Undiagnosed but high blood sugar

It does strike me as a rapid and steep rise - and the speed of changing BG is often the cause of distress, as much as the actual level it goes to. I've gone up just over 1 since my breakfast and I think most people would expect a rise of around 2-ish.

It's really a matter to be discussed with medics - and ASAP I would suggest.

Hi All,

In my experience (and we all vary) I wouldn't expect to see a reactive hypo dip in BG for several hours after eating.

When @nosher was in hospital for tests for his RH they did an oral glucose tolerance test for 72 hours, and I think he went low far outside the usual OGTT 2 hour limit.

Having siad that, with a high sugar meal, there is no reason why RH wouldn't trigger in 30 mins, if the circumstances were right.

I usually dip at 3-5 hrs, depending what I ate (the higher carb the food was, the earlier and lower the dip). But activity and stress levels can play a huge part, both in triggering the low, and affecting the depth of the low.

All of that is personal experience, so yours may be very different.
- especially as there are different types of RH. I'm the boring bog standard variety, I think, while noshe is rare and interesting

Medical staff are trained to treat a hypo with fast acting carbs. And that is a perfect response for diabetics.

But most of the RHers who roll up here benefit from a VERY different treatment.
With us, the trick is to AVOID the hypo in the first place, and that means eating low carb, slow release foods. Eating regularly.
Reactive hypoglycaemia is triggered when you eat too many carbs and your body over reacts by squirting excess insulin into the bloodstream, causing a sharp and excessive drop in blood glucose. So it is possible to fast, very succesfully, because you wont get a reactive hypo if you don't eat the carbs that will trigger it.

Put simply - avoid the carbs and you will avoid the reactive hypo.

Hope that helps. You may well find it worth googling and searching articles on RH, but please be wary of any advice that tells you to stuff carbs, it is far better to prevent the situation in the first place!

Hi @Ballofwool
Sorry, been working all day. There have be a few misconceptions posted which is understandable.
You can get very high blood glucose levels very quickly, at an OGTT, my bloods shot up from 5.0 to over 12 within the first hour.
You can have fast 'dumping syndrome' with Hypoglycaemia.
You won't go low for hours with RH, just like @Brunneria and myself. I start to go down after 3 and a half hours so I eat more smaller meals through the day.
You can go low after a carb laden roast dinner.
If your Hba1c fasting level is already high, say above 7, that's where it will stay eating low carb meals. Until you have complete control can your numbers appear normal.
Do not have this recommended glucose for a hypo, a plain biscuit and a cuppa will do, until they have normalized, then eat a small low carb meal.
Don't have the milkshakes, they are lethal, my friend!
The reason why you didn't get the feeling of having a hypo, is that you are unaware of the symptoms, I thought is was getting old or a bug, flu, or something.
Do have a read around the Reactive Hypoglycaemia thread.
You can look at Wikipedia, that's the easiest to search.

Keep asking questions there is loads to get your head around.

BooJewels said:

It does strike me as a rapid and steep rise - and the speed of changing BG is often the cause of distress, as much as the actual level it goes to. I've gone up just over 1 since my breakfast and I think most people would expect a rise of around 2-ish.

It's really a matter to be discussed with medics - and ASAP I would suggest.

Click to expand...

Thanks @BooJewels you have done some reading yourself and helped out very well. Thanks again, your posts have been informed and logical.

A doctor wouldn't know RH, if he fell over it!

My spike is huge and because I produce too much Insulin, that causes the hypo and everything else.

Now I am confused - thought that Diabetes involved an inadequate Pancreas in the case of Type 2 and totally 'shot' in the case of Type 1 My question, therefore, how can an inadequate or failed Pancreas 'spike' sufficiently to reduce a reading to 2.5? If it can do that why the hell does it not perform when we need it but not of course so much that we Hypo?

BaliRob said:

Now I am confused - thought that Diabetes involved an inadequate Pancreas in the case of Type 2 and totally 'shot' in the case of Type 1 My question, therefore, how can an inadequate or failed Pancreas 'spike' sufficiently to reduce a reading to 2.5? If it can do that why the hell does it not perform when we need it but not of course so much that we Hypo?

Click to expand...

Hi @BaliRob

Now I'm going to blow your mind now!

I produce far too much Insulin.
It is the extra insulin that makes you hypo!
My metabolism 'reacts' to too many carbs and sugars!

My symptoms mimic type 2 but I spike very quickly, and hypo really slowly.
There are other variations of Hypoglycaemia, there is the diabetic ones. Like @Brunneria
And the non diabetic ones like myself.

Hope that sorta clears that up!

Hi @BaliRob

I'm afraid you will find that confusion is obligatory.

Type 2 is a highly complex thing, and we all have a subtly different way that it works in our bodies.

When you factor in 1st and 2nd insulin responses, stress, exercise, additional hormone reactions, insulin resistance, age, beta cell deterioration, personal fat thresholds and personal carb tolerances, as well as what we choose to eat, the permutations really are infinite.

Me? I started out with reactive hypoglycaemia, which lasted for about 30 yrs of excessive insulin production, reactive hypoglycaemic lows, accompanying weight and insulin resistance. Plus other hormone nonsense. Eventually my poor overused beta cells began to give out, and I now have a fun combo of RH and T2.

As far as I can tell, I have virtually no 1st insulin response, and my second response is sluggish but excessive. Either I produce too much insulin, too late, or I release too little of glucagon (the hormone that 'turns insulin off') leading to those reactive hypos.

In contrast, most type 2s never experience hypos - so their issues are very different.

Sometimes they produce enough insulin, but it is delayed, leading to damagingly high BG until the insulin turns up. Or their beta cells are clogged with fat, so they can't work properly.

But we all fit under the T2 umbrella.
The trick is to find out what works for you - then stick to it.

Ballofwool said:

This is all really fascinating to me, I never knew blood sugar could be so complicated when it goes wrong. Thanks for the input everyone!

Click to expand...

Hi @Ballofwool
Before diagnosis, my blood glucose levels, would vary from very high to very low.
If I didn't eat, I would get normal levels of around 4-6mmols.
I am now in ketosis, in complete control.
I am what you would call, allergic to carbs and sugars.
I produce too much Insulin, when I eat carbs and sugars.

But I'm weird!

nosher8355 said:

Thanks @BooJewels you have done some reading yourself and helped out very well. Thanks again, your posts have been informed and logical.

Click to expand...

Thank you. I knew a very little about RH as I had a period of weird hypos a few years before my diabetes diagnosis, so I suspect I might have been similar to Brunneria, albeit at a much milder level - and we're talking 30-ish years ago now. I still occasionally went hypo as a T2, so I've always been prone to wide swings. Thankfully, the recent combination of insulin and lower carbing has significantly narrowed the gap for me.

Not many people do!
I believe there are RH ers out as I was diagnosed as T2 or other types, simply because our GPs, don't have a clue, what they are looking at!
Even some endocrinologist, according to my consultant, wouldn't recognize it, that's why there is so few of us!
I believe that low carbing could be the control that a lot of conditions would benefit from.
And reduce costs and demand on the surgeries and hospitals.

I was lucky that my GP in those days was genuinely interested in diabetes and not just the allocated member of staff to keep the stats straight. He has two passions; diabetes and palliative care. Unfortunately for me he was offered the position of opening and running a new hospice locally and took it. Our practice these days seems to be staffed by part-time youngsters who last about 5 minutes, getting in some on-the-job training before moving on to a full time position. Luckily I have a lovely DN and we just decided to cut the docs out of the equation for now, we're managing fine without them.

When you do have something rare and a bit unusual, it must make getting good care even harder and you end up becoming your own expert, because you understand it better than anyone else.

When I was younger I used to have hypos if I ate too many sweet things - crunchy nut cornflakes were delicious but deadly as far as I was concerned or left it too long between eating. My Dr said my BS was probably going too low and he told me to eat regularly throughout the day and change to something less sweet for breakfast. Once I started eating bran flakes etc and porridge for b/fast and a banana (remember them??) mid morning I wasn't too bad. Funnily enough I seemed ok in the afternoon. I still eat a mid-morning snack albeit a low carb one when I'm working because I have my b/fast at 6.30 and it's a long time till lunch and I still find that if I leave it too long I get slightly 'shaky' but not to the extent I used to