what usually is going on in the pancreas when RH is happening. Two years ago when I was diagnosed with RH, it was explained to me that RH is usually due to insulin resistance and the pancreas’ attempt to over-compensate. Just had my insulin and c-peptides checked (along with glucose) and my insulin actually went down when my glucose went up. Fasting glucose was 77, insulin 2.4 and c-peptide .55 Postprandial glucose 178, insulin 2.3 and and c-peptide .66 If it was Insulin resistance, wouldn’t my insulin rise with my glucose? Obviously a 5 hour gtt test with insulin readings would give a better picture of what is happening when I go hypo, and when I see an endo next week, I will request it. But I want to go into my appointments prepared, and knowing what I’m talking about. The notes on my lab report said that high glucose with low insulin indicate type 1 diabetes. My hba1c is great at 4.7, but more and more my pp sugars stay high longer and I have less frequent hypos. Is this potentially RH turning into diabetes? Or is this just the normal course of RH, that the phase 1 response doesn’t work and phase 2 over compensates?
Hi, and welcome to our forum.
First of all RH is not dependent on being insulin resistant, but it would not help in the initial stages before diagnosis and going very low carb. Insulin resistance will make your pancreas work harder and most of any surplus insulin will more than likely turn into visceral fat.
What happens is the pancreas does overcompensate because the initial release is not enough to the amount of glucose derived from most carbs and sugars. The blood sugar levels spike quickly , that is when you get the insulin overshoot, which after time lowers your blood sugar levels into a hypoglycaemic episode.
I would definitely express a desire for a fasting extended OGTT.
This test will give your specialist a lot of information, it won't actually diagnose RH but it's another step for a true diagnosis. Your Hba1c, and other tests so far do indicate something close to some type of insulin imbalance in your blood.
If it is something similar to Hypoglycaemia, then dietary control is the only treatment that will work. That means avoiding foods that trigger the insulin response.
Have you a glucometer to record your blood sugar levels and record it in a food diary? Then you can see what foods you are intolerant to, by tracking your levels before and after eating.
What sort of dietary advice have you had so far?
I have been in total dietary control for over four years and have not had a hypo since my last eOGTT!
You are asking the right questions.
Be truthful with your specialist, write down your symptoms, tell your specialist, that you need the tests to get a true diagnosis and you want to find if allergies or intolerance to foods particularly reducing carbs and sugars will help you cope with whatever condition you end up having!
Best wishes