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tovli

Why? Unexpected Low Reading After Meal

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tovli

What can cause an unexpectedly low blood glucose level after a meal?

 

I ate 10oz Salmon, 1/2 large sweet potato, a salad of romaine lettuce, red and orange peppers, with "aged" balsamic vinegar (extra carby) and olive oil, and 4oz Rose wine.  Carb Manager put the meal at around 25g net carbs and 600 calories.

 

My 1hr from start eating BG reading was 110.  

 

I probably had a sip or two of the wine 10-15 minutes earlier than the "start eating", could that cause an insulin flood and squash the later meal glucose?

 

 

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Dowling

Perhaps your BG was extra low before you started to eat. What were you doing before the meal? Perhaps your BG went higher after the 1 hour because the fiber in your meal delayed the glucose response. These are only guesses based on the info given. I wouldn't worry about it though 110 is a good reading

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CommuniqueDiabetes

I agree with Dowling, maybe it was really low before you ate.

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tovli

Happened again today with a different meal / circumstances:

 

Ate homemade Chicken soup, 1 matza w/butter, and 4 oz of chardonnay with the meal:  1hr reading 75.  Only the second time I have seen my BG this low. 

(My wife ate 1-1/2 matza and less chicken.  Her 1hr reading was also low at 100.)

 

Q) We both had a snack one to two hours before the dinner, so is it possible our bodies were "prepped to flush carbs" with excess insulin running around?  Is that a thing?

 

Q) Is chicken soup a magic elixir for anyone else?

 

I know anyone else would be asking "That's a great reading; What's the problem?"  I'm sorry.   I've been trying to understand what foods my body doesn't like for 250 finger sticks worth of meals.  Most readings correlate (roughly) to the carb count, but this is the second time I'm way below the expected, and the sixth time I have seen lower than expected BG 1 hour after chicken soup.

 

 

 

 

 

 

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tovli

Ok, another datum - Same chicken soup and 1 matza, without the wine and without the snack and for lunch instead of dinner.

 

This time the 32g carb elicited a 1 hour BG of 126 for me and 129 for my wife (again 1-1/2 matza in her case).  

 

I've heard that when you eat the carbs can make a difference, so this is again a poor excuse as an experiment, but I think dispels the "magic elixir" hypothesis.

 

I was assuming that if after I eat a meal, the meal effect is done by 90-120 minutes after the meal.  When I did the Glucose challenge, I peaked at 40 minutes and returned to the starting/fasting BG at 80 minutes.  Then continuing to drop dramatically until 90 minutes after the meal, when the readings became "dramatically flat" at what would be considered "normal".  

 

Perhaps the insulin levels that I cannot measure are still high, even though the BG reading has stabilized at or below "fasting BG".  I don't know if the "snack-then-meal" is causing higher insulin levels at  a lower BG, or using the already existing insulin level of the snack to give a lower meal BG.

 

Anyone know how the "carb - insulin - more carb" signal/response actually works?

 

 

 

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Hammer

In a non-diabetic, when they eat food, the food is converted into glucose, and is then released into their bloodstream.  The blood then passes through the pancreas, which detects this increase in glucose, and begins to release their first phase insulin.  This is insulin that is stored in the pancreas.  As the first phase insulin is being released, your pancreas gears up to begin producing your phase two insulin.  The first phase insulin is just a small amount of stored insulin, but by releasing it when extra glucose is sensed by your pancreas, it gives your pancreas time to begin producing your phase two insulin.  These two are what are able to keep a non-diabetic's glucose from rising too high after eating.

 

In a type 2 diabetic, you may not have any phase one insulin, and or, you'll have insulin resistance.  When your first phase insulin is released, your insulin resistance prevents the glucose in your bloodstream from entering your blood cells, and because of that, the first phase insulin will not have any effect on your glucose levels, so the first phase insulin is continuously being released in an attempt to bring your glucose levels down.  Once the first phase insulin is used up, your second phase insulin starts to be released.  What can happen is that, because so much insulin was released into your bloodstream, eventually your insulin resistance stops resisting the insulin, and the glucose begins entering your blood cells, but by now, you have an excess of insulin in your bloodstream.  That excessive amount of insulin will make your BG levels drop low.  This is called reactive hypoglycemia.  This can happen even if you are not diabetic.  Reactive hypoglycemia usually happens when you eat a high carb meal, but from what you said, it doesn't sound like you ate a high carb meal, so I don't know if that is what you are experiencing.

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tovli
18 hours ago, Hammer said:

In a non-diabetic, ...

 

In a type 2 diabetic, ... This can happen even if you are not diabetic. ...

 

Great.  Thank you for walking me through the mechanism.  The medical articles and chapters in the books I read didn't sink in like your explanation has.

 

It is disconcerting to not be able to directly measure the insulin levels.  It makes me question the statement in Bernstein's book that "damage occurs above blood glucose levels of 160" if my BG measurement is not tightly correlated with my insulin level.

 

I keep hoping that the occasional meals that busts my 140 target for a short time are still better than the way I was eating prior.  I cheated once last year with an "old normal meal" (6" Italian steak sub with fries and a cherry Coke), and came home with a 1hr 217 reading.  These days I'm under my 140 limit four out of five meals, and don't often see 1 hr readings above 170.

 

I didn't have a mental model how my readings could be in the 70-80 range, so your explanation really helps.  

 

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Hammer

While it's not good to spike high after a meal, if the spike is short lived and drops back down to more normal levels within an hour or two, that shouldn't be a problem with nerve damage.  It isn't just high glucose levels that can do nerve damage, it's high levels that last a long time.  From what I've read, it's better to spike to 160 for a short time, as opposed to being at 140 for a long time....not that either are good in the first place.

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