Do I have hypoglycemia?

Raider007 said:

Hi all,

Just so you know I have not officially been diagnosed with Diabetes. I am into healthy living and started a low carb diet about a 6 months ago. I first started with Carnivore and then after about 3 months started transitioning into Keto. I have lost 10kg of body weight. I am fairly active and do to resistance gym sessions a week and 2 cardio sessions a week. Then we hike and walk the dogs for another 1 to 3 days a week.

I recently got myself the freestyle Libre 2 sensor to track my blood glucose just out of interest to see what my glucose is doing when eating, drinking coffee etc. I am quite interested in insulin and I know there is a link but its not the same thing. Insulin resistance could be completely out of wack and I may not pick it up with the glucose monitor right?
So having seen my results for the past two days using the Libre 2, I have noticed that my glucose drops to about 3 mmol/l (55 mg/dl) while sleeping. See graphs below. I am not 100% sure how to interpret this but from what I read online it seems that I may be suffering from hypoglycemia while sleeping? Any advice from what you can see below and taking into consideration that I am on a low carb high (good) fat diet.

For reference, the limits are set to 3.9 to 6 mmol/l. Thats the green band in the graph.
At around 7:30 I had my first cappuccino and 30 mins later another one.

View attachment 71272

Thanks in advance. If you need any other information please let me know.

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You're not diabetic, and therefor not on any medication that can lower your blood glucose more that it should go. And you don't have RH, so you don't have a condition that makes you go too low, either. And you're on a carni diet... Those numbers are entirely normal for someone following that way of eating. If you go low, as you've noticed, your blood glucose comes back up on its own, without help from you: that's your liver correcting for lows, so no danger there; the fail-safe the body put in place, is working perfectly fine. From where I'm sitting, your body is doing everything it should be. Also, there's such a thing as compression lows. If you sleep on your meter, it could give a false low reading. But all in all... I don't think there's anything here to worry about. Others'll chime in though, I'm sure, so don't just take my word for it.

But for the moment, relax.
Jo

yep - just to add to what @JoKalsbeek said - these levels that go red - they are for diabetics taking meds which lower blood glucose in various ways - your body will maintain whatever level you need, and to some extent, losing that ability to control blood glucose is what defines diabetes...

You can adjust the upper and lower levels in the app so that it looks less ...well... alarming, but really, what you can get most out of a CGM is the real insight into what your body does in reaction to various activities and foods, so that you have a better handle on all of the (somewhat conflicting) advice you might pick up, in the end, what works for you is the only "right" thing...

Raider007 said:

Hi all,

Just so you know I have not officially been diagnosed with Diabetes. I am into healthy living and started a low carb diet about a 6 months ago. I first started with Carnivore and then after about 3 months started transitioning into Keto. I have lost 10kg of body weight. I am fairly active and do to resistance gym sessions a week and 2 cardio sessions a week. Then we hike and walk the dogs for another 1 to 3 days a week.

I recently got myself the freestyle Libre 2 sensor to track my blood glucose just out of interest to see what my glucose is doing when eating, drinking coffee etc. I am quite interested in insulin and I know there is a link but its not the same thing. Insulin resistance could be completely out of wack and I may not pick it up with the glucose monitor right?
So having seen my results for the past two days using the Libre 2, I have noticed that my glucose drops to about 3 mmol/l (55 mg/dl) while sleeping. See graphs below. I am not 100% sure how to interpret this but from what I read online it seems that I may be suffering from hypoglycemia while sleeping? Any advice from what you can see below and taking into consideration that I am on a low carb high (good) fat diet.

For reference, the limits are set to 3.9 to 6 mmol/l. Thats the green band in the graph.
At around 7:30 I had my first cappuccino and 30 mins later another one.

View attachment 71272

Thanks in advance. If you need any other information please let me know.

Click to expand...

Hi,

Looks normal if your not on meds or diagnosed, to me..

I’ll stick my neck out & say the little V dip as you rise out of the 2 am at 3 am, could be a “compression low?”
CLs can happen when the wearer sleeps on the sensor applying pressure giving a false low or lower reading until you turn over.
The quick bounce back with no food is a giveaway.
There is a lot of online graph pictures of non-diabetics posting graphs.
You really shouldn’t be too concerned if you set the upper limit to 8mmol, even drifting towards it is not an issue.
It’s all about the recovery.?

it isn't so much that this happens inevitably as we get older, as much as it happens the more often we ask a lot of our insulin production.

Ie, if you are on the carb rollercoaster that results from eating what we are often advised to (lots of starchy foods) - then the very simple version is that your body requires more insulin to have the same effect. This is no different to saying "if you drink too much coffee, you begin to need more caffeine to have the same effect".

This is just one way of describing insulin resistance.
The good news is that if you don't repeatedly swing into very high blood glucose (which can be most easily achieved by not eating the things that trigger this, starches and sugars) - then your ability to control blood glucose is very capable and complex and will carry on being fine. The amount of normally circulating glucose is surprisingly small - about a teaspoon worth.

Hypoglycaemia in non diabetic people is usually caused by a reaction and intolerance to certain foods.
As do allergies.
Also, most hypoglycaemic episodes happen during the day and it would be unlikely after so long after eating during sleep.

Sleep, a very broad subject.

Consider this an adjunct - not a reaction (see what I did there...?)

We need to be a little careful in use of terms here - the kind of hypoglycaemic episodes you are talking about @Lamont D are fairly severe.. the term just means lower blood glucose than normal, so any process in the body that demands sudden energy can lead to hypoglycaemia.

Personally, I would say that the feeling of "hangriness" characterises what most non-diabetics experience as hypoglycaemia - the brain demanding more sugary food.. and making you feel a little weak, and snappy and generally low.

allergies and intolerances - sure, as well - I'm just setting the bar a little lower.. (or higher depending on which way round you see it)

but, when you consider that one of the most common sudden demands for lots of energy, is dreaming - then this happening at night is pretty clear, but again, totally normal, and for most people, your liver will cope and keep the balance without you even knowing.

Chris24Main said:

Consider this an adjunct - not a reaction (see what I did there...?)

We need to be a little careful in use of terms here - the kind of hypoglycaemic episodes you are talking about @Lamont D are fairly severe.. the term just means lower blood glucose than normal, so any process in the body that demands sudden energy can lead to hypoglycaemia.

Personally, I would say that the feeling of "hangriness" characterises what most non-diabetics experience as hypoglycaemia - the brain demanding more sugary food.. and making you feel a little weak, and snappy and generally low.

allergies and intolerances - sure, as well - I'm just setting the bar a little lower.. (or higher depending on which way round you see it)

but, when you consider that one of the most common sudden demands for lots of energy, is dreaming - then this happening at night is pretty clear, but again, totally normal, and for most people, your liver will cope and keep the balance without you even knowing.

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I do agree with your terminology.... Hypo means low.
So yeah, non diabetic people (and some T2s etc) do almost certainly have lower than normal (4mmols) for certain, Hypoglycaemic conditions are usually described as a hypo, below 3.5mmols, but it is as individual as with how the patient demonstrates their symptoms. As individual as what or how much intolerance before one reacts.
Terms are important to clarify what you are saying.
And I would use the terms intolerant and allergic, in the same way as it is the reactions that are different.
Symptoms, for me start with blurred vision and a low to medium headache behind the eyes, others get other symptoms.
If the hangry ness, could have a pill to stop it. What a difference that would make if you come out of keto.
Wanting to eat the fridge, is something I have encountered too many times.
But as usual it is your brain telling lies about what you need to do about the hypo.
For a diabetic, in most cases, it is a glucose fix. For me, something low carb, just to nudge my BG levels back into normal, cos you just don't want the rollercoaster ride of BG levels and the rebound effect.

For some unknown reason and I have asked, as dreams have always been relative to me.
It does seem that sleep, and I mean the state of deep sleep is important to my health and wellbeing.
It is when, my energy levels seem to respond to help so much for what I need. It is very unusual for me to be mentally tired, even through depression and chronic anxiety, if I was in keto or in normal BG levels. I have energy levels that are brilliant throughout the day. I use fasting. This helps with my busy days. And I have for a long time finish any food around 7pm. So even if I do hypo, it is before bed, intentionally.
Sometimes after a really graphic Technicolor story dream. I have been floored by it. But if I check my BG levels, they are always in normal. Go figure.
I try to not make my liver do much, if I can. And food in general, is something that I can live without for some reason, I think I only eat, cos I enjoy it, and nutrition, but not always do.

KennyA said:

My BG does that overnight. It will go low and wake me up with sweats and nightmares.

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Had it as a kid long before CGMs & alarms. Trigger dreams I called them.

I don’t get the dreams, unless I miss the alarm? Weird David Cronenberg stuff…

I think that the dreams the vivid ones that you can recall are entirely natual.
They are not supernatural cos at times, mainly high temperatures, your brain makes you sweat, but it is intriguing if you do get a low or not, as I do.
An adrenalin rush is very similar or even cortisol it is a natural extension of dealing with the circumstances.
I have said often, that I found that when we eat, rather than calling it a first phase insulin response. It is a hormonal response. And most metabolic conditions are an imbalance in hormones somewhere.
The boffins are still trying to work it all out.
There is still so much we don't know.

I have had some weird recurring dreams.
The weirder ones in my blogs page, grrr!
But I noticed when my anxiety was really awful, I had recurring dreams of inadequacy in my old job. Which I retired from nearly twenty years ago now. But still get them.

Raider007 said:

I did read online that these low glucose levels at night could interfere with your sleep. I do struggle to get decent sleep most nights. Your thoughts on that

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As you are not diabetic, I'd suggest eating more before sleep. You can experiment whether that's a bigger evening meal or soemthing before bed. See which works for you, the lows aren't aren't problem on their own but if you aren't sleeping well, that needs addressing.
I have a friend who swears by a banana before bed, something to do with the magnesium or was it potassium?