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Reactive Hypoglycaemia

Discussion in 'Reactive Hypoglycemia' started by Lamont D, Jan 27, 2015.

  1. alembic1989

    alembic1989 Type 2 · Member

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    Hi.
    Since the beginning of 2019, I've been trying to get my blood sugars under control.
    I've been following a low carb diet and have been exercising regularly ( I'm a personal trainer). I've been monitoring my sugar levels rigorously before and 2 hrs after eating as well as when first waking up. The results have been startling. In the last couple of weeks I've noticed some very low readings. I feel fine, not shaking, not cranky ( like I use to get on low readings). I don't lack energy when I train. I'm getting readings of around 5.5 2 hrs after eating my midday meal. I have my final meal at around 6 pm and my readings before this meal have recently been about 3-3.5! which really surprised me as I didn't feel bad at all.
    My question is this.
    Should I be worried about such low readings when I feel perfectly fine?
    I should also mention that I do intermittent fasting from 7 pm to 11:40-12pm the next day. 1 hour ago 2 hrs after my midday meal my sugars were only 4.4! At the start of the year my doctor wanted to put me on medication ..but I wanted to continue as diet/ exercise controlled.
    Are these low readings bad for me?
     
  2. Brunneria

    Brunneria Other · Moderator
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    Hi,

    (sorry, in advance, for the essay :) )

    Diabetics on insulin (or other strong medications) are told to consider any measurement under 4mmol/l as a hypo and treat accordingly.
    This is because the medication can overcome the body's own natural blood glucose balancing act, and their blood glucose can dip sharply into dangerous hypo territory. But it happens because of the medication they are using.

    Most of the rest of the population aren't taking those meds and if their blood glucose dips a bit their own body will just raise it up again by raiding glycogen (glucose) stores in the liver. If you tested a wide range of people with normal blood glucose, throughout the day, a fair few of them would be in the 3s and 4s, without any symptoms of hypoglycaemia. They might feel peckish, and fancy a snack, or feel a bit tired, but only within normal limits.

    Then you get RHers, whose own bodies tend to do what the insulin and strong drugs do for diabetics - they produce too much of their own insulin, it drives the blood glucose down rapidly (too fast and too far for other mechanisms to react to balance things out) and they get hypo symptoms and feel grotty.

    So - you have probably guessed what I am going to say, by now :D - unless you are getting hypo symptoms, then I don't think you need to be worrying. Especially as you are familiar with how those hypos feel for you.

    Having said all that, sometimes our hypo signals and our hypo awareness shifts over time, and they way we used to identify hypos may be different - especially if you are now eating low carb or keto. That can mess with hypo awareness, while the ketones protect us from the brain dysfunction that comes with non-ketogenic hypos. It is a bit complicated. So just double check with yourself, are you REALLY functioning well at those low numbers? Or are you in a bit of a zombie daze and not realising that you are flirting with a hypo? And if you are confident that you are functioning well, then I wouldn't worry about it, except to be aware of what is going on.

    I often have a snack while I am preparing my evening meal. Just a cube of cheese, or a nibble of cold meat, or similar. Just to stop my blood glucose dropping during that last half hour before the next meal. Kitchen knives, glass bowls and gas flames, are not always my friend when I am teetering at the bottom of my blood glucose comfort zone. ;)

    By the way, you asked if low readings are bad for you?
    There is some evidence that VERY low hypos can be harmful. Your numbers in the 3s and 4s are not very low, so I wouldn't worry about that, either.

    And WELL DONE for getting control and doing so well that you don't need medication and have found a way to avoid hypos. Congratulations. I bet you feel much better.
     
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  3. alembic1989

    alembic1989 Type 2 · Member

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    Thank you so much.
    You're right, I feel so much better know.
    It appears this Keto diet is working.
     
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  4. Miss.T. Morning

    Miss.T. Morning · Member

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    Hi, new here today andjoined as there was a reference made to 'idiopathic post prandial hypoglycemia' but now I can't seem to locate it in order to raise a question.
     
  5. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi, @Miss.T. Morning and welcome to the forum.
    Idiopathic post prandial hypoglycaemia is now not used in medical terms.
    It is called Reactive Hypoglycaemia, which have a few different types and causes.
    Idiopathic means no known cause, but in the last ten years or so, the reason for the Hypoglycaemia is now known.
    I have ' Late Reactive Hypoglycaemia'!
    It is caused by too much insulin, as your pancreas over compensates for the excess glucose.
    Please do ask away, someone will help you with advice.

    Best wishes
     
  6. Miss.T. Morning

    Miss.T. Morning · Member

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    Ah, I see!
    Reactive Hypoglycemia.
    What a relief to find a name for what I am going through!
    The hypos I experience have shattered my life really but Docs are not interested as my bg levels are pretty good.
    When feeling bad they range from 4.6 to 8.6.
    When I tried an optimum nutrition diet (pyramid diet) the symptoms went away but as Docs said I was healthy and nothing to worry about I began eating carbs after 3 days without food due to flu bug. This resulted in blurred vision and then 3 months of double vision. So Scary but never thought it was bs until I suddenly remembered something I'd seen on line about bg levels. Been searching for advice ever since. Have blurred / double vision again now so trying to adapt my diet.
    Great to hear from you !
     
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  7. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    I believe that your doctor, will think that because your blood sugar levels are normal from Hba1c tests or fasting blood panel tests, that you're normal, I know exactly what you are referring to.
    The condition known as reactive hypoglycaemia, is non diabetic!
    The condition has similar symptoms and post prandial readings as a type two, but the difference is afterwards when what is known as an 'insulin overshoot' is triggered by too many carbs or sugars. You go hypo!
    Maybe the other reason is because there is no known cure for RH. And your doctor is oblivious to the fact you need to control your blood sugar levels, to stop the symptoms, only dietary restrictions will do this!

    What I would recommend is to read the threads on this forum, I know there is a lot, but educating yourself why it is happening and why dietary intake can make you healthier and get rid of the symptoms.

    If you can, what tests have you had?
    Have you had a definitive diagnosis?

    Best wishes
     
  8. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    Lamont D, is double vision a symptom of RH? I've never experienced that when I had hypoglycemia in my 20's and type 2 diabetes in more recent years.
     
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  9. Brunneria

    Brunneria Other · Moderator
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    I agree Winnie
    It isn't a symptom that I have ever experienced.
    But I suppose it may be a symptom for some people, when experiencing hypos.

    I certainly wouldn't expect any double vision to persist after a hypo had resolved - unless the double vision was not connected to the hypo, and was related to another medical condition.

    Having said that, I have read of type 1 hypo experiences so extreme that they cause visual blackouts (blindness), but I am not sure whether they are the result of the brain ceasing to interpret signals from the eyes, or the eyes themselves ceasing to function.
    Again, they seem to resolve (in the accounts I have read) once the hypo is resolved.

    Blurred vision (which I HAVE experienced myself) occurs after the sugar levels in the liquid inside the eye affect the focal length, and resolves when the blood sugars return to normal.
    In my case, I had it during my last Glucose Tolerance Test, when my blood glucose rapidly rose, then fell. It took a couple of days to resolve.
     
    • Agree Agree x 1
    #1369 Brunneria, Apr 25, 2019 at 6:12 PM
    Last edited: Apr 25, 2019
  10. Miss.T. Morning

    Miss.T. Morning · Member

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    Hi Lamont D,
    Thanks for your reply.
    The first GP I saw told me I was the wrong shape to be diabetic and could find a shop that would test my blood. The second was concerned that my symptoms were unusual and referred me to a private (expensive!) endocrinologist. After much blood was taken for all manor of tests the endocrinologist said I was healthier than he was and didn't have hypoglycemia. By the time of this second visit I was following the optimal nutrition diet and symptoms had stopped. But when I returned to GP after first bout of double vision and asked for dietary support she was unhelpful saying that I wasn't diabetic.
    So I haven't had a diagnosis but plan to involve the eye specialist in writing to my GP, at my next appointment.
    I have a blood monitor now but not exactly sure what to look out for given that my readings don't identify my physical problems.
    Although I only joined the forum last night I had been reading through the posts for the last week or so and am beginning to understand the low carb life style choice. I think I now need to work out how much carbs I need at each meal. I gave up sugar a couple of years ago, don't drink alcohol and live what I think is a healthy life (mmm?)
     
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  11. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    @Miss.T. Morning your experiences with your health care providers and endocrinologist serve as good examples of what's wrong with our current healthcare system. Your health care provider's comment that you are "wrong shape to be diabetic" is not true. Those who have diabetes can be thin too, referred to as "thin on the outside, fat on the inside" (TOFI) in the research. Additionally, if your endocrinologist didn't order a 6-hour GGT to evaluate you for hypoglycemia, it's still possible you could have Reactive Hypoglycemia.

    When I began experiencing my disabling hypoglycemic symptoms, I was thin, weighing 105 pounds. I was diagnosed with hypoglycemia with a 6-hour Glucose Tolerance Test. I did not have diabetes at the time, just hypoglycemia, which is now referred to as Reactive Hypoglycemia. Another 20 - 25 years would pass before I crossed over into pre-diabetes, then type 2 diabetes.

    Also of interest, during my GGT, my hypoglycemia didn't appear until after the 4th or 5th hour, can't remember which. At the time, if I'd been given a 4-hour GGT, my hypoglycemia would have been missed. I was lucky my health care provider was knowledgeable enough to know that this can happen, and that to do a true "rule out" of hypoglycemia, a 6-hour GGT is required.

    Now that you have a glucose meter, you can monitor what's actually happening with your glucose levels after eating a typical "processed food" meal of starch and sugar, preferably within a half-hour or hour of waking. Just don't include any protein, such yogurt, milk, or eggs, or fiber rich foods, such as vegetables. A little bit of fat is okay. Water is okay. Coffee or tea...perhaps not due to the caffeine. You could have a couple of pieces of buttered toast with jam, or a scone or two.

    Take a pre-meal glucose level to get a baseline glucose reading so you know where you started, then eat your "processed food" meal of starch and sugar, then start checking your glucose level every hour or 1/2 hour. Note the time, your glucose level, and any symptoms you may be having.

    Important: When taking your glucose level, wash your hands or test finger with soap and water to remove any sugary residue that could cause a level that reflects the sugar on your skin, not the sugar in your blood. When in doubt of a "high" reading, you can always wash your hands again and test again.

    I suggest having a beverage on hand with added sugar to bring your glucose levels back up quickly if your symptoms become too uncomfortable (but be sure to test your glucose levels first because that's the information you need). This time of year, perhaps a glass of freshly squeezed lemon juice and water with added sugar. I'd then follow that with a protein based snack such as nuts or cheese, then a regular meal that includes protein, fat, and carbs.

    I never tried what I described above because I had a lot of fear around hypo's. They were just awful, and scary too. I remember having to ask my husband to bring me milk in bed a few times because I was too weak to get out of bed. A half hour later, I was fine.

    If you feel much the same, perhaps instead of doing the above, you could instead test your glucose level anytime you feel the symptoms of hypoglycemia. That would be instructive too. It would just require that you take your glucose meter kit with you wherever you go, because I almost always was out doing errands when it would happen to me.

    Regarding your double vision, I think you need to see an ophthalmologist who can dialate and examine the interior structures of your eyes (not an optometrist who checks your vision for the purpose of selling your eye glasses). I'm dumbfounded as to why your health care provider hasn't already referred you for a proper eye exam given that you experienced double vision for 3 months, and are experiencing it again. That makes no sense to me at all.

    A number of my family members have a rare genetic eye disease. Around the time that I was diagnosed with hypoglycemia, I experienced pain, then a minor vision loss. I saw an ophthamologist the same afternoon. I'd had a flame hemorrhage. He told me that he's only seen two patients with the type of hemorrhage that I had, and that we both were taking birth control pills. I stopped them immediately, and never had another problem.

    It's best to identify eye problems as soon as possible.

    And I should probably add here, if you are taking any medications, check the "adverse side effects" for each medication. Sometimes the problem isn't a health condition, it's a side effect of the medication you're taking.

    I hope some of this helps. You might find this website in the US helpful to learn more about Reactive or Functional Hypoglycemia in addition to the Reactive Hypoglycemia forum here... https://hypoglycemia.org/tests/ I found the additional information and video under the "Learn" tab at the top of the screen particularly informative.

    And here's a Blood Sugar Glucose Converter so you can translate mg/dL readings (US) into mmol/L readings (UK)... https://www.diabetes.co.uk/blood-sugar-converter.html
     
    • Informative Informative x 1
    #1371 Winnie53, Apr 26, 2019 at 7:07 PM
    Last edited: Apr 26, 2019
  12. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Hi, @Winnie53,
    Yes, I suffered quite a lot from blurred vision, including a distinct visual alteration before diagnosis. As @Brunneria said, it is as similar to when T2s get enlarged blood vessels in and around the eye. Retinopathy is similar. I get blurred vision when I go above normal levels as a warning that I am not in normal levels range.

    Do you need glasses?
    Maybe, if you don't, it could be that having near or perfect vision, would be less likely to get the symptoms of blurred vision.
     
  13. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    @Lamont D, you experienced blurred vision 24 hours a day? Blurred vision is not double vision. They're very different. My mother had double vision while pregnant with me. She had a subdural hematoma which was removed after I was born. The only time I've experienced blurred vision was after I started the LCHF diet and my blood glucose levels started coming down. it lasted for a month or more.
     
  14. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    The thing I've learned from my experience of Hypoglycaemia is that doctors know very little about how to treat the condition and symptoms.
    And more importantly, what is healthy, for those like me, it is definitely not!

    Using your blood glucose monitor is all trial and error, you have to be regimented in using it as a tool. Start a food diary and log what you eat, portion size, pre meal test, one hour after, two hours after, and after at three and four hours.
    The only other time I would use your glucometer is to find out what your blood sugar levels are, if you feel awful.
    You will learn a lot from keeping a food diary. Your blood sugar readings will tell you what foods are spiking you too high, which doesn't, how much of certain foods you can tolerate, and see how well you are doing.
    There is a sticky about recording blood sugar levels at the top of the forum page.

    Best wishes
     
  15. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    They're are MANY causes of double vision, some serious. If she has double vision, it needs to be evaluated by an ophthamologist. If it's blurred vision, agreed, could be due to abnormal glucose levels. She needs to test to find out what's going on. Without data, it's really hard to know.
     
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  16. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    To try and describe the eye blurring is quite difficult because I was used to it, when wearing reading glasses, as I have done for nearly thirty years, it would not be there, but distance it was there, I had, ( past tense), very good distance vision.
    I would get blurred vision, at that time, during the morning, then it would vary until early evening, that was when it was worst, trying to watch television, would be very difficult, as a headache would often accompany the blurred vision. Taking the dog for a walk, in the early evening was a normal thing at that time.
    You have to remember this was before diagnosis. And my blood glucose levels were on a rollercoaster, and it mirrored my dietary intake at that time. Porridge for breakfast, which would of course send me hyper, then I wouldn't eat until a few hours later, my bloods would dip down, I would eat something like baked potato, spike again! Then a meal of healthy carbs for dinner, again, spiking me! So my bloods would yo yo all day. I was trying to eat less, so my meals were stretched out to three a day, and the longer between meals, would lower my bloods into hypo levels exacerbating the symptoms.
    Of course, since diagnosis, my blurred vision, only occurs, rarely, recently, I had a heavy head cold including sinusitis, and my blood levels were raised even though I was fasting or eating healthy for me, very low carb. But it was there, especially in the evening.
    Two years ago, I went for my usual annual diabetes optical tests. I had fasted, and my reading was normal. So my eye test before this was always twenty twenty vision. However, it was found that I had a visual defect related to my age, and now I have glasses for distance as well as reading, I should have varifocals lenses, but I can't afford them! But these lenses have improved my eyesight incredibly, I can watch HD television now!

    I had no idea, that my eyes were that bad! And so different from the symptoms of blurred vision when on that blood glucose rollercoaster!
     
  17. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    @Miss.T. Morning according to the information below, if you are experiencing double vision, you should be seeing two of everything, then, if you close one of your eyes, just one of everything. Are you experiencing double vision or blurry vision?

    If your vision is blurry, don't get a prescription for glasses until your glucose levels have normalized. If you are experiencing double vision, it's doubtful that it's due to hypoglycemina.

    Medical Definition of Diplopia, binocular

    Diplopia, binocular: Double vision (diplopia) that is only evident when looking through both eyes and disappears if one eye is closed or covered. The condition is caused by misalignment of the eyes by the extraocular muscles (the muscles around the eyeball that control gaze). This may be due to strabismus (misalignment of the eyes from birth), neurologic damage to the extraocular muscles (as from a brain abscess, stroke, head trauma or brain tumor), diabetes, myasthenia gravis, Graves disease, or trauma to the eye muscles, as from a fracture of the orbit.

    https://www.medicinenet.com/script/main/art.asp?articlekey=23254
     
    • Informative Informative x 1
    #1377 Winnie53, Apr 26, 2019 at 9:59 PM
    Last edited: Apr 26, 2019
  18. Winnie53

    Winnie53 Type 2 · Well-Known Member

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    I've experienced much the same. I don't like this part of getting older!
     
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  19. Miss.T. Morning

    Miss.T. Morning · Member

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    Good Morning!
    Thank you for your reply and maybe I should explain my symptoms.
    After not eating for 2-3 days while in bed with flu and a chest infection I noticed the TV was difficult to focus on and the script was impossible. At the same time as I'd been told I was very healthy and didn't have a blood sugar problem AND wasn't able to taste properly after the flu bug I became attracted to carbs.. I had lost a lot of weight and wasn't experiencing a hypo when I ate them so I indulged myself. It was hand in hand with the blurred vision but by the end of 2 weeks it was complete double vision. After a visit to my optician he made an emergency appointment for me with the ophthalmologist.
    When asked if I was diabetic I said no (what I'd been told) but that I did have a blood sugar problem. Each person I saw just believed the 'not diabetic' bit and they began a search for a reason for double vision. Everything so far has been coming back as normal. Just waiting for 2 more results.
    Meanwhile, I had a sudden awakening after reading something about hypoglycemia on-line. I jumped out of bed in the middle of the night to research and began to change my diet the next day. Within a week the double vision had gone. I had a few weeks of perfectly clear vision but was never sure how much protein, carbs etc I should eat. The hypos returned. Followed by blurred vision, as now and intermittent double vision.
     
  20. Miss.T. Morning

    Miss.T. Morning · Member

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