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GTT help with interpretation

M

mahorela

Member
Messages
15
Type of diabetes
Don't have diabetes
Hi guys

I have recently undertaken a GTT 2 hour test with fasting Insulin due to a ramping up of hypoglycemic events in the past few months although I can remember having hypo events as far back as when I was 7 years old. My doctor has gone on holidays and I'm not seeing an endo yet but my results are as follows;

(mmol/L)

my fasting glucose was 3.6
my 1 hour glucose was 3.8
my 2 hour glucose was 3.6

My fasting insulin levels were 8.

I felt terrible for the rest of the day after the test, irritable and fatigued. I have my own theories about what this means but I'd love to hear the thoughts of those more experienced and knowledgeable than I. I realise that any opinion given is just that, an opinion.

I'd really appreciate anyone taking the time to reply.
 
So what did they say about your results? Or did they not comment?
I think that for reactive hypoglycemia you need to keep measuring for up to 5 hours or maybe longer.
Levels in the 3s is a bit low, but virtually no rise at an hour seems bizarre.
Do you have your own blood glucose meter?
 
I'm still waiting to get my doctors interpretation, the pathology lab won't comment. I have since bought a meter and have been checking it regularly, it has pretty much backed up what I saw in the test. It doesn't seem to matter what I eat, my readings just don't go up after eating and after 2 hours are usually marginally lower (and lower again 4-5 hours).

I'm transitioning into ketosis now (I have done the low carb thing before) and my fasting blood sugar is a bit higher (4-5) and stays more stable but I have never seen it go over 5.5.

Just to clarify, my test shows that they gave me 75g glucose load.
 
Very interesting. Do you get hypo symptoms (http://www.diabetes.co.uk/what-is-a-hypo.html)?

My blood glucose actually doesn't go above 5.7, but then again I don't eat any carbs.

Really to see no rise during a GTT is astonishing to me. My guess is that you have an excellent insulin response and no insulin resistance. So you blood glucose level might peak at less than an hour and be low again at an hour. Have you tried testing, say, 15, 30 and 45 minutes after eating something starchy?
 
I definitely do get hypo symptoms, more in line with reactive hypoglycemia and I have ever since I was a kid. If I wasn't eating well and was out playing basketball all day I would get hypo symptoms, which at the time I just assumed was because I was hungry, I'd go and eat something sweet and I'd feel better. I was always a skinny kid, sporty but was never any good at endurance sports. Things worsened in my mid 20's, I started to get neuropathy in my feet and muscular fatigue set in but in an unusual kind of way where I still had good athleticism and strength but it would rapidly dissapear. I'm in my mid 30's now and I'm still pretty athletic, I can still dunk a basketball with ease but I almost never get dunks in games because by the time I sprint the length of the court I haven't got the strength. After weight sessions or heavy cardio sessions people are regularly noticing that I am very pale with dark circles under my eyes. My laymans interpretation is that I may have some problem with glycogen storage, it's all very new to me though and I'm still trying to get my head around it.

I am working at getting back into ketosis but I should eat something starchy and do some more testing as you advised to see if I can catch a spike. Any ideas on what I should eat?

thanks again NoCrbs4me.
 
Hi and welcome

I think you may find this youtube video VERY interesting.
It is a long, slow watch, but gives fascinating information that I hadn't come across anywhere else.

 
I wonder if you might not be a good candidate for Super Starch - it's slow release carbohydrate and is used by performance athletes, especially low carb endurance athletes. There's quite a few Youtube videos about it:


I know from personal testing that it doesn't work for me as a Type 2, but since your issue is low BG and hypos, it might help you?
 
Thanks Brunneria and Indy51, I saw that KRAFT video linked on another post somewhere in this forum. I'll get watching both of those video's now.

So I would be right in assuming that my blood sugar readings etc are unusual and don't really fit the standard RH profile?
 
The three best ways that I know to diagnose RH are:

A 5 hour GTT (2 hours won't show it for most RHers)
A GTT followed by a 72 hr fast (@nosher8355 has done this, so can tell you more)
Using a Freestyle Libre for a few days (this one is only something I discovered very recently when I got the Libre and saw my RH very clearly. The libre isn't available on the NHS)

My view is that in order to identify RH you need blood glucose tests every 15 mins during a GTT, certainly for the first hour or two, because RHers tend to shoot up very high, very fast, and a test at 2 hours simply won't spot that, because they may be back down to normal by then. Then the test needs to be much longer than 2 hours to catch the drop when it happens.

But it is very individual when that happens. Could be 90 mins, could be 5 hours. With me, it depends on a lot of things - how much carb was eaten, how much fat and fibre were eaten alongside (which doesn't happen in a GTT), also stress and physical activity levels.

All these factors make it almost impossible for a doctor to even see the signs of RH, and then they don't know what they are looking at, because it isn't something they see often. Plus, of course, the very limited treatment options, with diet being the biggest and best solution.
 

There is another thread on the RH forum called flat curve response Hypoglycaemia.
Have a read of that,!

A two hour OGTT, is not long enough to get hypoglycaemic tests from. That test gives results on type two. And measures spikes from a glucose load.

An extended OGTT, can be up to five hours to see if you go hypo.
The 72 hour fasting is to discount other more serious conditions and confirm RH!

I've no doubt because of your response to glucose, you will get a referral.
More tests do need to be done though.

Welcome to our unique club.
RH certainly throws up the weirdest conditions!!!!!
 
Thanks @nosher8355, I definitely need to do some more tests. According to my test results "All values are within normal limits" hopefully my GP has the foresight to realise that no, these aren't normal results. Apparently, 3.6 is considered the lowest possible value in the normal range, in my estimations with my own meter, I am feeling neuropathy and neurological symptoms in the low 4's.

That Dr Kraft interview is astonishing, really opened my eyes. My takeaways from it are that very little can be determined from testing glucose levels and that a 5 hour insulin response test is needed in any case, HR or diabetes. I will be pushing to get this test done, but as they stated and I can attest to, getting doctors out of their comfort zone is very difficult. One thing that really stood out to me was the connection between Meniere's disease and blood sugar, I have been diagnosed by an ENT specialist as having Meniere's disease due to gait and neuropathy problems and fullness in my inner ear, tinnitus etc. Some months/years ago I realised that this wasn't the case and I was misdiagnosed, but interesting how metabolic dysfunction and Menieres symptoms are related.

The super starch looks great but 25 serves for $84 (aud) and only lasts for 2-4 hours?? A little too rich for my blood.

It seems low carb is the key to RH, Diabetes and probably every other metabolic problem. Funnily enough (lol) I can go into ketosis with the greatest of ease, I cut out carbs for 2 days and used a test strip yesterday and was at 4 mmol ketones.

Thanks very much to everyone who has commented, i really appreciate the help in trying to get my head around this complicated problem.

As I said earlier in the thread, I can remember having hypo symptoms as early as 7 years old. Could I ask when/how you guys remember this starting for you?
 
mahorela said:
As I said earlier in the thread, I can remember having hypo symptoms as early as 7 years old. Could I ask when/how you guys remember this starting for you?
Click to expand...

I was 4.

I have seen an article saying that most childhood RH sorts itself out as the child gets older, but mine didn't. Though I think it was at its worst around my mid-teens (probably hormones) after that, I made connections with food, timing and general diet, and started to get a handle on it.
 

I'm a bit weird and a little different from yourself and Brun, as I developed the condition no more than ten years ago, if I did have it before then, there was no symptoms.
It was only because of the gradual weight gain and the T2 misdiagnosis and then the awful hypo hell I went through. I might still have been there except for my endocrinologist.

I totally agree, being in ketosis is the best solution to most blood glucose disorders.
The body could do without all the extra hormonal issues, when your body is not in balance and dietary conditions should at all times be treated by diet rather than meds if it can be avoided.
I've always had weird dreams though! Especially when ill!
 
This morning I ate a pretty carb heavy breakfast and tested my blood glucose every 10 minutes and finally found the spike. I started at 5.2 and spiked to 7.2 10 minutes after eating. Within the next 10 minutes I had dropped back to 5.2 and then 10 minutes later 4.4.

Within the hour I was back at 5.4 and I truly do feel like I've been on a rollercoaster.

Any advice for dealing with post rollercoaster syndrome?
 

I really wouldn't like to even best guess what or why is going on.
But as with all blood glucose disorders, it is always best not to do a lot of carbs, if you felt as though you've been on a rollercoaster or like I do, in the ring with Mohammed Ali, then you only feel good when low carbing.
If you don't spike, you don't go low, prevention is better than reaction! (I like that!)
As long as your in the normal range and feeling good, what do you want to have carbs for?

Fish and chips, next you'll be having chip butties just to **** me off!!!!
Love the fish, batter less!!!
 

Drink lots of water
Avoid more carbs
Rest
You should feel better after sleeping.

I always feel better after eating fat and protein (steak, full English, salad and mayo...)

But i have to tell you, that really isn't a big spike. It is still in 'normal' bg range

So you probably aren't experiencing a bg rollercoaster, but you may be experiencing something else - at a guess, it could be the huge insulin dumpage your pancreas released to stop the rise and keep your blood glucose at those levels. But that is only a guess! If that is the case, (remember, i am speculating madly) you may be experiencing the after effects of too much insulin causing insulin resistance.

When i feel IR like that, i feel heavy limbed, lethargic, achy, apathetic. The big muscles in my arms and legs ache dully. Is that ringing any bells?

@nosher8355 is your man to tell you about speedy glucose spikes and rapid drops, but he's away for a few days, so you may not get a quick response.
 
Last edited by a moderator:
I've just popped on, still no news, waiting!

Now that you have said that Brun. The overshoot of insulin could happen much quicker and not allow the spike to occur.
Diet is still the answer though!
 
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