Low carb for unexplained hypos?

[Kirstyr]

first of all I’m not diabetic.

Been to see Gp as having lots of hypos around 5pm with no cause. Tried carbs before they happen, I walk home from work and the blood sugar drops. (From 5 to under 2.5 in less than 20 mins) fasting bloods 4.1-6.1 so I did wonder if there is a bit of resistance on the days where I’m over 6?


GP unsure of reasoning - suggested to try a low carb, high Protein and fat diet. (I’m currently trying low gi and have tried with and without snacks...) I wasn’t sure if this might make the hypos worse given they seen activity related? If it doesn’t work she wants to refer me to endocrine..

I’m going to give it a go but anyone with experience?

 

[EllieM]

You should consider heading over to the reactive hypoglycaemia forum to see if its symptoms ring any bells.

https://www.diabetes.co.uk/forum/threads/information-for-newbies-and-basic-stuff.87932/

The above thread by @Lamont D , describes the basics, though I'm not sure whether this applies to you given that you seem to be triggered by exercise rather than food. Do the hypos only happen when you take exercise?

 

[kitedoc]

Hi @Kristyr, If the GP does not know what is what, the wisest thing to do is for him to refer you to an endocrinologist.
The endocrinologist can assess you and, if they are good at their job, discuss with you for may be happening and what test or tests will best sort out your problem, and most importantly, help you find the best way to prevent the problem.
I agree with @EllieM, having a look at the Reactive Hypoglycaemia forum may be helpful to you in the meantime.
Best Wishes.

 

[Kirstyr]

Thank you both. It’s not reactive except reactive to exercise not food. I’m going back in 2 weeks so if low carb doesn’t work I’ll ask for the referral. Gp did suggest referral but she wanted to try this first... she knows I work with some of the endocrinologists and I work with the diabetes dietitian so have already tried a few things unofficially.

 

[Lamont D]

Thank you both. It’s not reactive except reactive to exercise not food. I’m going back in 2 weeks so if low carb doesn’t work I’ll ask for the referral. Gp did suggest referral but she wanted to try this first... she knows I work with some of the endocrinologists and I work with the diabetes dietitian so have already tried a few things unofficially.

Hi @Kirstyr
I agree with @kitedoc, you need a referral and tests.
There are many types of Hypoglycaemia, not just reactive hypoglycaemia or reactive or intolerance to food.
Until you get the tests which can only be sanctioned by an endocrinologist, no one can tell you what is happening or how to treat it, except that a low carb diet can only help you in your general health. Not a low GI diet because in my experience, a carb is a carb and unless your metabolism is actually in good health, carbs will create a problem for you.
Your GP is grasping for a reason why you are going hypo, he can't explain it, nor can you understand why, even though he may recognise the symptoms of hypoglycaemia, he has not had the expertise or experience to correctly identify the actual cause or condition.
The medical term before this decade for reactive hypoglycaemia, was idiopathic post prandial hypoglycaemia. Idiopathic means no known cause.
As I stated above, there are many types of Hypoglycaemia, and most of them are so individual to that patient. Soon it should be tested for as such. You may find that it could be triggered by exercise, as there are many diabetics that find strenuous exercise rockets their blood glucose levels, so if that happens to someone like me who has a trigger for an overshoot of insulin, that spike, will cause a hypo.
Until the tests are done, you won't know!
Get a referral!

Best wishes

 

[johnme]

You may find that it could be triggered by exercise, as there are many diabetics that find strenuous exercise rockets their blood glucose levels

Have I understood this correctly? Are you saying there are lots of people whose bg goes up on exercise? I’ve recently discovered this about myself. Gentle exercise sends it down, sustained exercise sends it high for hours. I didn’t realize that was common

 

[DCUKMod]

first of all I’m not diabetic.

Been to see Gp as having lots of hypos around 5pm with no cause. Tried carbs before they happen, I walk home from work and the blood sugar drops. (From 5 to under 2.5 in less than 20 mins) fasting bloods 4.1-6.1 so I did wonder if there is a bit of resistance on the days where I’m over 6?


GP unsure of reasoning - suggested to try a low carb, high Protein and fat diet. (I’m currently trying low gi and have tried with and without snacks...) I wasn’t sure if this might make the hypos worse given they seen activity related? If it doesn’t work she wants to refer me to endocrine..

I’m going to give it a go but anyone with experience?

Kirsty - How do you feel when you are down at 2.5-ish, and when you are there, when had you last eaten, and what did you have?

I accept I'm appearing to ask for very specific detail there, which is likely unreasonable, but if it's something like, "4 hours since my lunch, and I'd usually have a sandwich, crisps and fruit" (or whatever), that's the sort of thing I mean.

 

[Kirstyr]

Kirsty - How do you feel when you are down at 2.5-ish, and when you are there, when had you last eaten, and what did you have?

I accept I'm appearing to ask for very specific detail there, which is likely unreasonable, but if it's something like, "4 hours since my lunch, and I'd usually have a sandwich, crisps and fruit" (or whatever), that's the sort of thing I mean.

At 2.7 (no exercise involved) I was dizzy, clammy, shaky, tired, headache, hunger. Eaten 60mins previous (cereal bar) and had homemade veg & lentil soup, whole meal seeded bread 2 slices, an activia yoghurt and a apple, approx 4 hours before the low.

At 2.5 (after a 25 minute walk) I was working a theory for some reason snacks (especially the ones containing more sugars) were causing the crashes (which I now know wasn’t the case). Last meal was 3 hours previous, and similar to the above meal. The symptoms however were slightly more severe, as well as the above feeling faint, and disorientated, not able to walk straight, abdo pain and feeling a bit sick.

Symptoms usually resolve within 1-2 hours of eating, but sometimes I was getting further dips later in the evening.

On day 1 of trying the gp suggestion, a lower carb lunch (I went for 15g) it does seem to have prevented a hypo on walking home, I also have a libre sensor for the next 2 weeks and can see I am spiking quite rapidly, and dropping at a similar rate into symptomatic hypos post meals with significant carbs (so far). I dropped during exercise (cardio at gym) and also again an hour after (both symptomatic I’m low 3’s) approx 2 hours after a meal with carbs (45g), I’ve also had a couple of overnight hypos (2.7-3.0 region) which I do wake for. Wasn’t sure if they were exercise related delayed hypos though..

I have another doctors appointment booked in a couple of weeks and intend to have more data from my libre trial to take along... I just wanted to see if there was anything underlying that warranted further investigation I expect gp will be happy they have managed it if the current trend continues and prevented the after work hypos but it still doesn’t answer my question as to why it is happening.

 

[bulkbiker]

Have I understood this correctly? Are you saying there are lots of people whose bg goes up on exercise? I’ve recently discovered this about myself. Gentle exercise sends it down, sustained exercise sends it high for hours. I didn’t realize that was common

Yep extremely common... in fact I could almost go so far as to say "normal"?

 

[Lamont D]

At 2.7 (no exercise involved) I was dizzy, clammy, shaky, tired, headache, hunger. Eaten 60mins previous (cereal bar) and had homemade veg & lentil soup, whole meal seeded bread 2 slices, an activia yoghurt and a apple, approx 4 hours before the low.

At 2.5 (after a 25 minute walk) I was working a theory for some reason snacks (especially the ones containing more sugars) were causing the crashes (which I now know wasn’t the case). Last meal was 3 hours previous, and similar to the above meal. The symptoms however were slightly more severe, as well as the above feeling faint, and disorientated, not able to walk straight, abdo pain and feeling a bit sick.

Symptoms usually resolve within 1-2 hours of eating, but sometimes I was getting further dips later in the evening.

On day 1 of trying the gp suggestion, a lower carb lunch (I went for 15g) it does seem to have prevented a hypo on walking home, I also have a libre sensor for the next 2 weeks and can see I am spiking quite rapidly, and dropping at a similar rate into symptomatic hypos post meals with significant carbs (so far). I dropped during exercise (cardio at gym) and also again an hour after (both symptomatic I’m low 3’s) approx 2 hours after a meal with carbs (45g), I’ve also had a couple of overnight hypos (2.7-3.0 region) which I do wake for. Wasn’t sure if they were exercise related delayed hypos though..

I have another doctors appointment booked in a couple of weeks and intend to have more data from my libre trial to take along... I just wanted to see if there was anything underlying that warranted further investigation I expect gp will be happy they have managed it if the current trend continues and prevented the after work hypos but it still doesn’t answer my question as to why it is happening.

Only tests can tell you why it is happening, insist on a referral.

 

[Alison Campbell]

I’m going to give it a go but anyone with experience?

Just wanted to add that this was my experience before going to the doctor and then I was diagnosed with impaired fasting glucose 6.3 and later with prediabetes. Unfortunately I didn't get a meter at the time but a moderately low carb diet really sorted out the highs and lows for me.

 

[Kirstyr]

Having a libre is really helping me see what is happening... my fasting glucose is currently not terrible, (although it fluctuated between 3.7 and 5.7 before breakfast this morning) I’m having a few nighttime hypos, potentially delayed from the exercise so will look at a protein based supper to see if it helps prevent that one. Exercising on a lower carb diet yesterday, led to a spike during exercise (it reached about 9) but didn’t seem to drop immediately after which I was pleased about and came down steadily. I’m spiking terribly with any carbs over 20, regardless of time, had a spike from 5 upto 11 earlier, and then a crash down to the low 4’s all within 90 minutes or so, I certainly felt the rollercoaster, but had definite symptoms of a mild hypo during the crash... I imagine the libre readings are about 0.5 out on this sensor.

I can see the low carb meals give a much better profile so certainly will be the direction I’m heading longer term (but will also be asking the doctor about other tests to find out the cause of the spikes and drops)

 

[Alison Campbell]

Sounds like a good idea for those extra tests and well done for your doctor suggesting lower carbs. Let us know how you get on.

 

[Lamont D]

Having a libre is really helping me see what is happening... my fasting glucose is currently not terrible, (although it fluctuated between 3.7 and 5.7 before breakfast this morning) I’m having a few nighttime hypos, potentially delayed from the exercise so will look at a protein based supper to see if it helps prevent that one. Exercising on a lower carb diet yesterday, led to a spike during exercise (it reached about 9) but didn’t seem to drop immediately after which I was pleased about and came down steadily. I’m spiking terribly with any carbs over 20, regardless of time, had a spike from 5 upto 11 earlier, and then a crash down to the low 4’s all within 90 minutes or so, I certainly felt the rollercoaster, but had definite symptoms of a mild hypo during the crash... I imagine the libre readings are about 0.5 out on this sensor.

I can see the low carb meals give a much better profile so certainly will be the direction I’m heading longer term (but will also be asking the doctor about other tests to find out the cause of the spikes and drops)

A carb is a carb, if you have a condition similar to mine, this is what you will find for yourself. The roller coaster ride is definitely not nice and avoiding those rides is truly the best way forward. And getting those diagnostic tests!

Best wishes and happy New year

 

[johnme]

Yep extremely common... in fact I could almost go so far as to say "normal"?

Thanks very much for that info. It's a bitter blow to discover yet again I'm not 'special.' Seriously, happy new year to you and anyone else reading this.

 

[Resurgam]

In my early 20s when first put onto a 'healthy' high carb diet I would go out for a breath of fresh air after lunch and collapse with 'wobbles'.
I suspect that even back then I had problems with over production of insulin, as once I reverted back to lower carb foods it went away - 'it must have been a virus' I was told.
Perhaps, just from the first day of your altered diet, you have the same sort of problems - it took another 40 years for me to be diagnosed type 2 diabetes, but only 80 days of low carbing to have a non diabetic Hba1c, so if diet is the problem, a few days without so many carbs might well show the way you need to eat to avoid the 'wobbles'.

 

[Kirstyr]

Thank you everyone. I’ve stuck to lower carbs for 2 days, no hypos, exercise performance is good, with only a slight increase in glucose during exercise, a slow drop after which doesn’t result in hypos. I was getting overnight hypos which have also now stopped. I do think this is the solution for me, I hope the trend continues, I’m feeling heaps better...