Prediabetic and severe postprandial somnolence

[Halfie]

Hi all

I was diagnosed prediabetic a few months ago with HbA1c of 42 (UK based) but I have, for months and months, had major fatigue 2 hours after eating. When I say major fatigue, I mean falling asleep in my office chair or with my head on my desk. Its like someone switches me to the off position for 20-30 minutes and I cannot fight it.

This is obviously concerning so I have invested in a monitor and tracked my levels today. There seems to be a huge dip at the same time the extreme fatigue hits:

1220 (before food) 6.2
1245 - Lunch, scrambled egg on toast with cheese and a small piece of chocolate
1345 - 8.0
1445 - 8.2
1450 - 6.9 (and I feel dreadful!)
1500 - 5.6 (yawning, very sleepy, feel awful)
1515 - 5.1 (still sleepy, still feel awful)
1600 - 5.7 (feel ok, lethargy has gone)

So within 30 minutes I've dropped 3.1 mmol/l!! I cant find any info on what the usual trajectory is for blood sugars coming down is, but this seems extreme to me. Could this be causing the general feeling dreadful and overwhelming need to sleep? This is a very regular occurrence, almost daily!

Any help gratefully received.

Many thanks

 

[Lamont D]

On those readings, in my opinion.
Fasting not bad, just above normal.
The spike is around the two hours time.
Fifteen minutes later a drop of over two mmols. This in itself is quite usual, however the symptoms are your brain requiring more glucose. This is because it seems that the amount of insulin required is pushing your blood glucose levels down quickly. than you have been used to in the past.
Insulin resistance, which could be a precursor to T2, could be a cause of higher than normal levels of insulin is not responding to the food.
You have started looking at what certain food does to your blood glucose levels. How about a different meal with a bit less carbs. It is the carbs and sugars that spike your BG levels. A food diary over time will tell you a lot about how intolerant you are to carbs.
It does seem that your body finally responds to the drop. That is why it does come back up.
If you adopt a low carb diet, T2 might not be the final outcome.

 

[Halfie]

On those readings, in my opinion.
Fasting not bad, just above normal.
The spike is around the two hours time.
Fifteen minutes later a drop of over two mmols. This in itself is quite usual, however the symptoms are your brain requiring more glucose. This is because it seems that the amount of insulin required is pushing your blood glucose levels down quickly. than you have been used to in the past.
Insulin resistance, which could be a precursor to T2, could be a cause of higher than normal levels of insulin is not responding to the food.
You have started looking at what certain food does to your blood glucose levels. How about a different meal with a bit less carbs. It is the carbs and sugars that spike your BG levels. A food diary over time will tell you a lot about how intolerant you are to carbs.
It does seem that your body finally responds to the drop. That is why it does come back up.
If you adopt a low carb diet, T2 might not be the final outcome.

Thank you, that's really helpful. I shall keep a food diary and look at insulin resistance too. So fed up of feeling so horrendous.

 

[Claudia 1961]

Thank you, that's really helpful. I shall keep a food diary and look at insulin resistance too. So fed up of feeling so horrendous.

This was great to read as I have the same problem. It’s like carbs wipe me out. My hba1c is 6.6 but my post prandial levels and fatigue are horrendous. I shoot up to 9.8 and higher if I am not careful. Try cauliflower rice with Moroccan seasoning and other vegetables to feel full. Go for protein and mainly green vegetables. Half a cup of fruit when you have it. Bitter chocolate. Try the eggs with one slice bread only and make it low carb. Do not be afraid of healthy fats like eating an avocado. The weight will not like on as you body will use fats instead of carbs as fuel but will not spike on fats, protein and lots of fibre.

 

[HSSS]

To me that looks like you have a somewhat delayed response to the carbs and then it kicks in fast and heavy. Fairly common insulin resistance response. The actual numbers are not unusual or awful so I suspect it’s the speed of the drop and change that is wiping you out until things settle back down. Are you doing anything in those 2 hrs? Sitting at a desk or moving about?

I’d suggest as both prediabetic (presumably wanting to return back to normal) and someone with an impaired insulin response you’d want to limit the trigger to this feeling - the carbs. You may find some types worse than other not just the amount. Also try moving around soon after eating, even a 5 min walk! To try and get the insulin responding a bit sooner but hopefully more gently. It’s going to take a llittle experimenting and testing but hopefully you’ll find some patterns and food that helps. For instance this lunch would be better with less toast and more eggs and cheese. And switch the chocolate for as higher % dark chocolate as you can tolerate and work up to 90% as you adjust your taste buds. Milk or white chocolate isn’t not your friend.

 

[Halfie]

To me that looks like you have a somewhat delayed response to the carbs and then it kicks in fast and heavy. Fairly common insulin resistance response. The actual numbers are not unusual or awful so I suspect it’s the speed of the drop and change that is wiping you out until things settle back down. Are you doing anything in those 2 hrs? Sitting at a desk or moving about?

I’d suggest as both prediabetic (presumably wanting to return back to normal) and someone with an impaired insulin response you’d want to limit the trigger to this feeling - the carbs. You may find some types worse than other not just the amount. Also try moving around soon after eating, even a 5 min walk! To try and get the insulin responding a bit sooner but hopefully more gently. It’s going to take a llittle experimenting and testing but hopefully you’ll find some patterns and food that helps. For instance this lunch would be better with less toast and more eggs and cheese. And switch the chocolate for as higher % dark chocolate as you can tolerate and work up to 90% as you adjust your taste buds. Milk or white chocolate isn’t not your friend.

Thank you so much, that makes a lot of sense. Sadly I am sat at my desk for the majority of the day but I will try moving around after eating to see if that helps. I think I also need to keep a food diary to see what makes things worse/better, At the minute I'd sell my soul to feel better and not be worried about eating incase I drop off during an afternoon meeting (and that has happened more than once!!).

 

[Outlier]

We are all different, but this used to happen to me and doesn't now that I have cut out carbs. Might be the same for you. Try it and see.

 

[Liam E]

Hi all

I was diagnosed prediabetic a few months ago with HbA1c of 42 (UK based) but I have, for months and months, had major fatigue 2 hours after eating. When I say major fatigue, I mean falling asleep in my office chair or with my head on my desk. Its like someone switches me to the off position for 20-30 minutes and I cannot fight it.

This is obviously concerning so I have invested in a monitor and tracked my levels today. There seems to be a huge dip at the same time the extreme fatigue hits:

1220 (before food) 6.2
1245 - Lunch, scrambled egg on toast with cheese and a small piece of chocolate
1345 - 8.0
1445 - 8.2
1450 - 6.9 (and I feel dreadful!)
1500 - 5.6 (yawning, very sleepy, feel awful)
1515 - 5.1 (still sleepy, still feel awful)
1600 - 5.7 (feel ok, lethargy has gone)

So within 30 minutes I've dropped 3.1 mmol/l!! I cant find any info on what the usual trajectory is for blood sugars coming down is, but this seems extreme to me. Could this be causing the general feeling dreadful and overwhelming need to sleep? This is a very regular occurrence, almost daily!

Any help gratefully received.

Many thanks

Swap the toast out for bacon. You know you want to and your pancreas will thank you.

Have you considered it might not be the blood sugar swing making you feel that bad? Other possibilities include hypothyroidism and sleep apnea among others. It is worth getting both checked if a very low carb lunch doesn't cure the problem. Your partner will be able to tell you if sleep apnea is likely, or there are phone aps now that can have a good stab at it too. If a very low carb lunch doesn't fix it and sleep apnea can be ruled out then it might be worth speaking to your doctor to get a thyroid test done.