Reactive Hypoglycaemia

Brunneria said:

Sometimes we get a sudden hypo experience if our bg drops sharply, even if it doesn't drop down to the low numbers usually associated with hypos.

So if your bg had been high, then dropped during your supermarket trip, you might feel hypo-ish, even with numbers in the 5s.

PEople call it a 'false hypo' (even though the symptoms are very real), but I have read that some American sources are calling it a 'reactive hypo' which is a much better and more accurate name.

The question is, what did you eat up until your Supermarket trip? If it had carbs, which sent you high, then dropped you low, that could explain the experience. Also, how long was it since you last ate? Time can be a factor too.

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I can give you my readings for the day so far:
5.20am woke feeling hungry. Had very small flapjack
7.45am 5.5
7.55am Porridge with whole milk and few blueberries
9.10am 5.8 felt a little shaky after school run
9.55am small Apple
10.15am 5.6 checked as not feeling right
10.20am few almonds
11.05am 5.6 on returning to car after shopping "episode"
11.10am 1 plain biscuit and white coffee
12.30pm small sandwich, celery and Alpro yogurt
1.45pm 6.0
2.40pm 7.2 feeling shaky so retested 6.6

That's it so far. I think I may be coming down with a cold with probably isn't helping! May be the apple spiked me and brought me down quickly and that's whys I had the symptoms?

nosher8355 said:

Hope im not crossing Brun, but you haven't mentioned your blood glucose level after two hours on your prolonged OGTT! Do you know it? If not why did they stop the test, did they treat you for a hypo?
An eight point rise in an hour is definitely quick spike territory and you probably peaked at around an hour and a half!
As Brun said I did have the 72 hour fasting test. But that was to eliminate other conditions.
But you might get this as well!
Sorry for the questions!

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Hi Nosher, thanks for your reply. I don't have the results from the extended GTT yet (get them this Thurs). They didn't stop the test. I was told they would only stop if my level dropped to 2 or below which it obviously didn't. I did begin to feel unwell around 3 hours after the glucose load. Heart was racing, felt a bit light headed, shaky and tired etc. Was like that for about 20 - 30 mins and then started to feel a little better. I'm guessing my body released some glucose or whatever it does? The 72 hour fast sounds pretty awful. Should I be asking for one of these when I see the consultant on Thurs? Thank you for your advice. Everyone on here seems so knowledgable and supportive. I have felt pretty rubbish since March this year. It's so frustrating and you feel so alone. It's nice to know there is support out there!

Hi Lina,
No, I am basically on three low carb meals a day.
I can control my BG unless I slip up in a big way like last week.
At lunch today we were out by the sea in Cumbria and I had half a lidl high protein roll with butter and a boiled egg plus half a pink lady and some walnuts and it filled me for over four hours.
I find walking and gardening enough exercise for me nowadays. 3 miles walking usually, but I am getting up in years and have 'electronic ignition!'
best wishes
Derek
)

Linagirl said:

Hey Derek

Not yet but I am eating little and often so whether that helps to slow things down I don't know. Are you eating more often? I can't see any other posts other than yours now on this thread so I'm not sure what I have done

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So I have kicked the carbs for two days now and had a sicky headache yesterday then a dash to the bathroom today (Derek!) and no headache until tea time tonight. Does that sound about right for carb withdrawal? I have also given up caffeine at the same time.

Today I have eaten

2 x bacon
Egg
Mush and tomatoes for breakfast 8am blood sugar was 5.7 after two hours

10am 5 strawbs 5 raspbs

12.30 salad leaves Turkey green red and yellow peppers tomato and a fig with olive oil and balsamic dressing salt and pepper bs was 8 after 2 hours

3.00 homemade broccoli and cauliflower and leek soup with butter salt and pepper blood sugar was 7.8 after two hours

5.00pm beetroot

6.30pm chicken tenders stem broccoli and spinach with butter


How does that look?

Many thanks all

Sounds like coffee withdrawal to me! (I have watched Mr B go through it several times.

But just in case, try drinking more - lots of water - and see if the headaches go.

Thanks yes I have drunk quite a bit of water and it has eased thanks

Feeling really tired. Is anyone able to take a look at my food diary and tell me if I am doing it right? Think I need to try the yoghurt to get some more calories in xx

Thanks Nosher. Sorry to sound desperate I'm just feeling a little lost right now hopefully once I have the current lot of tears done I'll feel better and know where I am going on

Linagirl said:

Thanks Nosher. Sorry to sound desperate I'm just feeling a little lost right now hopefully once I have the current lot of tears done I'll feel better and know where I am going on

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The weepiness and tiredness are all signs of carb withdrawal, but don't worry, it passes, and once it does, you really do start to feel better.

Drink plenty of water.
Make sure you add a little salt to your food (this helps with the water balance in your body)
Don't do too strenuous exercise
Make sure you eat plenty (important to eat lots of low carb foods so you feel satisfied and don't go hungry)
If you start to get that terrible carb craving gnawing feeling (not everyone does) that isn't quite hunger, but just makes you think about stuffing stodge and carbs, then eat something protein or fat. They both kill the cravings. The things I go for are 2 squares 70% choc, or a slice or two of cheese, or a coffee with cream. They seem to kill the cravings dead. Once I even had a cup of bovril with some cream in it. Worked like a charm!

Kaz261 said:

I can give you my readings for the day so far:
5.20am woke feeling hungry. Had very small flapjack
7.45am 5.5
7.55am Porridge with whole milk and few blueberries
9.10am 5.8 felt a little shaky after school run
9.55am small Apple
10.15am 5.6 checked as not feeling right
10.20am few almonds
11.05am 5.6 on returning to car after shopping "episode"
11.10am 1 plain biscuit and white coffee
12.30pm small sandwich, celery and Alpro yogurt
1.45pm 6.0
2.40pm 7.2 feeling shaky so retested 6.6

That's it so far. I think I may be coming down with a cold with probably isn't helping! May be the apple spiked me and brought me down quickly and that's whys I had the symptoms?

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Hi @Kaz261

Sorry I didn't see your post til just now.
I have to say that your day's food would have me feeling VERY shakey.
It is almost all carbs, and virtually no protein.

My body goes downhill from the first portion of carbs of the day - so the longer I delay that first carb, the better I feel.

You started at 5.20am with a flapjack and then went on porridge, fruit, a biscuit, a sandwich...

This is not a criticism, because most people eat this way, but (speaking for myself) it really doesn't do my RH any favours.

Can I suggest that you experiment with a completely different way of eating for a day or two, and see what happens? I have no idea if you want to lose weight, or not, but even if you do, set aside any queries about not eating fat, or NHS guidance on 'healthy eating'. Just for a day or two try low carb.

To give you a rough idea:
Egg and bacon for breakfast.
Salad, cheese, ham, chicken, coleslaw, for lunch
Chicken, green veg, maybe a full fat yog for tea
IF you want snacks, have cheese, or nuts

Don't go anywhere near bread, rice, oats, potato, pasta, flour, etc.
Have good filling portions, add mayo, grated cheese, cream, if you want.

Just give it a try.
And see how you feel,

nosher8355 said:

There's no need to ask for a 72 unless they think it is something that needs to be eliminated, like insulinoma!
Don't be awed, by your specialist. He is going to help you through this, don't be afraid to ask even if you think they are stupid questions. If carbs make you ill, then you can get enough from salad vegetables, the full fat will help and and if they say complex carbs, they in my experience are just as bad!
Ask him what he thinks it is. If he doesn't know, ask for a referral to a glucose endocrinologist specialist! They are out there. Ask him if he thinks it could be RH or a metabolic syndrome.
Ask him, what he has discounted, especially if he still thinks you are not diabetic.
You should ask for a copy of your results.
You should probably have to give more bloods.
Just thought did they send bloods from the prolonged test to the labs, similar to the one that they test hba1c or liver function etc.?

Hope they have an answer for you, Thursday!

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The prolonged GTT was carried done in hospital so bloods were sent straight to the lab for analysis before the next test was carried out. This is how I know I didn't drop below 2. I'm so nervous about Thurs. In the past 6 months I've gone from being well to having diabetes and now possible RH. I have two young children (6 & 2) which makes the whole thing more worrying. It's been such a shock as I have non of the usual risk factors for diabetes: never been over weight, no family history, always are a reasonably healthy diet (although not a saint!). I guess this doesn't make you immune eh! Thanks again for the advice, I'll let you know how it goes. I may have more questions then, hope you don't mind?

Heres the thing, diabetics if around 2 they get sent to hospital as its too low and can induce coma. (my dad is t1) My body warns me at 4.5 or so if my blood sugar like I've stood up too quick. We feel a sharp rise or drop, diabetics get Hypoglycaemic unawareness, im very aware of something being wrong. I think anything under 4 definitely under 3 shows our blood / insulin is unusual especially as we get such severe symptoms.

Brunneria said:

Hi @Kaz261

Sorry I didn't see your post til just now.
I have to say that your day's food would have me feeling VERY shakey.
It is almost all carbs, and virtually no protein.

My body goes downhill from the first portion of carbs of the day - so the longer I delay that first carb, the better I feel.

You started at 5.20am with a flapjack and then went on porridge, fruit, a biscuit, a sandwich...

This is not a criticism, because most people eat this way, but (speaking for myself) it really doesn't do my RH any favours.

Can I suggest that you experiment with a completely different way of eating for a day or two, and see what happens? I have no idea if you want to lose weight, or not, but even if you do, set aside any queries about not eating fat, or NHS guidance on 'healthy eating'. Just for a day or two try low carb.

To give you a rough idea:
Egg and bacon for breakfast.
Salad, cheese, ham, chicken, coleslaw, for lunch
Chicken, green veg, maybe a full fat yog for tea
IF you want snacks, have cheese, or nuts

Don't go anywhere near bread, rice, oats, potato, pasta, flour, etc.
Have good filling portions, add mayo, grated cheese, cream, if you want.

Just give it a try.
And see how you feel,

Click to expand...

Thanks, I'll give that a try. I've been reluctant to change breakfast for two reasons. Firstly I have two small children and don't have much time before the school run and secondly I walk to school and back, so am worried that I'll be low on energy.

I have to agree though, I do eat a lot of carbs. About 200g a day, but this is how the dietician told me to eat. When I started to have RH symptoms she said to eat every two hours but to include carbs. Since reading this thread I've wondered if starting the day with carbs is making matters worse. I often wake around 5.30am feeling sweaty and anxious this is why I have a flapjack! It also seems to ease the shakes when I get up at 7am.

Interestingly, we had a beef stir fry for dinner last night with lots of veg. I had only a very small portion of egg noodles with it. My level before was 6.1. One hour after 7.2 and two hours after 6.2. I felt hungry again after two hours but not shaky. May be the low carb diet can help. How many carbs do you have in a day? Is that all carbs or starchy carbs?

I also have to keep an eye on my cholesterol. It was 5.1 at the last check which had gone down from previous. It makes me a little wary about eating too many eggs and processed meat etc. Have you found this diet to increase yours at all?

Thanks for your advice is really is much appreciated x

Kaz261 said:

Thanks, I'll give that a try. I've been reluctant to change breakfast for two reasons. Firstly I have two small children and don't have much time before the school run and secondly I walk to school and back, so am worried that I'll be low on energy.

I have to agree though, I do eat a lot of carbs. About 200g a day, but this is how the dietician told me to eat. When I started to have RH symptoms she said to eat every two hours but to include carbs. Since reading this thread I've wondered if starting the day with carbs is making matters worse. I often wake around 5.30am feeling sweaty and anxious this is why I have a flapjack! It also seems to ease the shakes when I get up at 7am.

Interestingly, we had a beef stir fry for dinner last night with lots of veg. I had only a very small portion of egg noodles with it. My level before was 6.1. One hour after 7.2 and two hours after 6.2. I felt hungry again after two hours but not shaky. May be the low carb diet can help. How many carbs do you have in a day? Is that all carbs or starchy carbs?

I also have to keep an eye on my cholesterol. It was 5.1 at the last check which had gone down from previous. It makes me a little wary about eating too many eggs and processed meat etc. Have you found this diet to increase yours at all?

Thanks for your advice is really is much appreciated x

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Oooh, lots to respond to in your post above:

Quick and easy LC brekkies.
I can't be bothered to phaff at breakfast, unless it is weekends. So mine are Coffee with a good glug of cream every weekday morning (and I do mean a GOOD glug). Believe it or not, if you use a good portion of cream you will stay satisfied for hours.
Alternatively, buy some sliced ham and sliced cheese. Grab a couple of slices of each out of the fridge and wander through your morning eating them like a sandwich. Quick. Easy. satisfying. and no washing up!

The eating carbs every 2 hours thing is standard advice, but personally, I find all that does is keep me wobbling up and down on the edge of hypos all day.
Nosher eats about 7 times a day, but he avoids carbs. i think he has the occasional half apple and savoury biscuit, but the rest of the time is is low carb. Keeps him comfortably stable, but without the shakes.

Your dinner last night sounds a great start. My body wouldn't have liked even the small portion of egg noodles, but would have loved it if I had added fat (maybe cheese afterwards, or more oil on the veggies). The oil would have kept me from feeling hungry.

I tend to stick as low carb as I can. Getting there is a learning curve, and everybody's LC diet is different, because their body reacts to different foods in different ways (I am grain intolerant). But I am usually under 50g carbs a day, and often under 30g. The lower I go, the better I feel.

You mentioned cholesterol. I had a total cholesterol of 5.2 a couple of years ago. And then went very low carb, which means I eat a lot of cream, cheese, butter, coconut oil, and nuts. Last month, my cholesterol had risen to 5.4. But my healthy cholesterol is what had risen, while my 'bad' triglycerides had fallen. so my overall 'healthiness' had significantly improved.

There is also evidence that the older women get, the higher their cholesterol should be, and that it is actually protective as we age.

Have a read of this article by Zoe Harcombe.
http://www.zoeharcombe.com/the-knowledge/we-have-got-cholesterol-completely-wrong/
She is really on the ball about recent medical info, in a way that the cumbersome beaurocracy of the NHS simply cannot be. Doctors have to follow outdated Cholesterol guidelines, because that is a rule of their employment.

Tests not tears!