Reactive Hypoglycaemia and exercise

[Lamont D]

Hi, Mine isn't triggered by what I eat, I just go high when I do and need to inject or go for a walk to bring it down, so this was a walk last week. No food was consumed in the 4 hours prior to me starting the walk at 21.30 when I was seeing 9.8. 45 minutes later and walked 2 miles, and I'm at 3.8. no rapid injectables involved on that day. This was the result of my C-Peptide test a few years ago on a quiet day with no real exertion, and I'm falling into T1 territory with my own insulin production.
I suspect I'm falling into this category, but it's very deep and I'm not a biochemist, so looking at all avenues. Diabetes runs in my family, 3 siblings, father and his siblings struggled with it.... Always blamed on T2, but that's likely because it's so misunderstood.

https://www.sciencedirect.com/science/article/pii/S0002929707613445

I'm confused.
You go high if you don't eat and walk?
And only a c-peptide test?
No other tests than the obvious blood panel for hba1c?
Have you an endocrinologist?

As per forum rules I cannot diagnose, however, by your description and my experience, this is not RH.
RH is caused by food. There are other conditions that have episodes of hypoglycaemia, they, if not T1 or Lada, are usually pancreatic conditions, such as insulinoma.
But I could be wrong..
I would advise you, to go back to your surgery, and ask your doctor for a referral to a specialist.

I will tag @EllieM to pass on more about why you are having to use insulin.

Best wishes.

 

[Ashintheuk]

I'm confused.
You go high if you don't eat and walk?
And only a c-peptide test?
No other tests than the obvious blood panel for hba1c?
Have you an endocrinologist?

As per forum rules I cannot diagnose, however, by your description and my experience, this is not RH.
RH is caused by food. There are other conditions that have episodes of hypoglycaemia, they, if not T1 or Lada, are usually pancreatic conditions, such as insulinoma.
But I could be wrong..
I would advise you, to go back to your surgery, and ask your doctor for a referral to a specialist.

I will tag @EllieM to pass on more about why you are having to use insulin.

Best wishes.

This was one of the results when being treated as a T2 on multiple different tablet therapies. 3 year's later, I had exhausted those avenues and went onto insulin. I'm under a consultant because my GP was out of his depth. I've done the GAD antibodies test and also genetic testing, but my condition is a bit far out there as the research focused on western Europe, and my father had a lot of Asian and East Asian in his DNA.
I've had reactive episodes on exertion since the 70s.
My A1C is around 55 mmol/mol now. If I don't walk at least 5k steps, I need around 28u of basal, if I do walk, I need around 18u. In fact the 3.8 reading was on 18u and it was too much on that occasion.
I also use Fiasp rapid insulin to knock the top off the highs when obliged to be sedentary.

Feb 2016		Surgery (General Practice)​
Coded entry	Haemoglobin A1c level - IFCC standardised (XaPbt) 106 mmol/mol