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Help needed with diagnosis (RH.)

Discussion in 'Newly Diagnosed' started by iallaway, Dec 19, 2021.

  1. iallaway

    iallaway Reactive hypoglycemia · Member

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    Hello All
    I have just been diagnosed with reactive Hypoglycemia and Pre diabetes. I do not understand neither of the two stated. I had my last tollerence test this week and showed by sugar dropped to 2.2. Now consultant sent me letter and said I have a impaired glucose tolerance (pre-diabetes) Whatever that means. I passed out in hospital with the 2.2 but after eating mars bar, biscuits, sandwich and 2 cups of sweet teas I was then ok. The letter states I need to keep away from sugar and replace it with Glucose, sucrose, fructose and dextrose. I do eat maybe not that great as i am a lorry driver (No fast food dinning) I have sandwich cake etc. If I dont have sugary stuff then my sugar drops dangerously low all the time. I self buy libre2 and just bought Dexcom G6 to try. Im not too sure what Im trying to ask but I hope someone can help. I can attach the letter to this if anyone wants to see it. My Doctor has given me Glucogel and a monitor to fingerprick myself. Because I drive a lorry, by law from DVLA I need to keep my sugar above 5.0

    Sorry for the stupid post.

    Thank you
    Ian
     
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    #1 iallaway, Dec 19, 2021 at 4:06 PM
    Last edited: Dec 19, 2021
  2. Jaylee

    Jaylee Type 1 · Moderator
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    Hi Ian,

    Welcome to the forum.

    Not a stupid post at all..

    I'll tag in @Lamont D & @Brunneria who maybe able to fill you in on what's happening regarding your condition.
     
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  3. iallaway

    iallaway Reactive hypoglycemia · Member

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    Hello Jaylee,
    Thank you very much.
     
  4. Jaylee

    Jaylee Type 1 · Moderator
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    No problem. Actually. I'll tag in @searley . He is T1 like me. However...
    He may have advice regarding DVLA. He's a trucker too. :)
     
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  5. searley

    searley Type 1 · Moderator
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    It may be worse than what you think... you are infact incorrect about keeping your bg above 5... what's actually stated is you should not start a journey if below 5 but you can go as low as 4 and be legal. Below that you are classed as hypo...

    However where you may fall foul of the law... is you can NOT have a hypo where help of others is needed.. the fact you passed out puts you in a difficult position.. because it also means you are not hypo aware.... which to drive goods vehicles you must have hypo awareness you can not rely on cgm for this

    So I highly recommend you seek advice on this sooner rather than later and I don't think your gp is good enough for this as I highly suspect you'll be driving illegally
     
  6. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    Hi @iallaway and welcome to the forum

    Pre-diabetes is when somebody's longer term Blood Glucose (usually as measured by an HbA1C blood test) is between the normal ranges and those designated as being Type 2 Diabetic. So although is isn't something to be ignored, it isn't yet at a stage where medication should be required. Though in my view medication should hardly ever be required since Type 2 diabetes can be controlled by eating better - rather than eating what were told is 'healthy'.

    Reactive Hypoglycemia is where when you eat (too much or of too refined) sugars or starches e, your Insulin response is lagging the rise of glucose in your Blood Stream by so much that your Blood Glucose (sugar) gets high enough to trigger am over-reaction in insulin because your body needs that glucose out of your blood and fast! But since it has now ben a while since you ate/drank those carbohydrates, there is no more glucose coming along just yet and so the excess of insulin drives your Blood Glucose levels down below normal levels and even to quite dangerous ones (especially if you are driving at the time).So you can think of it as a series of over-reactions in both directions making a graph of your blood glucose look like a rollercoaster rather than a fairly flat track.
     
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  7. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    I am afraid I do not understand this. Glucose, sucrose, fructose, dextrose and anything else ending in "ose" is sugar. If your blood glucose drops too low, then yes, have some "ose", but not otherwise. Maybe the doctor is telling you what to do if you go too low - avoid normal sugar because it is bad for us generally, but use one of the others to bring your blood levels back up.

    Hopefully @Lamont D and @Brunneria will come along soon.
     
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  8. iallaway

    iallaway Reactive hypoglycemia · Member

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    Hello Searley
    Thank you for that, for the past few months I have been testing myself. I am aware when I go low. I only went low because I had to fast from 9pm for glucose tollerance blood tests and it went low and passed out at 2.2 approx 1330 the next day during my blood tests. I also self fund the libre 2 to help me by giving me alarms at 5.0 so I can act on it then.

    Thank you
     
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  9. searley

    searley Type 1 · Moderator
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    Laws on testing will be that all the time you are driving you must have had a test within the last 2 hours.. and a minimum of 2 tests a day even on non driving days...

    you may still be on dodgy ground re the passing out... as if you knew you were low to the point of passing out you should have aborted the test... passing out should mean your license is revoked until you can prove you've had no issues for a minimum of 3 months... so whatever you do don't let it happen again testing or not.. once good license is revoked you may not get it back

    I still think you need to seek advice on this

    You have to tell the DVLA about RH anyway... so makes sure you have at least 3 months full bg tests
     
  10. Antje77

    Antje77 LADA · Moderator
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    Are you sure about this?
    I thought the rules on being above 4/5 are only applyable to diabetics on glucose lowering medication. Non diabetics go into the 3's regularly and are perfectly fine to drive and do not need to thest their BG.
     
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  11. searley

    searley Type 1 · Moderator
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    Rh being different to insulin treated diabetes will likely have different rules.. however any illness that can cause you to pass out will have to be declared to the DVLA in relation to goods vehicles and they will give guidance on where they want to be on the BG.. but having 3 months of data will be a good start in relation to keeping the license... but RH being much more rare may cause issues

    The issue is RH will fall under the General blanket of hypoglycemia and there is guidance on hypoglycemia on the DVLA website but nothing specific to RH... so until you can get specific guidance from them on RH you'd have to follow general blanket rules.

    Goods vehicles always add more complications than driving cars.. even have to declare BP meds even if you don't really have high bp

    And this is because BP meds could make you pass out....

    So getting the right guidance from DVLA is important as undeclared illnesses have upto a £1000 fine.. but having an accident with an undeclared illness could result in much worse


    Even nhs detail here https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/

    state:
     
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    #11 searley, Dec 19, 2021 at 6:33 PM
    Last edited: Dec 19, 2021
  12. Jaylee

    Jaylee Type 1 · Moderator
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    Unfortunately, a condition that may affect one's fitness to drive by means of loss of consciousness or cognitive recognition can be an issue with the DVLA.. it's not just about the meds that may cause a hypoglycaemic event.
    That includes people with epilepsy or seizure issues too.

    I'm rooting for @iallaway to find a way to manage his condition & be safe..
     
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  13. iallaway

    iallaway Reactive hypoglycemia · Member

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    @Jaylee, thank you for that, and thank you everybody for your input, I will still try to find the answers to my originl post.
     
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  14. EllieM

    EllieM Type 1 · Moderator
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    @searley Do @iallaway 's libre results count for his 3 months of test results (should he need them)?

    And as regards treating the RH and the prediabetes I believe that the advice you'll get for both is the same: cut down on carbs in your diet because your body isn't coping with them well. (Disclaimer, not a RH or prediabetes sufferer or a doctor).

    @iallaway, you might want to have a read on the reactive hypoglycemia forum in the meantime.
    Reactive Hypoglycemia | Diabetes Forum • The Global Diabetes Community
     
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  15. searley

    searley Type 1 · Moderator
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    Nope not in relation to goods vehicles dvla will only accept proper blood glucose tests.. 3 months worth.. libre can only be used for cars
     
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  16. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    Yes indeed. Finding help to manage your condition may well help deter any hypo episodes that cause you to pass out.
    Using a sensor. Is a great idea. I also feel your doctor issuing a meter was forward thinking..

    The RH side of things? I really can't help. I understand the working profiles of exogenous insulin. But (from my understanding.) a rogue pancreas over reacting to carbs? This is where the experience is needed to help you manage your particular condition..

    I'll tag in @Lamont D & @Brunneria again. They will get alerts when logged in.
    But I'll also take the liberty of tagging the title of your topic that best suits your diagnosis.

    It should atract input from other RH'ers. You certainly arn't alone..
     
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  17. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi @iallaway
    I have Reactive Hypoglycaemia and even though you have had some good advice from those that have had a similar journey, without going into too much detail. You cannot prevent hypos if you keep eating carbs and sugar.
    This goes against all medical advice, because as said before you do create too much insulin, and because of the prediabetes diagnosis, which I'm not to sure of, is probably the insulin resistance, you have built up and because of the spikes of quick high glucose from the carbs, your blood glucose levels are on a rollercoaster ride of highs and lows.
    I can explain this more if you wish.
    The have more sugars, like sucrose, it's total ********!
    You have a condition that reacts to sugar so what we will do is give you refined forms of sugar that will boost your blood glucose levels up quicker and trigger the insulin overshoot, which causes the hypos. Madness!

    Driving, I would seriously consider until you learn how to achieve good control, you are more likely to continue to have hyperglycaemic episodes which could be dangerous. I was advised to stop driving by my specialist endocrinologist.
    The DVLA as far as I am aware, is not aware of this condition, cos of the rarity and the medical advice is wrong.

    There is plenty more advice in our forum.

    Do read and keep asking.

    Stay safe
     
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  18. iallaway

    iallaway Reactive hypoglycemia · Member

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    Hi Lamont, Thank you and yes I would love for you to explain more. You could send me a pm unless you would prefer to say on here.
    Thank you to everyone
     
  19. iallaway

    iallaway Reactive hypoglycemia · Member

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    Thank you Jaylee, my GP did give me a monitor and after a year or so my consultant told me not to self test anymore. Well as I said 5 days ago I had this test done but consultant has not said wether to self test or not. I will contact him tomorrow to ask him, but I think I should be self testing.
     
  20. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Again, your consultant is totally wrong, you need to monitor your blood glucose levels, before and after eating. The main reason is you are going to have to discover how certain foods and drinks (mainly carbs and sugar) can cause the reaction. This is important for control, and the only treatment for the condition, that actually works is keeping your blood glucose levels in or just above normal range consistently. And depending on your body, because we are different, for example, because of health history, your intolerance to carbs, which ones, for instance my highest level was for potatoes. Yours are likely to be wheat or fruit, but each food will test different, cos of portion size, what protein, good fats, you do have with the carbs.
    And of course, since finding this out, potatoes in any way, are off the menu. And I am also, just to confuse things, lactose intolerant. You can eat cheese, but I can't!
    Cheese is very low in carbs. And is a good, go to snack. And if you are low and require a nudge back into normal range, or a small meal of salad or meat

    I, as part of my last job, was travelling about once a week up and down the country.
    Of course finding low carb food out there was no joke, but you will find your way around it. The shops and restaurants, even mackies have the information we RH ers need to know, but I eventually only eat freshly cooked food. And I'm sure you have had food prepared, to take with you.
    But you do have to be careful.
    Some processed foods are really bad for you, typically containing such things as palm oil, vegetable oils and additives.

    There is a lot of information on our forum.
    It can be done and I have stopped having hypos, because I don't have the food that cause the reaction.
    No carbs, no spikes, - no spikes, no trigger, - no trigger, no overshoot, - no overshoot, no hypo.

    Keep safe,, keep asking,
     
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