regimen of doing it as I have suggested, will be obvious when they occur and if it is carbs that will show up.

Keep safe

OK, so now I’m confused. As it’s a weekend I sleep later/longer. I ate at midnight (6.5 grams of carbs). Went to bed at 2 am. Woke at 11.20am and tested my blood, it was 4.1. Decided to wait for an hour to see what my sugar would be without eating. So while I was waiting (this might have been a mistake??) I decided to have a bath (which are always hot). At 12.20 (just getting out of the bath) my blood sugar was 5.1. Tested again at 12.45 in case it was a dodgy result (still feeling hot after the bath) but still no food and it was 5.3? Not sure if the bath has messed things up?

Tested again at 1.35pm -4.9.

 

[Daibell]

The only mention I can find of low carb diets causing hypos is in the first few weeks of one, when the body is converting from a high fat diet. The best treatment for reactive hypoglcemia appears to be to eat low carb (RHers over produce insulin in response to carbs so get hypo a few hours after eating them). Is there an alternative drug you can use other than nortryptiline?

The low-carb diet causing hypos is likely to have come from someone who believes that carbs are vital to the body's health when in many ways they aren't. I would disagree with the mention. It can be caused in the condition Reactive Hypoglyceamia which is a specific condition. I would buy your own strips for a while as I did and contact a GP if your BS rises when on a low-ish carb diet. Ask for your records to be changed.

 

[Eurobuff]

The low-carb diet causing hypos is likely to have come from someone who believes that carbs are vital to the body's health when in many ways they aren't. I would disagree with the mention. It can be caused in the condition Reactive Hypoglyceamia which is a specific condition. I would buy your own strips for a while as I did and contact a GP if your BS rises when on a low-ish carb diet. Ask for your records to be changed.

I’m thinking of getting a freestyle libre just to run for 2 weeks that the patch runs to see what’s happening. I am getting diabetic readings after food 10.6, 9.2 2 hours after food. But I tested this morning just getting out of bed 11 1/2 hours after eating and it was 4.1, rising to 5.2 after a bath but no food (scratching head). I suspect, which is what I’ve already said to the doctor (but he won’t accept it) that is why my hba1c is coming out as normal. Monday to Friday I’m at work have something quick for breakfast and lunch, which is low carb and low calorie as I don’t tend to feel hungry enough to eat any more. Don’t know if this is skewing the figures?

 

[OB87]

OK, so now I’m confused. As it’s a weekend I sleep later/longer. I ate at midnight (6.5 grams of carbs). Went to bed at 2 am. Woke at 11.20am and tested my blood, it was 4.1. Decided to wait for an hour to see what my sugar would be without eating. So while I was waiting (this might have been a mistake??) I decided to have a bath (which are always hot). At 12.20 (just getting out of the bath) my blood sugar was 5.1. Tested again at 12.45 in case it was a dodgy result (still feeling hot after the bath) but still no food and it was 5.3? Not sure if the bath has messed things up?

Tested again at 1.35pm -4.9.

My blood sugar always rises before I eat in the morning. I usually have breakfast about 3 hours after I wake up and my pre breakfast reading is higher than my wake up reading. It doesnt usually go above a 6 so it doesn't bother me.

 

[Ronancastled]

I tested this morning just getting out of bed 11 1/2 hours after eating and it was 4.1, rising to 5.2 after a bath but no food (scratching head)

Them small rises after activity are perfectly normal.
Body feeds itself from fat stores to provide glucose for your muscles, bodily functions & brain.
Perfectly normal in a non-diabetic.

 

[Lamont D]

OK, so now I’m confused. As it’s a weekend I sleep later/longer. I ate at midnight (6.5 grams of carbs). Went to bed at 2 am. Woke at 11.20am and tested my blood, it was 4.1. Decided to wait for an hour to see what my sugar would be without eating. So while I was waiting (this might have been a mistake??) I decided to have a bath (which are always hot). At 12.20 (just getting out of the bath) my blood sugar was 5.1. Tested again at 12.45 in case it was a dodgy result (still feeling hot after the bath) but still no food and it was 5.3? Not sure if the bath has messed things up?

Tested again at 1.35pm -4.9.

All those readings are in the normal range. (3.5- 6.00mmols) you have been fasting for about nine hours. Your body didn't do lot overnight.
So the bath was ok.
So because all this. I would imagine that even though it may not be RH, it could be some other metabolic condition. But without the tests, you can only go on what symptoms you are getting.

Stay safe

 

[Eurobuff]

Them small rises after activity are perfectly normal.
Body feeds itself from fat stores to provide glucose for your muscles, bodily functions & brain.
Perfectly normal in a non-diabetic.

So the 10.6 2 hours after eating, & 8.2 after 3 hours. What would that class as?

 

[Lamont D]

So the 10.6 2 hours after eating, & 8.2 after 3 hours. What would that class as?

It all depends on what and how carbs laden the meal was, take into account, what you drank and you didn't know what the pre meal reading was.

For example, if I had porridge for breakfast, which I was advised to, my blood levels would go from normal levels to double figures within an hour, that is because my insulin response is very weak. If you have insulin resistance or some imbalance in your hormone response, it will go that high, it doesn't mean that you are diabetic.

Stay safe

 

[Eurobuff]

It all depends on what and how carbs laden the meal was, take into account, what you drank and you didn't know what the pre meal reading was.

For example, if I had porridge for breakfast, which I was advised to, my blood levels would go from normal levels to double figures within an hour, that is because my insulin response is very weak. If you have insulin resistance or some imbalance in your hormone response, it will go that high, it doesn't mean that you are diabetic.

Stay safe

My carbs for that meal was 30grams.drank with 50ml of gin (zero carbs) and diet lemonade (zero carbs), but I didn’t check my sugar level beforehand. I thought that a non diabetic wouldn’t get a result of 10 as their body would stop that from happening? My original HBA1C was 7.9%, my next was 7.8%, the next 6.3% (that was after I started with the low carb of 50 grams per day. Previously my carb intake was 150 grams a day

 

[Lamont D]

My carbs for that meal was 30grams.drank with 50ml of gin (zero carbs) and diet lemonade (zero carbs), but I didn’t check my sugar level beforehand. I thought that a non diabetic wouldn’t get a result of 10 as their body would stop that from happening? My original HBA1C was 7.9%, my next was 7.8%, the next 6.3% (that was after I started with the low carb of 50 grams per day. Previously my carb intake was 150 grams a day

To try and let you understand, why. If you have t2, you are likely to have insulin resistance, hence your Hba1c and fasting levels would be at diabetic levels.
The low carb diet worked for you, but your insulin response because of the insulin resistance may still be imbalanced. So from normal any carbs will and do raise your blood levels higher than when you were t2.
The continued use of low carb has now put you in non diabetic levels, but the chance of getting higher levels is still there.
T2 is diagnosed on your Hba1c levels.
So if I was starting my journey again and I didn't have that breakfast of porridge, before my bloods were taken, my Hba1c would be normal and my fasting levels would be normal, hence classified as non diabetic.
Again, only trial and error, keeping a record and getting the tests, will get you a true diagnosis. If only for peace of mind and to lower the symptoms you are getting, stay as low carb as possible, it won't do you any harm.

Stay safe

 

[Ronancastled]

Firstly, congrats on getting your A1c down, great work.
The rises after carbs are indicative of some insulin resistance (impaired glucose tolerance) but we cant diagnose.
You'd benefit from an extended glucose tolerance test (eOGTT) with insulin draws as well.
That would tell you if your body is still producing normal amounts of insulin or if there's some impairment.

Have you a consult with an endo lined up by any chance ?

 

[Eurobuff]

Firstly, congrats on getting your A1c down, great work.
The rises after carbs are indicative of some insulin resistance (impaired glucose tolerance) but we cant diagnose.
You'd benefit from an extended glucose tolerance test (eOGTT) with insulin draws as well.
That would tell you if your body is still producing normal amounts of insulin or if there's some impairment.

Have you a consult with an endo lined up by any chance ?

No I haven’t. My doctor has put that my diabetes is “resolved”. According to him my hba1c’s are now normal so that’s it. We haven’t been able to have face to face consultations, due to Covid since March. So everything is done over the phone (apart from the blood tests!). All hospital referrals etc are on hold due to Covid again, unless it’s something like suspected cancer. It would be up to my doctor to refer me, which due to his diagnosis wouldn’t do. I was wondering if I could do a home OGTT, but wouldn’t be able to do the insulin tests though and don’t know how crucial that is.