Reactive hypoglycemia or what??

[FrenziedYak]

Hi,

Hope someone can shed some light on this...
In March, had several episodes of going hypo whilst out walking - felt dreadful, ate lots & rested, felt better.
In April, had standard health check and was told I was prediabetic (HBA1C 42). My brother is Type 2 diabetic and my son is Type 1 so I was determined I was going to not go down that road.

Did lots of research on dietary approaches and decided that low carb route was most promising. I had been slowly putting on weight for a long time (BMI 27) which I put down to being hypothyroid/Hashimoto's/post-menopause. Had given up trying to lose weight as nothing shifted.

Went low carb (less than 50g/day) and initially felt great on it and found it quite easy - and lost nearly a stone over 8 weeks. Then in last few weeks, started having hypos - after exercise and if I left it too long between meals. Put on a Freestyle Libre and was quite shocked to see I was going low for hours at night, which I didn't even think was possible for non-diabetics. I haven't been able to get a confirmation finger prick, but felt awful in the morning - headache & woozy & exhausted.

I have now shifted to moderate low carb (100-130gC /day) in last few days and not had night time hypos, but had a few exercise induced hypos from walking. Any thoughts? Is this reactive hypoglycemia? Hormonal hypoglycemia? Should I be pushing doctors for tests, or just be relieved that eating more carbs appears to be solving the issue for now??

 

[Lamont D]

Hi,

Hope someone can shed some light on this...
In March, had several episodes of going hypo whilst out walking - felt dreadful, ate lots & rested, felt better.
In April, had standard health check and was told I was prediabetic (HBA1C 42). My brother is Type 2 diabetic and my son is Type 1 so I was determined I was going to not go down that road.

Did lots of research on dietary approaches and decided that low carb route was most promising. I had been slowly putting on weight for a long time (BMI 27) which I put down to being hypothyroid/Hashimoto's/post-menopause. Had given up trying to lose weight as nothing shifted.

Went low carb (less than 50g/day) and initially felt great on it and found it quite easy - and lost nearly a stone over 8 weeks. Then in last few weeks, started having hypos - after exercise and if I left it too long between meals. Put on a Freestyle Libre and was quite shocked to see I was going low for hours at night, which I didn't even think was possible for non-diabetics. I haven't been able to get a confirmation finger prick, but felt awful in the morning - headache & woozy & exhausted.

I have now shifted to moderate low carb (100-130gC /day) in last few days and not had night time hypos, but had a few exercise induced hypos from walking. Any thoughts? Is this reactive hypoglycemia? Hormonal hypoglycemia? Should I be pushing doctors for tests, or just be relieved that eating more carbs appears to be solving the issue for now??

Hi @FrenziedYak welcome to our forum.
Obviously, I can't diagnose you from your post.
but I can try and explain certain things.
The CGM s known to get suppression low readings during sleep.
Reactive hypoglycaemia is a condition that reacts to food and can be a precursor to T2 diabetes.
other types or forms of non diabetic hypoglycaemia are dependent on the cause or the hormonal effects of the glands, such as hashimotos etc.
there are conditions such as insulinoma that causes hypoglycaemia.
The bottom line is the tests. And for that you need a referral to a specialist endocrinologist.
But first, I would keep a record from your CGM, to what you eat, exercise and anything else that you think that you should record.
And your final question about, if I've got this right, is your CGM recording hypoglycaemia whilst walking or doing exercises?
If that is the case, then your GP needs to know, show your doctor the CGM recorrds.
There must be a reason.
I do go hypo if I do strenuous exercises but I know why, because of RH.
I do believe that the hormonal response, which you have said is a issue you have been aware of.
my daughter has suffered with her thyroid. And had similar symptoms.
But other glands also have an effect.

Let us know how you get on.
Best wishes.

 

[FrenziedYak]

Thanks, Lamont D - that’s sound advice and I appreciate you responding. I wasn’t looking for a diagnosis, just other’s experience, although I appreciate we are all different. It is useful to know that you only go hypo with strenuous exercise, which is more what I would have expected. Do you also only go hypo after large carb meals - and if so, how large? Do you go hypo if you don’t eat for a few hours?

My plan is just as you suggested - collect data from CGM and relate to food, exercise etc and then go to doctor and ask if tests are needed. Also, I am completely confused as to what I should be doing diet-wise now as there is so much conflicting information.

I am aware of the compression issues with CGM, but have been unable to get a finger prick confirmation as I sleep through it all!! I think the fact that I felt dreadful the next day may go some way to confirming?

Thanks again for your considered response.

 

[Lamont D]

Thanks, Lamont D - that’s sound advice and I appreciate you responding. I wasn’t looking for a diagnosis, just other’s experience, although I appreciate we are all different. It is useful to know that you only go hypo with strenuous exercise, which is more what I would have expected. Do you also only go hypo after large carb meals - and if so, how large? Do you go hypo if you don’t eat for a few hours?

My plan is just as you suggested - collect data from CGM and relate to food, exercise etc and then go to doctor and ask if tests are needed. Also, I am completely confused as to what I should be doing diet-wise now as there is so much conflicting information.

I am aware of the compression issues with CGM, but have been unable to get a finger prick confirmation as I sleep through it all!! I think the fact that I felt dreadful the next day may go some way to confirming?

Thanks again for your considered response.

Hi again.

I can answer the first question with a yes.
I could give a few examples of what happens if I eat carbs.
But I am so intolerant that only a few grams of carbs will trigger the reaction.
Others might not be.
And if I fast, I do not go hypo.
It is the food carbs and sugars that trigger the reaction.
But (again) I have heard of others that are not as reactive as I am.

I have a simple way of finding out how intolerant you are and you have already started.
It is around your meals.
You record your pre meal reading (say 5mmols)
You record your two hours reading (8.5mmols)
That means your reading is 3.5 higher than pre meal.
Your spike was too high.
Because the benchmark is to be only 2mmols higher from your pre meal reading.

Your meal is too carb heavy.
Something in that meal is spiking you.
And to confuse it a little, it could also be the make up of the meal. Fats and protein might lower it


And I agree sometimes, you feel dreadful for a couple of days after a hypo. Or even what is known as a false hypo or a sugar crash. You don't go hypo but the symptoms are felt because of the sudden crash of your BG (blood glucose) levels.

Keep asking.

Best wishes.