I think I have Reactive Hypoglycaemia. What could you recommend for me ?

[Catkysydney]

Hello everyone,
Is there anyone to give me an advice, please ?

I think I have Reactive Hypoglycaemia. But I was diagnosed type 2 diabetes. I am not overweight( 158cm 54kg ), my BMI is 21.6. ( 18.5 -24.9 normal weight )

I have been having Hypoglycaemic symptoms from teenager, but I did not have any test. Just ate chocolate when I had the symptom. I knew my body needed it somehow.


My 4hour glucose tolerance test result was like this. (September 2018)

Result mmol/l
Fasting. 5.1
1hr. 14.1
2hr. 13.1
2.5hr. 10.2
3hr. 5.3
3.5hr. 3.6 Headache
4hr. 3.2 Body Shaking

But the lab doctor said I do not have Reactive Hypoglycemia because my blood sugar is not lower than 3.0 ! I have symptoms ( body shaking ) when my blood sugar becomes below 4.0..

I have high and low blood sugar, so I have spikes ! This is caused by weak insulin response, right ?

May be that is why I could not take some diabetes medicine, such as :

- Diabex ( Metformin ) , this made me exteremely ill soon after I started and

- Diamicron ( Gliclazide ) gave me hypoglycemia everyday.

I am taking Januvia ( Sitagliptin ) 100mg everyday to prevent high blood sugar. It is working for me, but not enough, so I have started low carbohydrate diet.

@Lamont D and @Brunneria, I respect your information, knowledge and experience.

What can you recommend for me other than low carbohydrate diet ?

GP told me if I loose 7 or 8 kg, diabetes will go away.. so my aim is 48kg.

I read one Japanese guy’s blog, he lost 20kg ( 90 to 70 ), then after that he does not need to take any diabetes medication. So his diabetes was cured. Amazing !

@Lamont D, Do you take any other medication for RH?? You said you are taking Sitagliptin.

Is there anyone can give me advice, please ??

Thank you very much for reading.

Best Wishes

 

[Brunneria]

Hi and welcome!

Sorry to hear that your test results showed glucose dysregulation. I couldn’t possibly commit myself to ‘diagnosing’ anything on the back of that test. We aren’t permitted to give medical advice or medication advice on here - we aren’t qualified, and your medical team have far better, more detailed info at their disposal.

However, I will stick my neck out and say that RHers and T2s can have overlapping blood glucose test results, so keep an open mind.

It is incredibly fashionable at the moment to think that T2 will resolve/reverse/disappear with weight loss. This is a rather simplistic way of looking at things, and (as with everything) the true situation is often more complex and varies from individual. The idea comes from a few studies done at Newcastle University, where overweight T2s were put on an 800 calorie a day strict diet and lost weight. If they had non-alcoholic-fatty-liver-disease AND they lost enough weight that their livers lost fat too, and were able to return to ‘normal’ function, then their T2 improved too.

The info on all the Newcastle Diet studies are available on the Newcastle University website, if you want to read further.

But, as you have probably already realised, the participants in that study are in a rather different situation from you, based on even the little bit on info in your post.
- you are not significantly overweight. You may not be overweight at all
- you suspect you may have RH
- you may have had RH since childhood

Has anyone ever checked you for a fatty liver? Done any liver tests on you that may suggest liver issues?

Of course, losing a few kilos may help - especially if you carry that weight around your middle. But I wouldn’t expect weight loss to be a magic wand for resolving all your issues. Sorry.

I’m afraid that the only suggestion I can really make is that you continue with the low carbing, fine tune it to find what works for you, and then stick to it.
That is, in my experience, the only way to get your life back when you have RH.
- but then, i have never taken any drugs for RH, so I don’t know what difference they may, or may not, make.

Interestingly, there are a growing number of studies showing that low carbing can reduce fatty liver, even without low calorie diets and rapid weight loss. https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)30054-8
But that is only relevant to people who had fatty livers in the first place.

Hope that helps!

 

[Catkysydney]

Hi and welcome!

Sorry to hear that your test results showed glucose dysregulation. I couldn’t possibly commit myself to ‘diagnosing’ anything on the back of that test. We aren’t permitted to give medical advice or medication advice on here - we aren’t qualified, and your medical team have far better, more detailed info at their disposal.

However, I will stick my neck out and say that RHers and T2s can have overlapping blood glucose test results, so keep an open mind.

It is incredibly fashionable at the moment to think that T2 will resolve/reverse/disappear with weight loss. This is a rather simplistic way of looking at things, and (as with everything) the true situation is often more complex and varies from individual. The idea comes from a few studies done at Newcastle University, where overweight T2s were put on an 800 calorie a day strict diet and lost weight. If they had non-alcoholic-fatty-liver-disease AND they lost enough weight that their livers lost fat too, and were able to return to ‘normal’ function, then their T2 improved too.

The info on all the Newcastle Diet studies are available on the Newcastle University website, if you want to read further.

But, as you have probably already realised, the participants in that study are in a rather different situation from you, based on even the little bit on info in your post.
- you are not significantly overweight. You may not be overweight at all
- you suspect you may have RH
- you may have had RH since childhood

Has anyone ever checked you for a fatty liver? Done any liver tests on you that may suggest liver issues?

Of course, losing a few kilos may help - especially if you carry that weight around your middle. But I wouldn’t expect weight loss to be a magic wand for resolving all your issues. Sorry.

I’m afraid that the only suggestion I can really make is that you continue with the low carbing, fine tune it to find what works for you, and then stick to it.
That is, in my experience, the only way to get your life back when you have RH.
- but then, i have never taken any drugs for RH, so I don’t know what difference they may, or may not, make.

Interestingly, there are a growing number of studies showing that low carbing can reduce fatty liver, even without low calorie diets and rapid weight loss. https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)30054-8
But that is only relevant to people who had fatty livers in the first place.

Hope that helps!

Thank you very much for you reply !!

Very valuable to me !!

I had a blood test for liver functions and had a CT scan for pancreas... I didn’t have any problem from them.

I don’t have digestive enzymes for fat/oil, this was diagnosed by a specialist. I don’t eat fatty food, that gives me diarrhea..

I do not drink alcohol nowadays. So my liver is OK, I feel.

Low carb diet is so far very successful for my blood sugar. I eat a lot of salad without any oil before the main meal to reduce the amount of food I eat. So far I lost 1kg within a month.

My friend told me that I should lose weight gradually, I cannot lose too much weight at once, I am amazed some actors lose or gain a weight in a short period of time.

Thank you for your information about Newcastle University. I will have a look !

Your information is very valuable and helpful for everyone. I sincerely appreciate your continuous contribution to this great group !!️

Best Wishes️

 

[Lamont D]

Hello everyone,
Is there anyone to give me an advice, please ?

I think I have Reactive Hypoglycaemia. But I was diagnosed type 2 diabetes. I am not overweight( 158cm 54kg ), my BMI is 21.6. ( 18.5 -24.9 normal weight )

I have been having Hypoglycaemic symptoms from teenager, but I did not have any test. Just ate chocolate when I had the symptom. I knew my body needed it somehow.


My 4hour glucose tolerance test result was like this. (September 2018)

Result mmol/l
Fasting. 5.1
1hr. 14.1
2hr. 13.1
2.5hr. 10.2
3hr. 5.3
3.5hr. 3.6 Headache
4hr. 3.2 Body Shaking

But the lab doctor said I do not have Reactive Hypoglycemia because my blood sugar is not lower than 3.0 ! I have symptoms ( body shaking ) when my blood sugar becomes below 4.0..


The test as I read it is very similar to what happens when I eat porridge for breakfast.
Also if I eat too much potatoes.
The relatively high spikes is symptomatic of glucose dumping, those readings will almost certainly trigger an overshoot if you have Hypoglycaemia.
The headaches, (over and back of the eyes) is again symptomatic, when your blood sugar drops quickly, blood sugar levels will only drop that quickly, when driven down by excess insulin or medication such as glicizide, that is why you went hypo!

I think I commented on the other thread about hypoglycaemic over 3!
I believe that if you had continued for another half hour, your blood sugar would have dropped further, the lab doctor, (if that is what he is!) Is talking rubbish. You go hypo, you are Hypoglycaemic, if you have regular episodes of Hypoglycaemia!
And according to this test, if you have too much glucose, you hyper, then hypo!
Classic symptoms of RH!
But obviously the 72 fasting test will probably be needed and other bloods to get a true diagnosis.
I too have a problem with some fats, mine are vegetable oils or polyunsaturated fats.
I avoid them completely. If you eat enough lean meat or cook with animal fats (if you can) or coconut oil, and others, this will help with the balance requirements of your dietary intake. And it will help with satiety in other words slow digestion a little.

As I have already said, since diagnosis, I have been in total control, because I don't eat the food that causes the trigger for an overshoot! No hyper, no hypo!
I am in ketosis, my Keto diet keeps my blood sugar levels in normal range, which my body really likes!
Even if you don't have RH, a very low carb diet is the best advice I can give!
And other than sitagliptin, my other tablets are an aspirin, Irbesartan for hypertension, (I haven't got hypertension!) And a antihistamine for night itching!
I got told for anything, I should be careful what I take! My tablets are all enteric, means that they don't dissolve in my stomach, but in the intestines. Most cold remedies contain sugar, and other tablets contain lactose!

Best wishes