Reactive Hypoglycemia

[northeast]

Hi everyone. I am new here. I was diagnosed about a week ago with Reactive Hypoglycemia. The doctor said I didn't have diabetes yet. I am just on the border of crossing over into pre-diabetes. My a1c was 6%.

What brought me to the doctor was episodes of shaky, jittery, nervousness, lightheaded, slightly wobbly, and hungry feelings. These feelings occur mostly after breakfast around 1.5-2.5 hours after. I usually don't get the feelings in the afternoon or evening except in a blue moon.

The morning of the appointment I had my fasting blood sugar taken. It was late around 10am and it was 115. I had those shaky, jittery, hungry, lightheaded feelings then. I asked why I had them at that level? The doctor said my blood sugar was used to being higher and that is why I felt those feeling.

My questions are this: Can I pass out from low blood sugar with these jittery, shaky feelings with a blood sugar of 90-105. The pharmacist said no as they are not true hypo numbers.

I have been testing for about a week now and had 3 of these episodes of feeling jittery and lightheaded and shaky in the mornining after breakfast. However, my BS were 95-103 during these times. Why am I feeling low when I really am not low? Are these false lows?

What can I do to prevent these feelings and if they start what do I do to stop them? Do I drink OJ, eat candy, eat glucose tabs or eat some normal food? Since my blood sugar isn't low, I am confused as to what to do?

Does Reactive Hypoglycemia usually turn into diabetes.

Also, does metformin help with Reactive Hypoglycemia and if so why?

Thanks so much for helping me understand what this is?

[Moonglo]

Welcome!

Your doctor was right. You will not go into true hypo with numbers around 90-100. As he said, your body is adjusting to your new lower numbers. In a few days you should be feeling better.

When you have a true low (usually less than 70), you could have some juice, candy, or glucose tabs to get it back to normal. I would caution you against treating fake lows with sugar because then you would only be raising your bg above where it needs to be, which could be counterproductive. Ymmv (your mileage may vary), but I found that when this happened to me, if I didn't treat it, the feelings would go away on their own, although you do want to be sure and test when you feel that way to distinguish between a real low and just feeling low.

I don't know much about reactive hypoglycemia, but what tests did your doctor run to determine that you are not diabetic? Did you have a glucose tolerance test? If you are not yet diabetic, I would imagine that you might be headed that way if you don't take care of yourself now.

As far as metformin goes, I would imagine it would help to treat reactive hypo because it helps us to manage the glucose our body makes better, which helps to keep the bg in a healthier range, which ultimately should help to keep those extreme lows from coming on. From what I understand, reactive hypo is when your body reacts to high bg by producing too much insulin to overcompensate, which makes you drop low. If that makes sense.

Don't take my word as the gospel, though. This is only what I have gathered from being around here. Stick around and read and post and keep doing so; you'll learn tons and hopefully make great friends in the process! :)

[butterflykisses]

The one thing I can tell you is DO NOT use fast acting carbs like those you mentioned (juice, glucose tabs, etc) to treat it. The "reactive" part of reactive hypoglycemia is your body over reacting to a glucose load and releasing too much insulin that causes your blood sugar to drop again. Something that has some fat and protein with some carbs would be best...some peanut butter and crackers for instance. That will slow things down and keep you from crashing again.

Eating a lower carb, more like a diabetic, diet will help you not only control your hypoglycemia but slow, and maybe prevent you from developing diabetes.

[foxl]

I agree ... also, if you hypo after breakfast, watch the carbs then, in particular -- breakfast is notoriously carb-y!

[RobertIA]

northeast,

I would first have to ask a question? Before you tested, were you sure that you had washed well with warm soapy water? This more than anything can give incorrect readings. I have done it often enough lately myself - and I should know better.

The doctor is more than likely right on. When the body is used to high BG and then it is taken away, it tries to encourage the body to give it more. Thus the false low feelings.

The pharmacist is correct. I do not know what the actual number range is, but I have been as low as 45 myself. Yes, I became very irritable and difficult to be around and had to apologize to my wife after. I still don't think she believes me that this happened.

I would also suspect that each person is different, and different low numbers may or may not cause people to pass out. But your numbers are more in the normal range and I would be very surprised for that to happen to you.

Your body will adapt to these numbers - not immediately as it took a long time for it to be adjusted to higher numbers. I am not medically qualified to give an answer, but my guess is that you have diabetes and much higher numbers. If you have increase your activity or exercise lately, then you may have reduced your insulin resistance and you body is helping somewhat in controlling BG.

Being diagnosed with hypoglycemia (I can't speak to reactive) is generally an indication that as you age, you will have diabetes. This is because the insulin producing cells are being overused to produce insulin that your body doesn't need. My daughter was diagnosed at age 22 with hypoglycemia and this summer (after 16 years) was determined to have prediabetes. I told her to treat it as if she had diabetes. She said she is and is using nutrition and exercise to keep control for the time being. And her doctor agrees. My brother was able control his diabetes with nutrition and exercise for about 40 years until cancer interrupted things and forced him to be on insulin.

Metformin - my suggestion is that generally it will not cause lows in most people and aids the body in insulin production regulation. While not perfect, it has been around for about 16 years and has a rather impressive track record. As to reactive hypoglycemia - ask your doctor.

Keep a positive attitude.

Bob

[northeast]

To answer some of the questions:

When I went to the doctor, they didn't wash my hands with soap and water, they just used an alcohol rub. (I always wash with soap and water at home since I started testing a week ago).

The doctors haven't done a glucose tolerance test yet. I think they want me to use diet and exercise and metformin for the next 3 months and then we will test again.

Thanks SO much for telling me to not do the fast acting carbs. I thought that was what I should do for the feelings. I understand if I am below 70 I should, but if I am at 90-110, then I should try to ride it out or eat something like peanut butter on a cracker. Sometimes this low feeling goes away in 30 minutes or so, but other times it can last one hour or longer. It's the longest hour cause I just feel off. When it passes it is such a relief.

I can say I quit drinking my morning coffee on an empty stomach three days ago and eating something small right when I get up, then again in an hour, then again in an hour. This has seemed to really help me feeling hypo. I got just a really really mild low feeling by doing this, so maybe this is the way to go?

I also do suspect I could be going in the direction of diabetes. My brother has it and so did my grandfather. Mom and Dad didn't have it. I am glad that I caught it early. I have been having these "low" feelings for over a year to two years now though, so I suspect something has been going on for some time. Luckily I am at 6% now and now I know I can work on my diet and exercise to get me in the 5% range. I can see that diet and exercise really works on getting the blood sugar in better control.

[Moonglo]

Be careful about using the a1c as your only diagnostic tool though... most people here say that the glucose tolerance test is more reliable because it shows how your body responds to glucose at different points beyond ingesting. An a1c can be skewed. For example, if your true hypos are because your bg was high and your body reacted to the high by shooting too much insulin through your system to lower it, well... the average of those two numbers paints a nice and peaceful picture, but does not give the full scenario.

Don't get me wrong... a1c's are useful in people who are actively working to control their bg, and if you get to a point where you don't have so many highs and lows, yours may be pretty accurate. But I would be leary of using it as my only picture of my health, if it were me.

My suggestion: definitely treat your body as if you are already diabetic now. It could absolutely prolong, if not prevent you developing the full blown disease. If you don't want to do a glucose tolerance test now, I would definitely ask about it at my next appointment in three months. Don't be afraid to be too aggressive; it may improve or even save your life one day.

Best wishes, and keep us posted! :)

PS- you are absolutely right... diet and exercise are your best tools for controlling bg levels. Sounds like you have the right attitude already!

[butterflykisses]

To answer some of the questions:

When I went to the doctor, they didn't wash my hands with soap and water, they just used an alcohol rub. (I always wash with soap and water at home since I started testing a week ago).

The doctors haven't done a glucose tolerance test yet. I think they want me to use diet and exercise and metformin for the next 3 months and then we will test again.



Hmmm...I thought You had the GTT which is how reactive hypoglycemia is diagnosed? There is a difference between "feeling" low because your body has become accustomed to being high and true hypoglycemia. With reactive hypoglycemia your blood sugar will drop into traditional hypoglycemia ranges, below 70, and could go low enough to pass out. My stepson and his mother both have it and both of them have actually passed out before. :eek: I had a manager who was having those hypo feelings, but always passed the GTT. The doctor told her that what was most likely happening was the beginnings of insulin resistance. Her resistance was rising keeping her blood sugar higher for longer periods of time. She did end up with diabetes. :(

[northeast]

Hi Katherine. No, I don't seem to be having true hypos. I get these feelings of shakiness, lightheaded, hungry, in the morning after breakfast and my BS can range anywhere from 95 - 108. I haven't had a GTT yet although probably after my next set of numbers they may want to. I have been checking 1 hour after eating and I am not seeing really high numbers, but I have modified my dinners. My 1 hour numbers range from the high 90's to high 110's, but sometimes go into the 120's.

I haven't caught a one hour number higher than 126 after dinner yet. I am experimenting with different times to see if I can catch my peak and always fall into the 90s at the 2 hour mark. I haven't had a high carb meal though like all pasta yet to see if that makes it go high. I am having carbs with every meal (even pasta), but it is a side versus the whole plate.

[butterflykisses]

Hi Katherine. No, I don't seem to be having true hypos. I get these feelings of shakiness, lightheaded, hungry, in the morning after breakfast and my BS can range anywhere from 95 - 108. I haven't had a GTT yet although probably after my next set of numbers they may want to. I have been checking 1 hour after eating and I am not seeing really high numbers, but I have modified my dinners. My 1 hour numbers range from the high 90's to high 110's, but sometimes go into the 120's.

I haven't caught a one hour number higher than 126 after dinner yet. I am experimenting with different times to see if I can catch my peak and always fall into the 90s at the 2 hour mark. I haven't had a high carb meal though like all pasta yet to see if that makes it go high. I am having carbs with every meal (even pasta), but it is a side versus the whole plate.

Have you had your thyroid checked?

[ADSOFT]

Wow, this is very interesting, you are getting hypo symptoms at BG'S close to 100.

Its seems as if glucose is just not getting into your system or it can't use it at that concentration.

Do you drink water? I wouldn't drink water right when you are feeling this way, it might help but it could make it worse.

But try drinking water after and before meals, take some vitamins. It seems that something is missing in your system and the glucose is just not getting into your organs.

Maybe you minerals are low, or your salt is low.

Did they check for your electrolytes. Could also be symptoms of dehydration.

Look up dehydration and see it that applies to what you are experiencing and your diet.

[northeast]

Yes, they checked my thyroid and it was fine.

I don't think I am dehydrated. My urine is usually pretty clear...not dark yellow. I don't drink anything over night and then just went straight to coffee (which is a diuretic). I have cut out drinking the coffee on an empty stomach and now I started eating something small as soon as I get up (i don't really feel like eating when I first wake up but you have to do what you have to do). I then eat again in hour and then again in another hour and a half. All small things with carbs and protein mixed. That is seeming to help and my hypo feelings have been MUCH reduced doing that. Someone said grazing might help even out my blood sugar from fasting over night so eating small things to just bring my bs up slowly might be the way to go. My doctor did tell me to eat as soon as I step out of bed to wake up my pancreas and liver. Who knows?

After that rough period of 10am-Noon or 12:30pm though, I feel fine all afternoon and evening with none of those hypo feelings. I am starting to think drinking the coffee on an empty stomach for perhaps an hour to 2 hours was what was doing me in along with only carbs for breakfast. The shredded wheat cereal really gave me these symptoms.

[butterflykisses]

Yes, they checked my thyroid and it was fine.

I don't think I am dehydrated. My urine is usually pretty clear...not dark yellow. I don't drink anything over night and then just went straight to coffee (which is a diuretic). I have cut out drinking the coffee on an empty stomach and now I started eating something small as soon as I get up (i don't really feel like eating when I first wake up but you have to do what you have to do). I then eat again in hour and then again in another hour and a half. All small things with carbs and protein mixed. That is seeming to help and my hypo feelings have been MUCH reduced doing that. Someone said grazing might help even out my blood sugar from fasting over night so eating small things to just bring my bs up slowly might be the way to go. My doctor did tell me to eat as soon as I step out of bed to wake up my pancreas and liver. Who knows?

After that rough period of 10am-Noon or 12:30pm though, I feel fine all afternoon and evening with none of those hypo feelings. I am starting to think drinking the coffee on an empty stomach for perhaps an hour to 2 hours was what was doing me in along with only carbs for breakfast. The shredded wheat cereal really gave me these symptoms.

I was watching a show on BBC last night called You are What You Eat, I think? Anyway, a woman helps people who are overweight learn how to live more healthy with diet and exercise. On this particular episode one of her "victims" was drinking a lot of caffeine and was describing a lot of your symptoms. She told her that she was suffering from caffeinism. Of course I am in no way suggesting this is your problem, just reading the coffee comment made me think of it. I have never heard of it before??? Sounds like you're working out a good solution for your problem and glad to hear you're feeling better.

[ADSOFT]

Yes, they checked my thyroid and it was fine.

I don't think I am dehydrated. My urine is usually pretty clear...not dark yellow. I don't drink anything over night and then just went straight to coffee (which is a diuretic). I have cut out drinking the coffee on an empty stomach and now I started eating something small as soon as I get up (i don't really feel like eating when I first wake up but you have to do what you have to do). I then eat again in hour and then again in another hour and a half. All small things with carbs and protein mixed. That is seeming to help and my hypo feelings have been MUCH reduced doing that. Someone said grazing might help even out my blood sugar from fasting over night so eating small things to just bring my bs up slowly might be the way to go. My doctor did tell me to eat as soon as I step out of bed to wake up my pancreas and liver. Who knows?

After that rough period of 10am-Noon or 12:30pm though, I feel fine all afternoon and evening with none of those hypo feelings. I am starting to think drinking the coffee on an empty stomach for perhaps an hour to 2 hours was what was doing me in along with only carbs for breakfast. The shredded wheat cereal really gave me these symptoms.


I haven't read the whole thread, but YES. When I was 18 and was starting college I heard that coffee kept you alert. So I drank about a 30oz cup. I shaking 45 minutes after and I was studing with friends, had a hard time controlling it. It was really scary, but it only happened once that I can remember. I think I just didn't drink that much coffee anymore, but kept on the coffee.

I can drink a gallon of the stuff now, but I noticed that even today if I drink it especially without food 3-4 hrs later I'm very tired and sleepy I have to get some food.

... YMMV.