Ha, yes there is always a however ! I am definitely a systems person. How systems are interconnected. I just find it a point of interest. Yes, an inflammatory response is a red flag for many diseases and problems. My C-reactive proteins fall within the ‘normal range’ but it’s a marker I keep an eye on when I get by blood panel done. Are your CRP levels something that would be raised in RH ? I mean there can be many reasons for an increase in CRP levels, including insulin resistance, arthritis, and autoimmune disorders. And just out of interest are your C-peptides raised or normal? I’m assuming they are normal as you are on a Keto diet. My C-peptides are normal, but at the lower end. I’m assuming from that I don’t have insulin resistance, or very little as my pancreas doesn’t produce shed loads of insulin to counter the insulin resistance. The fact that I have raised blood sugars, and completely unstable, I fear my pancreas is either periodically compromised or it’s due to coeliac , albeit I’m 100% gluten free, which compromises nutrient absorption. The interesting thing is I produce ketones, not a great amount, but they are consistently there.
I was advised to increase my carb consumption which I did and to my surprise my hypo events decreased Which is completely the opposite to yours. I couldn’t rely on my liver dumping, in fact I would watch as my blood sugars plunged at a fast rate but my liver would not step in with a correction. I had to intervene. This has changed with the upping of my carbs, now my liver dumps, which is what Type 2’s don’t necessarily need or want. I look at my night time graphs and I see my sugars going low, then a glorious thing happens, my blood sugars rise, usually to around 6. So your liver fails to correct the blood sugar tumble.
I love my exercises and I’m guessing part of the reason for my liver sometimes failing to dump is down to my depleted glycogen stores. So there are a number of possibilities for my blood sugars dropping, but as I said, they are far less frequent now. My CGM recorded all my hypos in the low glucose events feature And there were a lot.
The lack of a first phase insulin response, Im sure as you say, is the slow depletion of beta cell mass. But what causes that? What caused yours? If it starts a few years earlier, I read around 10 years, likely when one’s blood sugars are only slightly raised, it cannot be due to beta cell exhaustion or toxicity surely. So many questions !
So similar yet we are different.
I have no idea what my CRPs are, but I believe I would have been told at the time, if they weren't ok.
Because of the diet I was on a decade plus before diagnosis, (recommended) and being misdiagnosed with T2, my bloods were all over the place, and I did have insulin resistance, my arthritis is getting worse especially In my neck, (spondylitis) and my c-peptide is within normal but have had it done two or three times. My annual is five blood vials. I know my bloods during my first and second eOGTT, we're sent to a specialist laboratory. But was assured normal.
Unfortunately, when my my insulin levels were tested during the tests and after, it was always above normal, save for the fasting, first phase. Second phase was above normal and high, but insulin resistance was prevalent.
So I was over producing lots of insulin (overshoot) and swamping any action from my liver, wether there was, is anyone's guess. I still overproduce if I don't stick to keto.
I reckon with my food diary details, that my blood glucose levels peaked and troughed, multiple times a day, before diagnosis, when starting with porridge for breakfast first thing, as recommended.
If I'm not mistaken glycogen, glucagon, are stored for use. To be used when needed. So if not there or an imbalance, that is maybe why?
I asked my endocrinologist when and why, it all began?
He wasn't too certain but he did say it was a long time coming and with the lactose intolerance, the intolerance to other sugars, the glucose intolerance does correlate with the prediabetes, T2 misdiagnosis, insulin resistance, first phase, weight gain and all the symptoms.
But I believe, that looking back and other aligned gut and stomach issues, such as finding helicobactor pylori, a bad bacterial infection, and a hiatus hernia, and being warned of the effect to the antibiotics for the bacteria, has cleared the infection but could have done some damage to my homeostasis.
I was surprised to find a U.S.paper on the bacteria and the gut, brain axis, and hypoglycaemia.
It is included in the wiki page of route causes.
I informed my endocrinologist, who told me........ Maybe......it's as good as an explanation as any.
This is why, RH was formerly known as idiopathic. Because the route cause was a matter of debate, cos they were not sure that food was causing the hypo. Strange?
What else could it have been?
So I do agree that like most endocrine, metabolic conditions, the time it takes to develop is around a decade.
Abnormal BG levels can be dismissed as a one off, but frequent episodes, should always be investigated.
And of course an M.O.T. Should be done.
I have tried many times to find at what BG levels triggers the reaction. But without success. It is I believe an automatic (???) response. But if I do go above normal levels (ish) I do react.
It is intriguing that upping carbs has helped you suffer less symptoms and reduced the hypos.
There must be a reason for this, maybe the imbalance of other hormones not so much insulin, counteract the spike in some way? Maybe insulin in the second phase counters the spike, but does not cause another imbalance? I don't know! Maybe the exercise has a bearing?
As you say so many questions?
The one thing I haven't asked is.......
Have your doctors put a name to it, or the cause, or just another form of hypoglycaemia?
