Reactive Hypoglycaemia and Type 2

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Hi,
Anyone out there struggling with RH and T2?

I was diagnosed with reactive hypo glycaemia about 20 years ago. Told to eat "diabetic diet" - high in good carbs and eat frequently. I did and it worked, I stopped having hypos.
All was well, then
After 15years or so I started cheating on the diet (? becoming insulin resistant so craving more carbohydrate) and was diagnosed with Type 2 diabetes 2 years ago.
I did some research and decided to go low carb (60-100g/day but often cheated with the staff room biscuit tin). I lost nearly10% of my weight (78 to 71kg) which dealt with the diabetes (last few HbA1C's have been really good).
All was well, then
the reactive hypoglycaemia kicked in again with hypos which ended up with me occasionally being on the floor at work.
With no ideas from the GP or the diabetic dietician I solved the problem by putting the weight back on back to 78kg.
Now
I've stopped cheating and am stricter on my carbs so started losing weight again. At 73kg have started having hypos again.
By hypo I mean BG under 4 (3.9 - 2.8) and symptoms (weak, shaky, light-headed, inco-ordinated, emotional, tearful, need to sit down, make mistakes, say stupid things, sometimes have to lie down on floor before I fall over etc).
I think it's weight loss that does it???? Live a life of too long at work, lots of stress, supporting mother in advanced dementia, daughter with major depression and husband with depression he won't admit but none of this has changed.
In the last 6 days have had 6 hypos on 4 days.
Has anyone any ideas or how have you coped with this sort of problem?

 

[Brunneria]

Hi and welcome!

Yup. T2 and RH.
RH since 4 yrs old. T2 for approx 5 years now.
I keep both under control with low carbs (usually less than 50g carbs a day, moderate protein and fill the energy gap with good fats like butter, cream, olive oil, fish oils, fats on meat. non of that polyunsaturated rubbish )

Have a good rummage through the Reactive Hypoglycaemia section of the forum. You will find several of us, all in slightly different variations of the same boat all finding that diet is a better control than any drugs.

 

[Lamont D]

Hi and welcome to the forum.
Brun is right, keeping to a very low carb diet is crucial.

Throughout your post you say you have done ok on 'good carbs'.
As far as RH is concerned, there is no good carbs. Complex or whole grain, they are still carbs and if like me the trigger is glucose, which comes from carbs, then you have a problem, carbs are carbs, they will give you hypos.

I wouldn't have thought it was the weight loss to cause your symptoms.
I think it's the fluctuating blood glucose levels that's doing it.

There is a couple of other things you can do.
Eat more regularly every two to three hours. If you go too long without food, you will hypo.
Eat smaller meals, have a snack of very low carb instead of three meals a day.

Stress can have you all over the place, some of it is symptomatic and trying to get your head around it, is probably not helping, as you feel awful most of the time.

If you have questions, please ask, we will help.

 

[Brunneria]

@nosher8355

I kind of disagree with you about the weight loss being important.
A lot of type 2 diabetics have non alcoholic fatty livers (where a small amount of fat builds up in the liver and affects liver function, which a knock on effect of triggering T2).

For some, weight loss removes this liver fat, and the T2 improves.

If the T2 was masking the RH by keeping the glucose levels elevated, while insulin release was not working properly, then the RH would seem to improve. But weight loss would reveal it again.

My experience was that when I turned T2 my RH symptoms improved/became far less obvious.
But having the Freestyle Libre and seeing my bg mapped 24/7 on the wee screen showed that my RH was still up and running when/if I eat carbs. But the combo of very low carb and T2 has (most of the time) shifted my lowest bgs out of the hypo zone.

But of course, keeping yourself up at a 'T2 weight' is like cutting your nose off to spite your face - because the consequences of high bg are (in most ways) worse than the consequences of low bg.

And, ironically, the solution to controlling both is to control carb intake.

 

[Lamont D]

@Brunneria, no I didn't put it across properly.
I was pointing out that the symptoms were probably attributed to fluctuating blood glucose levels rather than weight loss.

I know the effects of a fatty liver and liver function. As I did have them.

I do need to learn more about T2 with RH, because at some stage in the future, I may develop that.