Hypo after very high carb meal (high carb on doctor’s advice)

CESM · Oct 5, 2020

After waiting 10 months, I’ve finally had a phone consultation with a diabetes consultant. In December 2019 I had HbA1c of 57 and was diagnosed as type 2. I was allowed to try and reverse it with a low carb diet, but in March 2020 (by when I’d lost a huge amount of weight) my HbA1c had shot up to 135 and it was assumed I was type 1. I was immediately started on insulin, which I’m still on. When my GAD blood test results came through it was found the my pancreas is still working, so I was diagnosed as type 2 again. In July my HbA1c had dropped to just 40 from 135 in the space of just 14 weeks.

When I spoke to the diabetes consultant, she thought that I’m more likely to be type 1 or LADA. Today I had the blood tests she wants. I was told to have a very high carbohydrate breakfast before the tests, one of which was C-Peptide. I ate about 90 grams of carbs (I usually follow a low carb diet). I was told to take my usual pre-breakfast insulin dose of 5 units of NovoRapid.

My question is this: when I tested my blood before lunch it was just 3.6 (it’s usually between 5 - 6.4). It’s my first hypo. I haven’t had much input or help for my diabetes because everything was put on hold because of Covid. I thought that eating a lot of carbs would raise my blood sugar. I don’t understand why my blood sugar dropped so low. Can anyone please help me with this?

DCUKMod · Oct 5, 2020

CESM said:
After waiting 10 months, I’ve finally had a phone consultation with a diabetes consultant. In December 2019 I had HbA1c of 57 and was diagnosed as type 2. I was allowed to try and reverse it with a low carb diet, but in March 2020 (by when I’d lost a huge amount of weight) my HbA1c had shot up to 135 and it was assumed I was type 1. I was immediately started on insulin, which I’m still on. When my GAD blood test results came through it was found the my pancreas is still working, so I was diagnosed as type 2 again. In July my HbA1c had dropped to just 40 from 135 in the space of just 14 weeks.

When I spoke to the diabetes consultant, she thought that I’m more likely to be type 1 or LADA. Today I had the blood tests she wants. I was told to have a very high carbohydrate breakfast before the tests, one of which was C-Peptide. I ate about 90 grams of carbs (I usually follow a low carb diet). I was told to take my usual pre-breakfast insulin dose of 5 units of NovoRapid.

My question is this: when I tested my blood before lunch it was just 3.6 (it’s usually between 5 - 6.4). It’s my first hypo. I haven’t had much input or help for my diabetes because everything was put on hold because of Covid. I thought that eating a lot of carbs would raise my blood sugar. I don’t understand why my blood sugar dropped so low. Can anyone please help me with this?

Hi there.

When you had your 3.6, did you wash your hands and try testing again, to make sure it wasn't contamination on your hands or something (although that's more usually associated with high sugars)?

Secondly, for some, who are insulin producers, a heavy carb hit can result in a vert fast and high spike, then an equally dramatic drop, so that maybe could have happened.

Thirdly, if, as you suggest, this was an unusual meal for you to have, your body wouldn't have been expecting it, so may not necessarily have had all the digestive juices and enzymes ready to deal with it - leading an an unusual reaction.

Forthly, there could be some stress in the mix, and fifthly....... Well, there's bound to be a fifthly!

There are so many things that could have brought about an odd reaction, and I totally get it would be perplexing with the test you've been having is meaningful to you.

In your shoes, I din't know when you will have the results of your test, and any discussion with your Consultant or Doctor, but I might try to just wait and see what the result is, and discuss it with them. Much else is likely to be speculation at this stage.

I think there is one thing none of us should doubt, and that is the diabetes can be a fickle thing, with many tricks to mess with our minds and bodies.

Fingers crossed you get the results you are hoping for.

CESM · Oct 5, 2020

DCUKMod said:
Hi there.

Hi DCUMod
Many thanks for your reply. Hope you don’t mind my comments in red!
When you had your 3.6, did you wash your hands and try testing again, to make sure it wasn't contamination on your hands or something (although that's more usually associated with high sugars)?
I’m very careful to always wash my hands before I test - that’s one thing my GP diabetes nurse drummed into me. However, I could try a double test if this happens to me again - I hadn’t thought of doing that.

Secondly, for some, who are insulin producers, a heavy carb hit can result in a vert fast and high spike, then an equally dramatic drop, so that maybe could have happened.
It’s possible that I’m still producing a decent amount of insulin. The consultant explained that I might be in a “honeymoon period” of up to 2 years of continuing to produce insulin. She will try and see if I can come off insulin and try tablets.

Thirdly, if, as you suggest, this was an unusual meal for you to have, your body wouldn't have been expecting it, so may not necessarily have had all the digestive juices and enzymes ready to deal with it - leading an an unusual reaction.
Interesting. The most carbs I would normally eat are 1 small slice of bread, one small potato, or a low-carb biscuit when I need to indulge. So your theory could account for some of the reaction.

Forthly, there could be some stress in the mix, and fifthly....... Well, there's bound to be a fifthly!
Only a fifthly? Probably a sixthly & seventhly too!!

There are so many things that could have brought about an odd reaction, and I totally get it would be perplexing with the test you've been having is meaningful to you.

In your shoes, I din't know when you will have the results of your test, and any discussion with your Consultant or Doctor, but I might try to just wait and see what the result is, and discuss it with them. Much else is likely to be speculation at this stage.

I think there is one thing none of us should doubt, and that is the diabetes can be a fickle thing, with many tricks to mess with our minds and bodies.

Fingers crossed you get the results you are hoping for. Thank you.
.

DCUKMod · Oct 5, 2020

CESM , there are quite a few T1s who still produce insulin; but just nowhere near enough to manage without injecting/pumping.

Fingers crossed for you.

Hypo after very high carb meal (high carb on doctor’s advice)

CESM

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CESM

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Hypo after very high carb meal (high carb on doctor’s advice)

CESM

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CESM

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