Feel hypo but BG's not showing it

I had 4 glasses of wine over the weekend as it was my friends birthday. My BG level went down to 4.8 instead of keeping in the 5's arggg..Although that is not danger level, as far as I know, taught me to be more careful. Interesting I read that people who are diabetic and pre-diabetic, they cannot drink as much as the average person as it can cause them to black out or feel the effects of the alcohol more quickly. A few weeks ago I had three glasses of wine when out and as soon as I hit the air I felt dizzy and came over all bad, never again

Hi @barb1

I think (but bear in mind this is my RH experience only, and not the result of some proper scientific study) that sometimes I get hypo symptoms when the blood glucose is dropping fast - even when it hasn't reached the low point yet. The speed of the drop seems to be a big factor.

Plus, if your RH hypos are anything like mine, they can be really sharp. Think of a V not a U or an L on the blood glucose curve. This means that unless you test at precisely the right moment you may be missing the low itself.

Then, finally, some the symptoms that I identify with the hypo itself don't seem to be symptoms of low blood glucose. They actually seem to be symptoms of massive stress hormone dumpage produced by my body to trigger the liver dump that will raise blood glucose back to safe numbers. For me, this means that the numb cheekbones and word loss, and weird disconnectedness is the low blood glucose, while the trembling, the shaking, the hollow wobbliness, all seem to be from the stress hormones that are being released in order to raise the blood glucose. Just think how you feel after a near miss with a car crash, or a terribly shocking experience and that is what I am talking about. So this means that those shocky wobbly feelings are actually kicking in after the hypo, and when your blood glucose is already on the rise. So your 4.5 could be after your low, not the low itself.

Obviously, I am just talking about my own RH hypos, which seem to be significantly different beasties than T1 or T2 hypos, from what I have read on the forum. Well, different and similar, because RH hypos are caused by our own excessive insulin, rather than from diabetic meds or injected insulin.

Hope that makes sense?

I find there are two things which give me hypo symptoms: low BG and fast falling BG.
Your hypo symptoms at 4.5 may be due to a steep fall.

barb1 said:

I recently was diagnosed as having reactive hypoglycaemia. Some of my hypos have been down at 2.6 and I had symptoms of dizziness, shakiness, tiredness, headache, tingling/numb lips.
Strangely though I have also had many of these symptoms when my BG has been around 4.5. Does anyone experience symptoms of hypoglycaemia with what is considered to be a normal blood glucose.
Of note I've had bariatric surgery and wonder if this may have any bearing on the findings!

Click to expand...

Not having read your posts, I gather that you are doing low carb to counter the symptoms. If not how are you treating the symptoms?

I would guess that you are becoming more aware of how your blood glucose levels are stabilising and you feel the symptoms if they go up or down.
The answer is yes, I do feel the higher or lower levels.
Of course having the surgery must effect how you digest food and having RH is unfortunately a side effect of the procedure.

If you haven't already, read the RH forum.

And keep asking questions.

Controlling RH is about what you eat!

Best wishes

Here is a graph I came across recently by Dr Ted Naiman that captures the typical reactive hypo condition.


And this is an example of my Libre captured reactive hypo moment...after a high carbs breakfast. In the past, when I am less insulin sensitive, the glucose will remain high for 4-5 hours. But as we improve our insulin sensitivity, fast glucose clearance in response to high carbs meal can result in more hypo events.

Thanks @kokhongw.

Interesting set of graphics.

Lamont D said:

Thanks @kokhongw.

Interesting set of graphics.

Click to expand...

Yes Lamont, and mathematically speaking the peak response is an almost perfect sine squared
pulse.
ATB
Derek

When blood glucose lowers fast can that be felt like sweat attacks ?

Freema said:

When blood glucose lowers fast can that be felt like sweat attacks ?

Click to expand...

The drop which is not as quick as the spike, does give you symptoms akin to either of the many symptoms which are attributed to either hypers and hypos, false hypos and wildly fluctuating blood glucose levels. Which includes being warm or sweaty all the time.
Despite being so aware of any spike outside normal levels now, before I was diagnosed, I was totally oblivious of what was happening to me. I had no awareness at all except knowing that something wasn't right! Which included sweating during the winter!
I didn't attribute any of the symptoms to what I was eating or the doctors referring to my weight and misdiagnosed T2.

The symptoms you describe could have many possible endocrine reasons.
As well as the hormonal things!

Best wishes

barb1 said:

I recently was diagnosed as having reactive hypoglycaemia. Some of my hypos have been down at 2.6 and I had symptoms of dizziness, shakiness, tiredness, headache, tingling/numb lips.
Strangely though I have also had many of these symptoms when my BG has been around 4.5. Does anyone experience symptoms of hypoglycaemia with what is considered to be a normal blood glucose.
Of note I've had bariatric surgery and wonder if this may have any bearing on the findings!

Click to expand...

Do you have T2D as well?

Brunneria said:

Hi @barb1

I think (but bear in mind this is my RH experience only, and not the result of some proper scientific study) that sometimes I get hypo symptoms when the blood glucose is dropping fast - even when it hasn't reached the low point yet. The speed of the drop seems to be a big factor.

Plus, if your RH hypos are anything like mine, they can be really sharp. Think of a V not a U or an L on the blood glucose curve. This means that unless you test at precisely the right moment you may be missing the low itself.

Then, finally, some the symptoms that I identify with the hypo itself don't seem to be symptoms of low blood glucose. They actually seem to be symptoms of massive stress hormone dumpage produced by my body to trigger the liver dump that will raise blood glucose back to safe numbers. For me, this means that the numb cheekbones and word loss, and weird disconnectedness is the low blood glucose, while the trembling, the shaking, the hollow wobbliness, all seem to be from the stress hormones that are being released in order to raise the blood glucose. Just think how you feel after a near miss with a car crash, or a terribly shocking experience and that is what I am talking about. So this means that those shocky wobbly feelings are actually kicking in after the hypo, and when your blood glucose is already on the rise. So your 4.5 could be after your low, not the low itself.

Obviously, I am just talking about my own RH hypos, which seem to be significantly different beasties than T1 or T2 hypos, from what I have read on the forum. Well, different and similar, because RH hypos are caused by our own excessive insulin, rather than from diabetic meds or injected insulin.

Hope that makes sense?

Click to expand...

That is crazy! That is exactly how I feel when I crash! I feel numb all over. Pulse speeds up, then goes low. I get glittery, anxious, can't think, mind dog from heck!

Brunneria said:

Hi @barb1

I think (but bear in mind this is my RH experience only, and not the result of some proper scientific study) that sometimes I get hypo symptoms when the blood glucose is dropping fast - even when it hasn't reached the low point yet. The speed of the drop seems to be a big factor.

Plus, if your RH hypos are anything like mine, they can be really sharp. Think of a V not a U or an L on the blood glucose curve. This means that unless you test at precisely the right moment you may be missing the low itself.

Then, finally, some the symptoms that I identify with the hypo itself don't seem to be symptoms of low blood glucose. They actually seem to be symptoms of massive stress hormone dumpage produced by my body to trigger the liver dump that will raise blood glucose back to safe numbers. For me, this means that the numb cheekbones and word loss, and weird disconnectedness is the low blood glucose, while the trembling, the shaking, the hollow wobbliness, all seem to be from the stress hormones that are being released in order to raise the blood glucose. Just think how you feel after a near miss with a car crash, or a terribly shocking experience and that is what I am talking about. So this means that those shocky wobbly feelings are actually kicking in after the hypo, and when your blood glucose is already on the rise. So your 4.5 could be after your low, not the low itself.

Obviously, I am just talking about my own RH hypos, which seem to be significantly different beasties than T1 or T2 hypos, from what I have read on the forum. Well, different and similar, because RH hypos are caused by our own excessive insulin, rather than from diabetic meds or injected insulin.

Hope that makes sense?

Click to expand...

Yes. Absolutely. This kind of answers Friday's episode I had. In hindsight I had had quite a few carbs over the day in my efforts to increase my ever dropping weight (incl ricemilk with a rice protein shake after 20mins light strength training to try get my body on 'build' mode!) I felt oddly jittery mid afternoon - I had to take a short walk, I felt anxious over nothing somehow??!! Then at lunchtime shortly after, had some different/new frozen roast potatoes with fish (to which I found they had dextrose on the ingredients after) I felt terrible. My mum said I went gaunt and lines appeared on my face. I had to lie down. I tested my BS and they were in the low 4's (im not sure of the peak as I felt to rubbish to bother getting the machine! but it was in the 7's when I eventually got around to it, then fell to 4's) but I felt ALL the horrible symptoms, dizzy, headache, my voice went, vision blurry, words gone, very dry mouth and I even had a pain in my chest like Id been kicked and felt exactly how you described - like after a carcrash of some description?!?. In body shock. My heart was fluttery and even the day after, I felt drained like Id done a marathon the day previously or something!!! I'm struggling to maintain weight and a very low 41kg (and 5'9 tall !) at the moment - I lost another 0.5kg on the scale over two days even though my diet did not change - So it seems these BS episodes of 'carcrash' eats away into my weight somehow too at the moment.???? Has anybody had that?!?!

I had an appointment with my dietician (who is one of the better ones as she works in diabetes, so has 'some' knowledge of endocrinology type stuff - there are some shocking dieticians who seem to know absolutely nothing, but she is certainly one of the better ones) but she is surprised to see I am still so low on weight as I have significantly increased my meals, protein, fats, and trying to balance carbs safely (the majority of the time until I decide ricemilk is 'a good idea'!!) yet still losing weight and having so many episodes and symptoms after eating/carbs, especially if I increase them over my 'safe' limit..... I'm feeling so low about it all I must admit I look like a rake and have no energy at the best of times at the moment - and then feel like Ive been hit by a train when I eat something a bit different or an extra potato!. I lose more weight if I cut carbs completely -so this is still out of the question - One is quite stuck! But anyway - Thankyou for your input and reply on here... It made for helpful reading and the sudden drop V, U and L analogy is useful to think about I was concerned as to why I felt so bad only being in the 4's. I seem to feel rubbish and very heavy/tired if my BS goes above a 6 and certainly a 7 for some reason also! I wish I had the answer so I could at least gain a few pounds to be on the safe side of things general health wise, but it just seems impossible no matter what I try!

What did your dietician recommend?

In my experience, I would listen to what your body is telling you about having too many carbs above your safe limit. I believe that getting your blood glucose levels in a stable normal range is the first step. It do the reduction of carbs over a few days. There is something called carb flu, the symptoms are akin to the symptoms of sugar crashes you describe.
Getting your balance of protein and saturated fats will of course help.
This may take time but worth it.
Then when you get your balance you can start experimenting with higher fats, protein intake to keep the weight.
But the bottom line is that it is the carbs that is creating the fluctuation in your blood glucose levels.

Best wishes