Reactive Hypoglycaemia

[Brunneria]

I have a 6 year old and a 2 year old and just feel nervous and guilty much of the time at the minute. Trips out are a nightmare at the minute as I'm still not confident in what I can eat. I find eating out very scary as I don't yet know what to eat. The confusing bit for me is that I can eat a certain amount of starchy carbs with a meal without causing my bg to spike significantly (an increase of 2mmols max and back down to 5's or 6's within two hours). I just get hungry and shaky two hours after eating even though my levels aren't low? This is what makes no sense to my consultant. Do you find this at all?

It looks like it is more about your insulin production, than about your carb intake. But the reality is quite different.

By that i mean that you eat x amount of carbs, and your body produces y amount of insulin.
In normal people, x and y match. So that y handles x, and everything stays in balance. No hyper or hypo.

It would appear, in you, that x and y do not match. You eat x, and you produce y, but y is too big, and takes you into a hypo (or shakiness) after 2 hours.

The answer is to avoid triggering your excessive y. And that means not eating x.

So really, your body isnt tolerating x amount of carbs at all - it is just that you don't see the problem till 2 hours after eating.

 

[Kaz261]

It looks like it is more about your insulin production, than about your carb intake. But the reality is quite different.

By that i mean that you eat x amount of carbs, and your body produces y amount of insulin.
In normal people, x and y match. So that y handles x, and everything stays in balance. No hyper or hypo.

It would appear, in you, that x and y do not match. You eat x, and you produce y, but y is too big, and takes you into a hypo (or shakiness) after 2 hours.

The answer is to avoid triggering your excessive y. And that means not eating x.

So really, your body isnt tolerating x amount of carbs at all - it is just that you don't see the problem till 2 hours after eating.

I agree Brun in theory. The only confusing bit for me is that I've checked my BG half hourly after eating (up to 2 hours post meal) and on those ocassions it didn't rise above 7.2 (starting at 5.7) and at 2 hours was 5.8. I still started to shake and feel hungry after the two hours even though I clearly wasn't hypo level?

 

[Wendolph]

I think insulin levels and blood sugar levels are different. Only the hospital can see them. For instance I just had coffee and 1 toast and some peanuts, I know I'm in range but my insulin has just been released and is working and you get that feeling of spin and tiredness. Nosher calls it allergic to food.
When you hit over 10 you feel high and lower than 4 or 3 you'll notice the difference, you feel sick, light-headed, confused, cant focus on anything, shaky, its a horrible horrible feeling.

 

[lindisfel]

Hi Kaz,
I don't know what kind of meter you have but if you can check its calibration it would seem appropriate. I got the diabetic nurse to check me and I checked myself with my meter at the same time.

Wendolf: Peak blood glucose is usually after having carbs. I peak at c.+1hr after starting a meal. The more carbs I have the higher the peak. Therefore I produce more insulin and within another hour I can hypo.
So as Brun says, I paraphrase, insulin and carbs are inextricably linked. Trouble is with RH the insulin is too much and too late and stores an inappropriate amount of fat in the liver as a consequence of too much insulin.
We RH's may like high GI carbs but they are destined to make us very poorly in the long run and hypos are horrid.

atb
Derek

 

[Wendolph]

@lindisfel Sometimes I peak at half hour sometimes 1 hour. My blood sugar shoots up straight away from 5 - 10 in 15 minutes. It usually stays high for another half hour to an hour then back to 4.6 then 5.5 then 4.5 etc every half hour. Sometimes at 3-4 hours im 4 or under at 6 hours im 3.6 but 6 hours is such a long time and test strips expensive so I can't test as often as id like.

 

[Kaz261]

I think insulin levels and blood sugar levels are different. Only the hospital can see them. For instance I just had coffee and 1 toast and some peanuts, I know I'm in range but my insulin has just been released and is working and you get that feeling of spin and tiredness. Nosher calls it allergic to food.
When you hit over 10 you feel high and lower than 4 or 3 you'll notice the difference, you feel sick, light-headed, confused, cant focus on anything, shaky, its a horrible horrible feeling.

My lowest ever was 2.7 and that was in hospital during my prolonged GTT. I had a 3.8 reading that night back at home but felt fine! Might have been a false reading on my meter. Mostly im never lower than 5. I have the ocassional high 4.

Do you have days where no matter what your BG seems to be doing you just feel tired, anxious and a bit shaky? I'm having one again today and I don't know why?

Food wise I've had Greek yogurt, nuts, 3 strawberries and a doz blueberries for breakfast and bacon, sausage, egg, mushrooms and tomatoes with a small slice of granary bread for brunch. I'm now topping up with a very small pear and more nuts, but don't feel at all right. We've brought the kids out for a walk in the sunshine and I'm sitting on a bench as i just haven't got the energy for it!

 

[Kaz261]

Hi Kaz,
I don't know what kind of meter you have but if you can check its calibration it would seem appropriate. I got the diabetic nurse to check me and I checked myself with my meter at the same time.

Wendolf: Peak blood glucose is usually after having carbs. I peak at c.+1hr after starting a meal. The more carbs I have the higher the peak. Therefore I produce more insulin and within another hour I can hypo.
So as Brun says, I paraphrase, insulin and carbs are inextricably linked. Trouble is with RH the insulin is too much and too late and stores an inappropriate amount of fat in the liver as a consequence of too much insulin.
We RH's may like high GI carbs but they are destined to make us very poorly in the long run and hypos are horrid.

atb
Derek

Hi Derek, I'll try and do that. The consultant told me that even the best meters can be up to 0.83mmol out. I'm seeing the Specialist Diabetic Nurse in a couple of weeks time so I'll see if I can check it against hers.
Regards
Kaz

 

[Brunneria]

Hi Derek, I'll try and do that. The consultant told me that even the best meters can be up to 0.83mmol out. I'm seeing the Specialist Diabetic Nurse in a couple of weeks time so I'll see if I can check it against hers.
Regards
Kaz

Wow. Your consultant isn't covering himself with glory when he gives out incorrect info like that!

Home bg meters work to an industry standard accuracy of + or - 15%.

That means that if your bg is actually 5 mmol/l it is considered to be totally acceptable for your meter to read anywhere between 4.25 and 5.75 mmol/l

Additionally, each individual reading (depending on meter and the particular test strip) can vary anywhere within that + or - range. You cannot expect consistency. One reading may be +12% and the next could be -8% and you will never know.

This is why it is very important, when home testing, to take every single reading with a pinch of salt. Never assume they are 100% accurate, and never assume that small differences between readings represent anything other than minute variations in how the meter worked in that particular moment.

If you try and compare your meter with another meter, you end up comparing your +\- 15% with the other meter's +\- 15%. You would have to run hundreds of tests to accurately calc any variance between them.

 

[Brunneria]

Can i suggest you all watch this video and read the article?

They give some really useful info applicable to both RH and the development of type 2 - and they answer your queries, @Kaz261
The fact that your consultant doesnt seem to grasp this pretty basic info means that he is not grasping the fundamental differences between T2 and RH, suggesting he doesnt appreciate that insulin resistance can develop decades before T2.

The article and vid give very enlightening explanations of insulin resistance - and also why insulin is rarely, if ever, tested. Just because someone's bg doesnt spike high after eating carbs is definitely not representative of how much insulin is released. Nor is being slim an indication of no insulin resistance.

Article:
http://realmealrevolution.com/real-...-resistance-and-how-can-the-banting-diet-help

This isnt the easiest video to watch - it is long, and slow, but it contains fabulous info

 

[Linagirl]

Just wondered what the experts (brun and Nosher) make of these lentil waves? Anyone think they would be good for us RHers

 

[lindisfel]

Hi Brun,
Isn't this true of any hormonal disease? It is certainly true of Conn's (excessive aldosterone). The body attempts to compensate for the high hormone level but eventually it cannot compensate and other problems become evident. Re: my bp goes up or in the case insulin resistance the blood glucose eventually rises.

Implications: Non diabetics need to be checked for insulin response and levels to find out if they are on the road to full blown diabetes.

For us it is too late, we may be able to eradicate RH and get our hba1c below 42 but we cannot say we are cured. We still may be above the non diabetic insulin threshold for a given amount of carbs etc.

Also the diagnosed high insulin pretype 2 needs to cut down on carbs and/or take an insulin antagonist?
regards
Derek

 

[Brunneria]

View attachment 16337

Just wondered what the experts (brun and Nosher) make of these lentil waves? Anyone think they would be good for us RHers

Well, i would be very wary.
62g carbs per 100g.
How big is a portion?
They are highly processed, so even if they started as low GI lentils, they may be quick release now. Plus rice flour...

But really, all you can do is eat some and monitor how it affects your body.

Good quality pork scratchings, on the other hand, have no bg impact whatsoever...

 

[Linagirl]

Oh now I like the sound of that!!!

 

[lindisfel]

Hi Lina,
Why not buy just plain red lentils from asda you only need say 30 grams and their glycaemic index is, I think, below 30.
regards
Derek

 

[Kaz261]

Can i suggest you all watch this video and read the article?

They give some really useful info applicable to both RH and the development of type 2 - and they answer your queries, @Kaz261
The fact that your consultant doesnt seem to grasp this pretty basic info means that he is not grasping the fundamental differences between T2 and RH, suggesting he doesnt appreciate that insulin resistance can develop decades before T2.

The article and vid give very enlightening explanations of insulin resistance - and also why insulin is rarely, if ever, tested. Just because someone's bg doesnt spike high after eating carbs is definitely not representative of how much insulin is released. Nor is being slim an indication of no insulin resistance.

Article:
http://realmealrevolution.com/real-...-resistance-and-how-can-the-banting-diet-help

This isnt the easiest video to watch - it is long, and slow, but it contains fabulous info

A very interesting article and explains insulin resistance in a very easy to understand way. I just wish my Practice Nurse would have told me last year when my hba1c was 5.5. I could've cut back on the carbs before it was too late. I didn't find out until Mar this year and by then my hba1c had come down to 5.3 - not through a change of diet though.

Will watch the video once we've got the kids to bed.

I've had a bad day today. No energy, feeling a bit light headed and achy. Feel like it beats me at every turn at the minute. Hate feeling like this!

Had a Sunday roast at mums which didn't go well! A mild hypo just before eating (although measured at 4.9 felt lower) and ate the only biscuit she had in the house - a choc chip Maryland cookie. Then a roast: two very small roast potatoes, carrots, peas, cauliflower cheese, cabbage and broccoli, beef and gravy. I was talked into a spoonful of stewed apple (no added sugar) and a small scoop of ice cream (which I kick myself for now of course) and my level 2 hours later is around 10! Not happy and I'm now waiting for the resulting hypo!

Do you eat a roast dinner? Apart from the obvious pudding and potatoes, is what I ate drastically wrong? x

 

[Brunneria]

My vwrsion of roast dinner is a carvery (can't be phaffed with the cooking!)

I have large versions of meat and veg (cabbage, cauli, broccoli, peas, onion, maybe a small carrot), one roastie, no mash or parsnips. Maybe a tablespoon of gravy (it is mostly starch).

I put butter on the veg, and cheese on the cauli. I eat the fat on the meat.

No pud. Although i would eat berries and cream at home, after, but i have never needed to.

Since you had eaten the cookie, which corrected any hypo, i would have been extra careful with carbs after - no potato, no gravy, no pud. That isn't a criticism - i know how difficult it is to not fall face first into carbs after hypoing! But ideally, you want to iron out the pendulum swing of high and low, rather than going high and dropping.

My suggestion is to eat something NOW. Before you hypo.
Protein and fat.
Scrambled eggs in butter. Chicken with mayo.
Something to catch you before you fall, that will be slow release and stop the pendulun dead.

 

[Kaz261]

My vwrsion of roast dinner is a carvery (can't be phaffed with the cooking!)

I have large versions of meat and veg (cabbage, cauli, broccoli, peas, onion, maybe a small carrot), one roastie, no mash or parsnips. Maybe a tablespoon of gravy (it is mostly starch).

I put butter on the veg, and cheese on the cauli. I eat the fat on the meat.

No pud. Although i would eat berries and cream at home, after, but i have never needed to.

Since you had eaten the cookie, which corrected any hypo, i would have been extra careful with carbs after - no potato, no gravy, no pud. That isn't a criticism - i know how difficult it is to not fall face first into carbs after hypoing! But ideally, you want to iron out the pendulum swing of high and low, rather than going high and dropping.

My suggestion is to eat something NOW. Before you hypo.
Protein and fat.
Scrambled eggs in butter. Chicken with mayo.
Something to catch you before you fall, that will be slow release and stop the pendulun dead.

Thanks Brun!
I've only just got your message, but I ate 6 Brazil nuts a while ago and have just had a scrambled egg with olive spread (butter was out of date!). I shall finish with a coffee and cream and hope this sorts me out. I think I'd better leave the low carb hot choc tonight after the day I've had but it is yummy!

 

[Lamont D]

A very interesting article and explains insulin resistance in a very easy to understand way. I just wish my Practice Nurse would have told me last year when my hba1c was 5.5. I could've cut back on the carbs before it was too late. I didn't find out until Mar this year and by then my hba1c had come down to 5.3 - not through a change of diet though.

Will watch the video once we've got the kids to bed.

I've had a bad day today. No energy, feeling a bit light headed and achy. Feel like it beats me at every turn at the minute. Hate feeling like this!

Had a Sunday roast at mums which didn't go well! A mild hypo just before eating (although measured at 4.9 felt lower) and ate the only biscuit she had in the house - a choc chip Maryland cookie. Then a roast: two very small roast potatoes, carrots, peas, cauliflower cheese, cabbage and broccoli, beef and gravy. I was talked into a spoonful of stewed apple (no added sugar) and a small scoop of ice cream (which I kick myself for now of course) and my level 2 hours later is around 10! Not happy and I'm now waiting for the resulting hypo!

Do you eat a roast dinner? Apart from the obvious pudding and potatoes, is what I ate drastically wrong? x

Sorry been busy with one thing and another!
I've just read through today's post and I think ill just sum up with how I got over my hypo hell.
It wasn't nice and it took a couple of weeks, to feel the benefits.
What I decided to do was just stay away from the temptation of doing any eating that even raised my blood glucose levels at all or as little as possible. I ate nothing but salad vegetables and meat for at least a week with the fat on, I skipped breakfast and cut down drastically on my fruit, then I introduced more fat and more veg, but still stayed away from any carbs as much as possible.
I ate little pieces of meat regularly through the day, which meant that I was never hungry and never ate big meals, so plate size dropped, my stomach receded, so I couldn't actually get through a medium sized meal after three weeks, I was just topping up through the day.
Little bits, then as I began to feel a little better and had more energy, thought about how I was doing, noticing no hunger pangs, started to lose weight, for the first time in decades.
I was determined to see a new me, and haven't looked back.
A potato or bread except one piece of Bergen, rice, pasta, processed foods etc all bit the dust!
That was over two years now,! I don't miss them!

It is not only carbs and sugars, that raise bloods, it is anything that turns to glucose, fructose and sugars that make you produce and over produce insulin.
Insulin is also our nemesis, we have to try and not produce insulin in more than very low quantities, enough to deal with our very fast glucose use.
Imagine a bottle of lemonade.
Shaken and the energy building.
You release the top by opening a little bit.
The effervescent of the carbon dioxide spills out the top.

That is similar to what our hormones react to glucose and the over production of insulin.
Our pancreas literally goes off like a bottle of pop.

When our blood is over flowing with insulin, that is hypo hell. And if we feed it more, it feeds the long list of symptoms even more, the more you feed our bodies with carbs, glucose and excessive insulin, the worse the fluctuations and the more severe the symptoms, the shittier we feel.

The only way I know to be really well, is to be in ketosis.
That is living with very few carbs as possible.
We have to be diet controlled.
We are literally allergic to insulin in a funny way.

If you have a peanut allergy, why would you eat them?
We have a carb and sugar, which turns into glucose, which is used too quickly allergy.
We over produce insulin to give us hypos.

It is an unusual and rare condition and unfortunately there is no other way to treat it.
We have to control it and if we do.
You can have a full life like myself and feel good.

We are just weird!
Get over that and you will feel full of energy and wonder why you had the carbs at all!

Sorry, very busy weekend with footie and fireworks and kids and grandkids. Oh yeah, the wife as well!

Sorry, not to answer individual questions, I will try to answer certain ones before I go to bed as I am tired, but healthy tired!

 

[Lamont D]

View attachment 16337

Just wondered what the experts (brun and Nosher) make of these lentil waves? Anyone think they would be good for us RHers

Leave them on the shelf, just looking at the carb content per 100g serving.
Personally, anything above 5% I would veer away from or test thoroughly!
Also as Brun has said they are factory processed foods and may have hidden sugars as well!

 

[Kaz261]

Sorry been busy with one thing and another!
I've just read through today's post and I think ill just sum up with how I got over my hypo hell.
It wasn't nice and it took a couple of weeks, to feel the benefits.
What I decided to do was just stay away from the temptation of doing any eating that even raised my blood glucose levels at all or as little as possible. I ate nothing but salad vegetables and meat for at least a week with the fat on, I skipped breakfast and cut down drastically on my fruit, then I introduced more fat and more veg, but still stayed away from any carbs as much as possible.
I ate little pieces of meat regularly through the day, which meant that I was never hungry and never ate big meals, so plate size dropped, my stomach receded, so I couldn't actually get through a medium sized meal after three weeks, I was just topping up through the day.
Little bits, then as I began to feel a little better and had more energy, thought about how I was doing, noticing no hunger pangs, started to lose weight, for the first time in decades.
I was determined to see a new me, and haven't looked back.
A potato or bread except one piece of Bergen, rice, pasta, processed foods etc all bit the dust!
That was over two years now,! I don't miss them!

It is not only carbs and sugars, that raise bloods, it is anything that turns to glucose, fructose and sugars that make you produce and over produce insulin.
Insulin is also our nemesis, we have to try and not produce insulin in more than very low quantities, enough to deal with our very fast glucose use.
Imagine a bottle of lemonade.
Shaken and the energy building.
You release the top by opening a little bit.
The effervescent of the carbon dioxide spills out the top.

That is similar to what our hormones react to glucose and the over production of insulin.
Our pancreas literally goes off like a bottle of pop.

When our blood is over flowing with insulin, that is hypo hell. And if we feed it more, it feeds the long list of symptoms even more, the more you feed our bodies with carbs, glucose and excessive insulin, the worse the fluctuations and the more severe the symptoms, the shittier we feel.

The only way I know to be really well, is to be in ketosis.
That is living with very few carbs as possible.
We have to be diet controlled.
We are literally allergic to insulin in a funny way.

If you have a peanut allergy, why would you eat them?
We have a carb and sugar, which turns into glucose, which is used too quickly allergy.
We over produce insulin to give us hypos.

It is an unusual and rare condition and unfortunately there is no other way to treat it.
We have to control it and if we do.
You can have a full life like myself and feel good.

We are just weird!
Get over that and you will feel full of energy and wonder why you had the carbs at all!

Sorry, very busy weekend with footie and fireworks and kids and grandkids. Oh yeah, the wife as well!

Sorry, not to answer individual questions, I will try to answer certain ones before I go to bed as I am tired, but healthy tired!

Thanks Nosher.
The support and advice you guys give is really going to get me through this and hopefully on to a healthier, more energised and fulfilling life!

Sorry for asking so many questions and airing my concerns, I'm not usually this high maintenance....honestly! As you all know, it's so difficult when you can't simply just talk to someone and get advice.
Sounds like you've had a great weekend
Thanks again