Reactive Hypoglycaemia

[Wendolph]

Does anyone know whether my blood results are synonymous with RH? Posted above? Many thanks x

It's difficult to say. My blood shoots up to 9-11 straight away then drops then 3-6. hours later its 4.2-3.7 I've caught a hypo at 3.3 but not caught them before as I only discovered rh in july. 'normal blood ' is 4-8 but symptoms account for alot.
A month ago after eating a breakfast bar 1/2 hours later 11 and after an hour my blood was 10.4 This week it was 7.8 then 5.6 my blood sugar is all over the place. From my records my dr confirmed rh but my low carb, has eased my levels! I'll probably look normal when they test me. Typical. But I'm not hypoing so fantastic

 

[Brunneria]

Does anyone know whether my blood results are synonymous with RH? Posted above? Many thanks x

Hba1cs show an approx average of bg over the last 3 ish months, with a bit more empahsis in the last few weeks. The good thing about it is that it will show huge issues (like some T2s get) with scores sometimes over 100.

The bad thing is that if you spend a lot of time hypoing and hypering, they can cancel each other out and give and average that is 'normal'.

Your score of 45 is prediabetic, but unfortunately, that doesnt tell the full story of your highs and lows...

Your fasting bg falls into the 'normal' and non-D range - which is great.

If you want to read more about fasting levels there is an interesting section about them in www.bloodsugar101.com that explains how bg deteriorates as we move (different speeds) into glucose intolerance and towards T2.

Spotting RH via standard bg testing is nearly impossible - thats why many docs dont believe it exists. And why they do the extended 5 hour OGTT to try and find it - on the rare occasion they go looking.

 

[Linagirl]

Thanks wendolph. They want to do a GTT now but I'm not looking forward to that!

 

[Wendolph]

Thanks wendolph. They want to do a GTT now but I'm not looking forward to that!

I had a gtt years ago and it hardly affected me, I got a bit jittery confused etc but within range. but for others its bad. I'm due another one soon and a mix meal test but I think that's 2 slices of toast with tiny bit of jam and I eat 3 or 4 slices being piggy. So im so used to eating lots of carbs I think my bodys used to it lol.

 

[Linagirl]

Thanks Brun x

 

[lindisfel]

Hi Kaz,
They come prepared and are baked on site.
They are at a special rate of 29p each a.t.m.
You can't miss them them they are triangular in shape, dark brown externally and seeded.
regards
Derek

Hi Derek,
No I haven't tried them. I have heard about them but have never been able to find them in our local shop. Are they freshly baked or pre-packed? I may just be looking in the wrong place. I'll give them a try though thanks. I'm only a tiddler but I'm constantly munching lol! Would be lovely to eat something that actually keeps me full for more than a couple of hours. The constant nibbling drives me mad! Take care

 

[Linagirl]

Are you under a consultant now wendolph? In hoping they will refer me to someone rather than try to deal with it at the doctors

 

[Wendolph]

Are you under a consultant now wendolph? In hoping they will refer me to someone rather than try to deal with it at the doctors

I saw an endo/diabetic dr and I'm under him now though he says its more biochemistry. None of my gps listened and I've seen loads. I got lucky and was refered by a type2 gp who noticed the symptoms and blood sugar levels didn't match.

 

[Linagirl]

I think I may be in luck as our nurse let slip today that they already have a reactive hypoglycaemic patient at our surgery (Telford) and he has seen a consultant so fingers crossed for me.

My bloods two hours after eating today have been 5.7 for breakfast and lunch and 6.7 after dinner. I was pretty pleased with that. No carbs it is still.

How do you all find sweet potato, parsnips and carrots? I have to avoid cruciferous veg although i eat it in moderation but t makes it a bit tricky sometimes to find food to eat.

Emma

 

[Wendolph]

I think I may be in luck as our nurse let slip today that they already have a reactive hypoglycaemic patient at our surgery (Telford) and he has seen a consultant so fingers crossed for me.

My bloods two hours after eating today have been 5.7 for breakfast and lunch and 6.7 after dinner. I was pretty pleased with that. No carbs it is still.

How do you all find sweet potato, parsnips and carrots? I have to avoid cruciferous veg although i eat it in moderation but t makes it a bit tricky sometimes to find food to eat.

Emma

To be honest I'm new to testing foods. Test strips cost a fortune. I'm not as sensitive to carbs as others on here. Sugary stuff is my nono and big meals. I drink alot of tea and snack on nuts and cheese so i feel ok in-between meals. Mostly.

 

[Kaz261]

Me again, sorry. I'm feeling little lost and desperate this morning. I've woken up this morning in "hypo hell" even though my level was 5.0 according to my meter. I woke at 5 ish heart racing and sweaty which settled reasonably quickly without doing anything, but when I got up at 7 I was very shaky and jittery. Yesterday I reduced my carb intake from 200g to approx 130 but increased my fat and protein. Does anyone else experience this in the mornings (it happens quite often for me) or could it be my food intake from yesterday?

 

[Brunneria]

Morning!

There could be several things going on with the 5am wakeup.
Have you heard of Dawn Phenomenon? and Liver Dumps?
It could be either of those.
Can you describe what you ate during the evening, including the times?

130 g carbs is still way above the level that causes RH in me. I am not saying that to criticise. But if you want to test whether low carb is going to help you, you may have to go significantly lower.

What did you do, at 5am to deal with the situation?

 

[Kaz261]

Morning!

There could be several things going on with the 5am wakeup.
Have you heard of Dawn Phenomenon? and Liver Dumps?
It could be either of those.
Can you describe what you ate during the evening, including the times?

130 g carbs is still way above the level that causes RH in me. I am not saying that to criticise. But if you want to test whether low carb is going to help you, you may have to go significantly lower.

What did you do, at 5am to deal with the situation?

For dinner at 5.40pm I had a bowl of homemade red pepper soup (peppers, tomatoes, red onion, garlic and veg stock), with 1 slice of Bergen bread and a chicken breast. At 8.50pm I had 100g full fat Greek yogurt, 2 strawberries and 6 blueberries with a sprinkle of milled linseed. I usually wake around 5 in the same state. Sometimes I need to eat a little, others, like today it's settled by itself and I can go back to sleep.

 

[Kaz261]

For dinner at 5.40pm I had a bowl of homemade red pepper soup (peppers, tomatoes, red onion, garlic and veg stock), with 1 slice of Bergen bread and a chicken breast. At 8.50pm I had 100g full fat Greek yogurt, 2 strawberries and 6 blueberries with a sprinkle of milled linseed. I usually wake around 5 in the same state. Sometimes I need to eat a little, others, like today it's settled by itself and I can go back to sleep.

I have heard of both those things, but not entirely sure what they are to be honest. I have tested my blood a couple of times when it happens and it's always been normal 5's.

 

[Brunneria]

Thanks.

Our blood glucose levels are controlled by hormones (as you know) with insulin being one of the biggies.

Apparently (I have never timed this!) if we go more than 5 hours without food, the liver often steps in to give the blood glucose a wee boost, by 'liver dumping' glucose from its glycogen stores, into the blood stream.

The fact that you woke up at 5 am feeling like that, with a bg of 5 something, suggests a few things to me (remember, I ain't mnedically qualified). Firstly, your bg probably dropped in your sleep, low enough to trigger a 'liver dump' and what woke you was the result - the impact of that. So by the time you woke up, your body had already raised your bg to the 5s, which is perfectly acceptable. (but it is worth noting that for me, dreams and anxiety can do the same thing. I went through a period a while back caused by work stress, where I was waking up in a similar situation, and when the stress was dealt with, the flustered wake ups disappeared too)

So, there is something going on with you that drops your bg down in the wee small hours, that triggers a liver dump.

It may be as simple as 'my last food was at 8.50pm, and had some carbs in it, so my bg was dropping at 5am, and my liver decided to dump some bg to bring it back up.'

As a suggestion, try having a non-carby snack just before you go to bed. I sometimes use peanut butter (on a spoon, not a cracker) or a slice of cheese or some nuts. It may help. And worth doing for a week or so, because the body gets into habits, and it may take several days for it to realise that the 5am surge isn't needed any more.

Also, if you do eat something at 5am, try nuts rather than a flapjack. If your bg is 5, you don't need carbs, and the nuts are nice and slow release, so they will gradually drip feed you til morning, rather than making your bg shoot up, then drop, in typical carb fashion.

Regarding Dawn Phenomenon, it is also caused by hormones, and it happens to everyone to some extent. It is just the body's natural 'wake up call' where hormones are released to prepare the body for the day's activities. And, in a person with well balanced normal hormones, the DP is a teensy rise in BG. In a person with screwy hormones, the DP can be bigger and more 'attention grabbing'.

My own experience is that my body gets into habits. The more I allow it to liver dump, the more trigger happy it gets. And the more I allow it to DP, the bigger and more over the top my dawn phenomenon bg rises are. Yet another reason I avoid carbs!

Hope that helps.

 

[Kaz261]

Thanks.

Our blood glucose levels are controlled by hormones (as you know) with insulin being one of the biggies.

Apparently (I have never timed this!) if we go more than 5 hours without food, the liver often steps in to give the blood glucose a wee boost, by 'liver dumping' glucose from its glycogen stores, into the blood stream.

The fact that you woke up at 5 am feeling like that, with a bg of 5 something, suggests a few things to me (remember, I ain't mnedically qualified). Firstly, your bg probably dropped in your sleep, low enough to trigger a 'liver dump' and what woke you was the result - the impact of that. So by the time you woke up, your body had already raised your bg to the 5s, which is perfectly acceptable. (but it is worth noting that for me, dreams and anxiety can do the same thing. I went through a period a while back caused by work stress, where I was waking up in a similar situation, and when the stress was dealt with, the flustered wake ups disappeared too)

So, there is something going on with you that drops your bg down in the wee small hours, that triggers a liver dump.

It may be as simple as 'my last food was at 8.50pm, and had some carbs in it, so my bg was dropping at 5am, and my liver decided to dump some bg to bring it back up.'

As a suggestion, try having a non-carby snack just before you go to bed. I sometimes use peanut butter (on a spoon, not a cracker) or a slice of cheese or some nuts. It may help. And worth doing for a week or so, because the body gets into habits, and it may take several days for it to realise that the 5am surge isn't needed any more.

Also, if you do eat something at 5am, try nuts rather than a flapjack. If your bg is 5, you don't need carbs, and the nuts are nice and slow release, so they will gradually drip feed you til morning, rather than making your bg shoot up, then drop, in typical carb fashion.

Regarding Dawn Phenomenon, it is also caused by hormones, and it happens to everyone to some extent. It is just the body's natural 'wake up call' where hormones are released to prepare the body for the day's activities. And, in a person with well balanced normal hormones, the DP is a teensy rise in BG. In a person with screwy hormones, the DP can be bigger and more 'attention grabbing'.

My own experience is that my body gets into habits. The more I allow it to liver dump, the more trigger happy it gets. And the more I allow it to DP, the bigger and more over the top my dawn phenomenon bg rises are. Yet another reason I avoid carbs!

Hope that helps.

Thanks Brun. That does help and makes some sense.

I have been waking at a similar time most nights for weeks. Probably since my diabetes diagnosis which to be honest has made me very anxious and I'm now on medication. This leaves me with two scenarios. The first that it could just simply be anxiety and stress related or as you say, that my levels are dropping too low and my liver is releasing glucose. I'm always hungry between 8.30 & 9pm and need supper but will try to avoid carbs.

I thought last nights supper would be OK as it was pretty low carb. I usually have 4 small multigrain crackers with cheese and a few nuts. I usually wake around 5 after this but don't generally feel as bad when I get up.

Sounds like I've got s lot of experimenting to do!

Thanks very much for your advice, it's VERY much appreciated x

 

[Lamont D]

Thanks Brun. That does help and makes some sense.

I have been waking at a similar time most nights for weeks. Probably since my diabetes diagnosis which to be honest has made me very anxious and I'm now on medication. This leaves me with two scenarios. The first that it could just simply be anxiety and stress related or as you say, that my levels are dropping too low and my liver is releasing glucose. I'm always hungry between 8.30 & 9pm and need supper but will try to avoid carbs.

I thought last nights supper would be OK as it was pretty low carb. I usually have 4 small multigrain crackers with cheese and a few nuts. I usually wake around 5 after this but don't generally feel as bad when I get up.

Sounds like I've got s lot of experimenting to do!

Thanks very much for your advice, it's VERY much appreciated x

Disturbed sleep is symptomatic and also the liver dump is normal.
I have got an answer, my body has adjusted to it. I only have a slight variation in waking.
But as I don't have many carbs, I think I've adjusted to normal levels.
Anything that upsets your body's norm will cause symptoms, you just have to see it through.
After a couple of weeks, you should be stabilising and getting better energy levels.

 

[Lamont D]

Thanks wendolph. They want to do a GTT now but I'm not looking forward to that!

At least they are on the right track.
Prolonged Glucose tests are ok. A nice relaxing day in hospital, relax and get some probably much needed me time.
Take your laptop or whatever and record what's going on, watch television or read a book.
Listen to music, do what relaxes you.
Your last meal will be the night before, you will take two small glasses of pure glucose and they will take a fasting blood sample and finger prick reading.
They will monitor and take bloods every half hour.
Until they are satisfied with your results.

A word of warning!
If you do hypo, don't let them feed you more glucose or sandwich or anything carby.
Have a biscuit and a cup of tea or coffee, to bring you back up slowly, the last thing you want is another hyper, then hypo, that's what happened on my first OGTT!
Usually staff, and they are good, will not know about RH, and will push the usual hypo treatment, download Wikipedia's page on RH and show them what they 're dealing with.
They should be receptive.
I had to stay in hospital for another few hours till I stabilised.

Hope it goes well for you and do record it! You will see how quickly you use the glucose and find when you spike and how long you return to normal blood glucose levels. Then if you hypo.
I take 3 and a half hours to four hours to hypo, that's why mine is called Late Reactive Hypoglycaemia.

 

[Lamont D]

I think I may be in luck as our nurse let slip today that they already have a reactive hypoglycaemic patient at our surgery (Telford) and he has seen a consultant so fingers crossed for me.

My bloods two hours after eating today have been 5.7 for breakfast and lunch and 6.7 after dinner. I was pretty pleased with that. No carbs it is still.

How do you all find sweet potato, parsnips and carrots? I have to avoid cruciferous veg although i eat it in moderation but t makes it a bit tricky sometimes to find food to eat.

Emma

If you want to eat these vegetables, then do so but you have to find out, how they effect you.
I personally can't do them only in very small portions!
It's about how you react to them.
It is very tricky, to find what you have to eat and maintain good blood readings, but you will find a way. Experiment and find out.
Base your meals around fresh meat and supplement with the rest.
Plan ahead and shop accordingly, there are always alternatives to carbs!

 

[Linagirl]

For me at least it seems that my issues are the rise and fall not the actual blood sugar is that familiar to anyone?