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Type 2 diet controlled false hypos ?

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whizzywheelz

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Hello,

I was diagnosed as Borderline Type 2 last May. It was thought that it could be successfully managed by diet alone. After much research Online and being particularly impressed with the advice re "test, test, testing" in order to "see" exactly what effect particular foods have upon glucose levels, I bought a glucose meter and with that and the fantastic App/book "Carbs&Cals" I systematically set about managing my carb intake through "seeing" exactly what specific foods and serving sizes did to my blood glucose and then fine tuning what I ate to ensure lower levels and since then I have lost over a stone in weight and been able to lower my HbA1c "scores" at each 3mth check. I am unable to do any vigorous "exercise" to help lose weight and lower levels as I have a painful spinal condition and am house-bound and totally bespoke-wheelchair dependent so the improvements have been down to managing my diet alone.

Just recently I have been feeling "trembly" and a bit "odd" - often this is when waking and has also occurred between meals on a number of occasions and when I have checked my blood glucose at that time it has been in the lower 4s and twice 3.9 then 3.2. I immediately eat something and then re check and my blood glucose is up to the 5/6s after about 20 mins. I ensure that I eat regularly at about 5hr intervals - breakfast, lunch and evening meal and recently have been having a snack before bed as I do go to bed late and it is quite a while since supper.

I've looked this up and understand that a Type 2 not on any medication can't have a hypo or indeed a "false" hypo so am wondering whether any other Type 2s not on medication have experienced anything similar ?

I have noticed that my blood pressure is also high at those times too so am wondering whether there is any connection ? Hmmm - "Chicken or egg !"

I am really pleased to have found this site as it's really supportive to know exactly what others living with diabetes are experiencing - "expert patients" who really do know what it's like and can come for encouragement, advice and support. Brilliant ! :thumbup:

I'm not one to rush for a doctor so am going to keep a detailed record of blood pressure/blood glucose/any tremblies etc. in relation to meals for the coming week to see if I can notice any particular pattern(s) and then if it's still happening and I can't see any possible connections I'll have to ask for a doctor or nurse's home visit to explore this but would welcome and appreciate any input/comments, advice from other Type 2s on this forum.

Best wishes :wave:
whizzywheelz
 
Hi whizzy! 4 short)i am type 2 for nine years now was having quite a few lows a week,anyway my
dsn suggested i cut down on two of my glizacide tabets and i find this has helped me, Mybe you could have a chat
to your diabetic team? All the best to you.
Debs
 
I used to occasionally have what I now recognise as hypos after going for a long walk with insufficient nourishment, a few years before I was diagnosed with Type 2. I'd go all wobbly-legged and break out in a cold sweat and need something to eat quick. If your blood sugar's down to 3 or 4, you're definitely going low enough to have a hypo. I'm taking insulin these days, and generally get one if my sugar drops below about 4.2. If your pancreas is being a bit erratic in producing insulin, it could be that its sometimes producing more than usual, too much for the amount of carbs you're having. I was on a very steady and regular insulin dose, but when I cracked a rib I woke up with a hypo a few mornings running because my body had upped its insulin production, and had to drop my dosage for a couple of weeks until my rib was better, at which point I had to up the injection dose again. My nurse reckons type 2s can often have erratic insulin production which means the same amount of carbs can have different effects on your body depending what your pancreas is up to that day.
 
Hi to Debs & Carandol - thank you so much for replying - that's a really nice introduction to this forum thank you - it feels good to know someone has taken the time to read my post and then given their time to respond - thank you both
 
Carandol, thanks so much for that. I've thought for a while that my pancreas might just be playing up and sometimes producing insulin and other times not. Your nurse might have a point.
 
Hello, yes, I too have experienced these "near hypo's". I was diagnosed with Type 2 last November, and also believed that I couldn't suffer a hypo as I am only diet-controlled, no medication. However, I have felt "odd" and "wobbly" at times and taken my blood sugar level to find it is 4.2 or 4.3, as soon as I eat something it corrects itself and I feel better again, so I would definitely say that Type 2, without medications can suffer from hypos - although this may not be what the medics say! I don't drink very often anymore and the one time I did have around 2 glasses of wine, the next morning my blood sugar level dropped to 4.3, and I knew it was low before I tested as I felt very tired and wobbly. I avoid alcohol at all cost, but on the odd occasion I "have to" at a celebration or dinner, then I make sure I eat something before I go to bed, and again as soon as I get up. Hope this helps, and good luck!
 
HI Pamzy2, thank you for your reply - it's really nice to receive responses to a post and it really helps to learn of others' experiences. Interesting what you say about having any wine ~ I too found that enjoying a glass with a meal for a celebration etc was sadly no longer enjoyable because it affected my BG ! How are you doing managing your blood sugars on diet control alone ? I use the most amazingly easy iPhone App & book Carbs&Cals. that I mentioned in my original post which shows photographs of all the regular foods we might eat set out on plates in different portion sizes and gives the carbs. cals. protein etc. count for that portion so is so easily immediately obvious for the portion size you choose ! Using just the App & Book and my glucose meter to see exactly what a given portion of carbs in a meal actually does to my blood sugar level I have been able to manage my carb. intake to lose a stone and keep my blood glucose levels down and my 3mthly HbA1c scores have consistently come down - thus heading off the dreaded day of needing medication ! I wish you every success in your journey. Thank you again for sharing your experience of "false hypos" - there's not much info online anywhere about this possibility to read up on and I agree that the medics don't really address it so any exchange with Type 2s who actually experience it is a real help- Thank you again :thumbup:
 
This is interesting.
I too am an unmedicated T2 (10yrs) using diet and exercise.
Over the last week or so I have started to really watch my carbs, keeping them to 60g where possible, but over the last couple of days I have had 3 'wobbly' moments after getting up from a chair. I don't test so I don't know what my BGs were.
I've had occasional 'wobbles' for as long as I can remember, but I'm a little concerned about these coming just as I play around with my diet.
However, I too didn't realise that the pancreas could be so erratic, so maybe I've always had a dodgy pancreas, kicking out variable amounts of insulin. Perhaps I should start testing.
 
Hello, my name is Sarah and I also experience "hypos" on diet controlled Type 2 Diabetes. My doctor doesn't seem interested in this as he's convinced it isn't possible to go too low on diet control only. I have found recently that I can only go roughly 3 hours after having something to eat before my levels drop to 4-ish. All I keep getting told is to eat more when I feel ill, which isn't helpful as I'm trying to lose weight and I am also unable to do physical activities. I feel like the doctors are more interested in curing the symptoms rather than finding the cause. My mum also experienced the same problem as I did on diet-only Diabetes and she ended up going into a coma since the doctors didn't her as to why she was going into hypos. I just wish the doctors would be more understanding and actually be willing to listen..

Best wishes,

Sarah.
 
Thankyou thankyou thankyou, I thought I was imagining it .
I was diagnosed type 2 in April and am diet controlled. I often feel strange around 3pm . I can't concentrate , become really sweaty ( like a hot flush) and feel pretty ill. When it happens I eat a bit of fruit and feel better within 20 minutes.
I had an interview on Friday afternoon at 3pm, I was well prepared and felt pretty good. I sat down in the interview room and felt awful , very hot and sweating, couldn't concentrate , the interview ers (who I knew well) were talking but I don't know what they were saying , needless to say I didnt get the job , not that bothered though if Im honest.
I saw all the articles about type 2 diet controlled not being able to have hypos but I honestly think I do.


Sent from the Diabetes Forum App
 

Hi, I suffered from frequent "low blood sugar". I can't use the word 'hypo' as it is reserved for real diabetics apparently (long story). I was told that I couldn't possibly be getting "low blood sugar" but I have had episodes for as long as I can remember (over 40 years). I usually got them during the afternoon dog walk, but I fixed them by eating an apple at the start of the walk. I would rather use an apple than, say, a dextrose tablet or lucozade etc., as it is natural and there is other goodness in it apart from sugars.
 
I think the confusion arises from the fact that only the low blood sugar episodes caused by meds and insulin {and I personally am not convince hat this should include oral meds] really need any type of treatment.

I occasionally suffer hypos because of my meds if my exercise'food intake routine is disrupted. Of course hypos are uncomforable but not dangerous for those not on insulin or large doses of blood sugar-lowering meds.
Anyone can suffer from low blood sugar episodes. I did for may years before diagnosis and at the same time of day as others have said.

False hypos are a different thing. They occcur when bgs have been running at high levels for a while . If you then start to reduce them for any reason your body reacts and you suffer a false hypo. As your body becomes used to lower levels these false hypos sop occurring.

Regarding the point about the pancreas producing insulin erratically - I have to say that once this was pointed out to me so much made sense.

I am glad that this information seems to be starting to be generally accepted.

Yes as Desidiabulum has said Diabetes should be seen as a syndrome therefore capable of infinite variation., and yes we should not blame ourselves and certainly should ot be blamed if we don't react as expected o reatment etc.
Of coyurse neither should we think that because something works for us it will necessarily work for someone else. There are many factors at work .
We can , however , all pool our experiences and I can never understand why simple dietary advice -like reducing carbs - iwhich may be the answer for some - can't be given to all when diagnosed.

I am a "slim" T2 possibly not veven a standard T2 so much of the advice and experiences on here doesn't apply to me.

I recognise that it does apply to the majority here though and wouldn' want to confuse them - especially the newly diagnosed
by contradicting advice which will work for the majority.

The policy of one-size fits -all treatment has much o answer for.

So , yes you can have a hypo but it will only be dangerous in certain circumstances. I fid that my judgement is impaired and I tend to overreat it resuling in spikes so i do my bes o avoid hem and ask others to deter me from overtreating one if it should occcur.
 
Hi Gezza - I thought of your experience & our PMs - & find you got here first

Other forum members may benefit from Gezza's experience & my comments.

IMO I still think your problem is being undernourished. 1500 kcals a day mainly from carbs means that your body cannot maintain a steady BG. Your figures show a spike after eating that falls to around 4 in about 2 hours. In my experience, carbs are fully digested in about 2 hours; proteins & fats take longer, so low BGs are less likely.

"carbs 58%, protein 24%, fat 18%, cals 1500" corresponds to weight (g) & energy:
carbs - 190 g, 760 kc,
protein - 80 g 320 kc,
fat - 60 g, 420 kc,
total 1500 kcal.

As I got back to your 1500 kcal daily, my algebra seems OK.

What does EMF mean? ElectroMotive Force or Eat More Fat.

If you are wary of increasing animal fats, try nuts particularly ground almonds or coconut - with your cereal, added to yoghurt, eaten as a snack. They are unlikely to raise your BG above your present levels, and as you've seen from my tests, are more sustaining, with a low spike of around 7-8, and a sustained reading around 5 for several hours.

You do not know when your tendency to low BG will be inconvenient or serious. An apple may take you back above 4, but is not sustaining.
 

Thanks. We must be using the same version of MyFitnessPal. I agree an apple is not sustaining but it works on the my "low sugar levels" (remember I can't use the word hypo). I would not like to wait for fat & protein to kick in. To be perfectly honest, post two-hours I am barely functioning at 5.0 on protein and certainly don't feel 'full of the joys of spring', don't feel particularly sustained, and would not like to have to run for a bus. There is, to me, a difference in what the bG meter says and how I feel physically. The meter is usually 'behind'.
 
So what IS the difference between low blood sugar and a 'hypo'? If someone wakes up with a BG of 4.2, is that a 'hypo'? Or 4.2 after not eating for a few hours but without symptoms of weakness or shaking etc? What's the difference between a non-diabetic at 4.2 and a T2 in either of those scenarios? My blood test results print out from the GP states that a normal fasting BG is 3.0–6.0, so how could 3.0 be normal if it's considered 'hypo'? Is it the presence of other symptoms?


Sent from the Diabetes Forum App
 

What I was told on this site was that a 'hypo' is what real diabetics get and "low blood sugar" is what charlatans like me who are only here to cause trouble get. That's the difference.

On a more serious note, I believe it is when one can feel it physically. There is no 'set' bG level apart from low, and in my case, below 4.0. My bG meter, which was within 0.2 of my actual HbA1C, is always behind, probably because my brain is telling me before the end of my finger.
 
Many years ago when I used to work very hard on building sites I would often get "trembly" and a bit "odd". This was down to me exhausting my supply of energy. It would be another 30 years before I got diagnosed with type 2. A fellow worker's wife was a nurse and she made him take high sugar sweets to work for him to suck on. No good for us of course! I manage to keep these events at bay nowadays by making sure I eat regularly. I don't eat at set times, I eat before I start to get too hungry, or before I do any exercise or hard work.
Lee
 

That's what I do. If I feel hungry then I eat something. When I walk the dog I eat an apple anyway, just in case. I am fortunate in being in a position (at home all day) to do this.
 
gezzathorpe said:
What I was told on this site was that a 'hypo' is what real diabetics get and "low blood sugar" is what charlatans like me who are only here to cause trouble get. That's the difference.
Click to expand...

Why is it so difficult to accept there is a difference? When you suffer your episodes they are likely unpleasant and have a real unpleasant physical effects yet do you run the risk of falling into a diabetic coma and actually suffering death or brain damage? That's the distinction I and many make.

I know as a T1 my son can die from a hypo whereas T2's (like me) using diet or non insulin stimulating meds and even non diabetics can occasionally suffer a bout of "low blood sugars". The effects may well be unpleasant but your natural liver dump response will in the end kick in and send your BG's north just as they've always done since the day you were was born.

That is common definition of a true hypo where the effective overdose of injected insulin (or more rarely from insulin stimulating medication) can override the bodies natural glucose liver dump response and that is why a true hypo is life threatening and should not be discussed in such a glib way.

Everyone is unique and everyone will have their own base fasting levels. I read somewhere that the average non diabetics fasting level is 4.2. As its an average some people will have fasting levels above that and some will have fasting levels in the 3's. People with fasting levels in the 3's do not spend the majority of the time in diabetic comas. Most don't even realise what their fasting level is!

A low blood sugar (or hypo) episode occurs at the BG that you feel the effects at. This can vary from person to person and be effected by say the time of day and how quickly your BG's are actually falling. The "less than 4" rule is there primarily for insulin using diabetics as a warning that they may need to take action if their BG continues to fall. The ADA defines a true hypo condition to begin at levels less than 2.7. The lowest level I've recorded was 2.2. I felt a bit weird but was entirely coherent and conscious and corrected by eating a round of toast with some marmalade on it. On another occasion I have actually fainted (for a few seconds) from "low blood sugars" at levels in the low 4's even though the low 4's are my normal fasting range.

The physical BG reading isn't in my opinion what counts it's the effects and importantly how often you are getting those hypoglycaemic events. If it happens on a regular basis you should take professional medical advice especially if you are not on any kind of insulin stimulating medication or insulin itself.
 
Thanks for the explanation - it makes sense.
 
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