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Diabetes Discussion
Reactive Hypoglycemia
Possible RH diagnosis advice
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<blockquote data-quote="captainscapegoat" data-source="post: 1616570" data-attributes="member: 451700"><p>Hi, new here!</p><p></p><p>If I'm posting in the wrong place, my apologies. I'm still in the process of trying to get a diagnosis on the NHS and its proving a difficult struggle. Any advice would be helpful, though of course I'm not expecting to actually diagnose myself, just point the NHS in the right direction...</p><p></p><p><strong>Brief history...</strong></p><p>I'm 45 year old, male, had a stressful lifestyle, with too much beer and carbs!</p><p>Started with severe constipation and more frequent urination.</p><p>Then, night-time jolts/spasms led to a week of sleeplessness. Still have twitches now even in the day.</p><p>Now also: <em>Ravenous</em> hunger all the time, cold sweats that peak in the afternoon and wear off in the evening.</p><p>Itching at night, anxiety bad especially during the cold sweats.</p><p>Also, a h.Pylori infection and vitamin D deficiency, plus a single blood test reading with increased pancreatic amylase.</p><p></p><p>GI Doctors started to treat the bowel problems as functional (I'm now in tertiary care, had scans etc) and the anxiety was treated with Mirtazapine, which I've since discovered messes with the glucose metabolism somehow (I'm now coming off it).</p><p>When the chills, sweating and hunger set in, I had the tranche of diabetes blood tests - <strong>all came back normal! GP response: you are fine, its nothing to worry about.</strong></p><p><strong></strong></p><p>The symptoms continued, so I bullied my GP into referring me to an private endocrinologist, convinced that all my symptoms had a common underlying source. The specialist suggested I might have <strong>reactive hypoglycemia </strong>and I'm supposed to be having an <strong>OGTT </strong>(if the appointment comes through back on the NHS - I think they have forgotten about me). He implied that a diagnosis of T2 diabetes/impaired glucose tolerance/insulin resistance/reactive hypoglycemia is effectively semantics.</p><p></p><p>Is that an a reasonable statement? Whats the difference relationship between T2 diabetes/impaired glucose tolerance/insulin resistance/reactive hypoglycemia? Am I correct the think that insulin resistance is the mechanism by which impaired glucose tolerance progresses through RH to full diabetes?</p><p></p><p>What is the glucose tolerance test like? It sound horrendous - if I'm likely to have HR, wouldn't the OGTT be likely to put me in A&E with a full on hypo? Is it even worth doing?</p><p></p><p>I'm currently avoiding refined carbs but still eating porridge and Lidl protein rolls, like many I'm used to a grain based diet. The cold sweats wear off at the same time every day. If I eat breakfast 2 hours earlier, the cold sweats wear off 2 hours earlier. Having a no carb omelet + veg for breakfast seems to make no difference.</p><p></p><p>I expect the OGTT to lead to a referral to an NHS dietician. I've read the NHS diet advice and its critique. Sounds like it doesn't work for most people, which I can understand. The endo recommended a low carb diet for RH. I'm browsing through the low carb diets on here. I'll admit I find it confusing: I'm dubious about the diet advice I'm likely to get from the NHS, but a LCHF diet is incredibly intimidating to me, especially doing it 'off reservation' ie. the docs don't approve. Also, I can see that there seem to be LCHF side effects, many of which seem like exactly what I'm trying to avoid! How do people manage this, especially without professional guidance?</p><p></p><p>Apologies for the long post. Any advice or pointing in the right direction would be appreciated.</p></blockquote><p></p>
[QUOTE="captainscapegoat, post: 1616570, member: 451700"] Hi, new here! If I'm posting in the wrong place, my apologies. I'm still in the process of trying to get a diagnosis on the NHS and its proving a difficult struggle. Any advice would be helpful, though of course I'm not expecting to actually diagnose myself, just point the NHS in the right direction... [B]Brief history...[/B] I'm 45 year old, male, had a stressful lifestyle, with too much beer and carbs! Started with severe constipation and more frequent urination. Then, night-time jolts/spasms led to a week of sleeplessness. Still have twitches now even in the day. Now also: [I]Ravenous[/I] hunger all the time, cold sweats that peak in the afternoon and wear off in the evening. Itching at night, anxiety bad especially during the cold sweats. Also, a h.Pylori infection and vitamin D deficiency, plus a single blood test reading with increased pancreatic amylase. GI Doctors started to treat the bowel problems as functional (I'm now in tertiary care, had scans etc) and the anxiety was treated with Mirtazapine, which I've since discovered messes with the glucose metabolism somehow (I'm now coming off it). When the chills, sweating and hunger set in, I had the tranche of diabetes blood tests - [B]all came back normal! GP response: you are fine, its nothing to worry about. [/B] The symptoms continued, so I bullied my GP into referring me to an private endocrinologist, convinced that all my symptoms had a common underlying source. The specialist suggested I might have [B]reactive hypoglycemia [/B]and I'm supposed to be having an [B]OGTT [/B](if the appointment comes through back on the NHS - I think they have forgotten about me). He implied that a diagnosis of T2 diabetes/impaired glucose tolerance/insulin resistance/reactive hypoglycemia is effectively semantics. Is that an a reasonable statement? Whats the difference relationship between T2 diabetes/impaired glucose tolerance/insulin resistance/reactive hypoglycemia? Am I correct the think that insulin resistance is the mechanism by which impaired glucose tolerance progresses through RH to full diabetes? What is the glucose tolerance test like? It sound horrendous - if I'm likely to have HR, wouldn't the OGTT be likely to put me in A&E with a full on hypo? Is it even worth doing? I'm currently avoiding refined carbs but still eating porridge and Lidl protein rolls, like many I'm used to a grain based diet. The cold sweats wear off at the same time every day. If I eat breakfast 2 hours earlier, the cold sweats wear off 2 hours earlier. Having a no carb omelet + veg for breakfast seems to make no difference. I expect the OGTT to lead to a referral to an NHS dietician. I've read the NHS diet advice and its critique. Sounds like it doesn't work for most people, which I can understand. The endo recommended a low carb diet for RH. I'm browsing through the low carb diets on here. I'll admit I find it confusing: I'm dubious about the diet advice I'm likely to get from the NHS, but a LCHF diet is incredibly intimidating to me, especially doing it 'off reservation' ie. the docs don't approve. Also, I can see that there seem to be LCHF side effects, many of which seem like exactly what I'm trying to avoid! How do people manage this, especially without professional guidance? Apologies for the long post. Any advice or pointing in the right direction would be appreciated. [/QUOTE]
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