Hypo at bedtime

[Andy-Sev]

Last night just before I went to bed after a completely typical day, which included a 3 mile walk at 8am, I felt light headed so checked my sugar levels and I was at 4.1. I am normally high 5s before bed and feeling this was too low for bed I had a couple of biscuits and rechecked 30 minutes later and I was down to 3.4 and feeling it. So I had 3 dextrose tablets and 30 minutes later was back to 4.1 so followed it with a slice of bread and some cheese and went up to 8.9 30 minutes later. I followed this by testing at 1 and 3 in the night with readings at 4.9 and 4.7.

Now the thing is that as I have mentioned elsewhere I am in the honeymoon phase and was taken off of insulin (twice a day regime) and put on Metformin after only a couple of weeks as my DNS was concerned about the mid morning hypos I was getting and because my levels had returned to normal. So why would I suddenly have a hypo late at night about 4 hours after I had eaten my evening meal?

 

[Lamont D]

Last night just before I went to bed after a completely typical day, which included a 3 mile walk at 8am, I felt light headed so checked my sugar levels and I was at 4.1. I am normally high 5s before bed and feeling this was too low for bed I had a couple of biscuits and rechecked 30 minutes later and I was down to 3.4 and feeling it. So I had 3 dextrose tablets and 30 minutes later was back to 4.1 so followed it with a slice of bread and some cheese and went up to 8.9 30 minutes later. I followed this by testing at 1 and 3 in the night with readings at 4.9 and 4.7.

Now the thing is that as I have mentioned elsewhere I am in the honeymoon phase and was taken off of insulin (twice a day regime) and put on Metformin after only a couple of weeks as my DNS was concerned about the mid morning hypos I was getting and because my levels had returned to normal. So why would I suddenly have a hypo late at night about 4 hours after I had eaten my evening meal?

If you had been diagnosed with T2 and those same symptoms of going hypo after a few hours, I would recommend you read the forum on reactive hypoglycaemia.
As your docs are not sure what you are, the not eating is symptomatic of some form of Hypoglycaemia.
You have lost all your glucose and your body is adjusting to low glucose levels in your blood.

I used to get mid morning hypos all the time until diagnosed. I have normal fasting levels.
I used to hypo after 3 and half hours. If I didn't eat low carb I would still.

I would definitely read the RH forum!

Can you give us your readings and what you have eaten to get those figures?

Your story is so similar to mine, misdiagnosis and GPs not knowing what was going on!

 

[Andy-Sev]

Hi Nosher thanks for the reply

I actually nosied around the RH forum and ended up calling up my DNS this afternoon to see what she said. Her answer was that it is not unusual and because I am not taking extra insulin when my pancreas misfires and splutters out an insulin surge I would notice it by feeling the low and being puzzled by it where as when those using insulin in their honeymoon feel a low it is often put down to the difficulty of judging insulin doses to a misfiring pancreas. Which all made sense to me when I thought about it.

The sad news is that she said it could well be a sign that my honeymoon is shifting from the easy going stage of not feeling like I have diabetes to the more up and down part as it misfires more often which ironically I said to her back in October it would be just my luck for it to start playing up at Christmas.

 

[Lamont D]

Ok, I here what she is saying if you are type 1!
But are you? and if you are, why metformin?
It's unusual for T1s to come off insulin!

Misfiring is another way of saying overshoot as my endocrinologist says.
I over produce insulin and that's the reason I hypo!
Doesn't that sound similar?

Maybe I might be completely wrong!

Are your fasting levels in the normal range?
Can you try a glucose drink without spiking and a couple of hours later going hypo?
Do you intermittently fast without going hypo?
Do you get bad mood swings and other symptoms that mimics T2?

 

[Andy-Sev]

I can definitely see where you are coming from and whilst I believe I am honeymooning I am not shut off to any other diagnosis purely because of how many stories I have read of misdiagnosis. But to answer your questions.

Initially my DNS felt I could be Type 2 due to age and weight, purely a statistical diagnosis despite at diagnosis I had high ketones and was seen by a specialist who said she suspected Type 1. The DNS felt that that due to the lows I was getting thanks to my blood sugar coming into range very quickly I should come off insulin and try Metformin as she believed it would help with the weight loss if nothing else. When after two weeks of being on just a single dose of Metformin at breakfast my blood sugar was still in range she was beginning to sway towards me being in honeymoon especially as I still haven't needed to up my dose and haven't gone full on low carb, I eat around 150g a day including pasta without it causing spikes.

Are your fasting levels in the normal range?
Yes they range from 4.5 to 5.9

Can you try a glucose drink without spiking and a couple of hours later going hypo?
Tried this a month ago before drink 5.4 two hours later 6.1 an hour after that back to 5.6 and then an hour later 5.2

Do you intermittently fast without going hypo?
Since coming off insulin the only other time I have dropped below 3.9 is after an intense 30 minutes on the excercise bike.
The longest I have gone without eating (other than sleep) is 6 hours and my blood sugar was never lower than 4.2 during this period.

Do you get bad mood swings and other symptoms that mimics T2?
During the first two weeks as my blood sugar came down I did have mood swings but now nothing out of the ordinary and in fact I would say I am more laid back than I have been in years.

What I am interested in seeing is the results of my first follow up HbA1c, I have the appointment to do the blood tests at the end of the week and will hear back in the New Year as to what the results are.

 

[Lamont D]

I can safely say, that what you have posted, it looks as though your dsn hasn't a clue!
But neither do I! Lol!

The thing about metformin it helps a little with blood glucose levels and protection of your organs but only helps very little as an appetite suppressant!

Whatever they come up with, will be very interesting! But not RH!

Maybe someone else has a clue.

 

[Andy-Sev]

I certainly haven't a clue and I reckon I may have read more on diabetes than my DSN since diagnosis. lol

As they say "Time will tell" I just hope time will tell me after Christmas so I can enjoy what appears to be a glorious "honeymoon phase" for as long as possible and keep to my current regime before I have my life turned upside down again, lol.

Anyway, cheers for your help