Could anyone explain to me what the
sawtooth curve for hypoglycemics mean?
I've been monitoring my BG these past few
days and it seems common for it to dip
down maybe 20 units in half an hour
(although biggest drop was 25 units
[1.4mmol] in 20 minutes) before rising (a
little bit, maybe 10 units at most,
0.5mmol) and then going down and then
slightly up again.
Add: I have also seen it rise about
almost 20 units in 15 minutes about 2.5
hours AFTER eating.
When i tested both times, i did not have
any hypo symptoms, however, and it never
dipped below 80. I was eating a hypo diet
however, so i am not sure.
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-07-08 10:27am
Various hormones in the body work to
regulate blood sugar. Even in a non
hypoglycemic person you'll find these
slight fluctuations.
The rise about 2 and half hours after
eating is perfectly normal, this is your
body preventing any further drop in blood
sugar.
Also bare in mind that the typical blood
glucose monitor has a 1mmol margin for
error - a blood sugar reading of 4mmol
could be anything between 3mmol and
5mmol.
Personally, a GTT will see my blood sugar
drop from 13mmol (234mg/dl) to 2.4mmol
(43mg/dl) in just over an hour. If I
haven't passed out, you'll then see a
small rise of 1-2mmol (18-36mg/dl) which
is blood sugar regulators (glycogen, for
example) kicking in. It'll then fluctuate
by around 1mmol. Aside from the initial
drop, the rise and fluctuation is
perfectly normal.
|
shawn604
New User, Becoming EHEALTHy
Joined: 30 Mar 2008 Posts: 28
Posted: 05-07-08 10:49am
I remember reading on this forum somewhere
that dropping too quickly is bad as well?
How fast of a drop is bad?
i was eating hypo diet too though, which
makes me worry a bit about how much it can
potentially drop if i don't. But maybe i
am worrying too much.
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-07-08 11:36am
The steep drop is the main problem in a
lot of cases. For me, my blood sugar drops
so fast and so far that glycogen can't
always stop the hypo in time. Yes, it is a
problem. I've seen reactive hypoglycemia
defined by the rate of drop of glucose
levels.
As far as I know, the drop for reactive
hypoglycemia should be over 2.6mmol/l in
an hour, or 1.6mmol/l in half hour. These
values vary a little depending on the
source.
Try not to worry too much. If you're
following the right diet and not suffering
symptoms, then it sounds like you're doing
fine to me. If you've had the condition
for some time you should be familiar with
the feeling of low blood sugar and be able
to take action if need be.
Are you diagnosed hypoglycemic? Has the
cause been found?
|
shawn604
New User, Becoming EHEALTHy
Joined: 30 Mar 2008 Posts: 28
Posted: 05-07-08 13:28pm
Ive had like 1.5mmol drop in 30 minutes
actually, but sometimes when it drops like
that i do not get symptoms. It is usually
a quick drop within 30 minutes then it
stabilizes a bit around the same number
for the next 30 minutes before anything
else happens.
Ive not had hypoglycemia diagnosed yet, my
GP is referring me to an endo today.
Sigh, have to wait probably another 3
weeks.
At the very beginning when i was getting
symptoms, i was eating a lot of white
rice, and i basically became disorientated
and just had to lie down a bit after the
meal. I went to the doctor and he
suggested that i may have low blood sugar
based on that, but the tests (poorly done
though) and my own GTT has never shown my
blood glucose lower than 3.8mmol/l. My
fasting was from 4.3-4.7 and 3 hrs after
eating i usually go back down to 4.7.
After the beginning, i had adjusted my
diet so that i do not eat so much at once.
i no longer became disorientated, but a
new problem popped up, apparently about 2
hours after a meal i would get nervous.
Some days i feel nervousness/anxiety
throughout the day as well as not being
able to think.
I went on brown rice / vegetable / meat
diet recently, and the symptoms subside
quickly, but i am not truly sure if that
is why i feel a bit better. I still
havent had a completely normal day in the
last 2 months though.
However, i seem to relapse when i loosen
my diet. It gives me bad days after a few
days of eating "slightly" bad stuff. But
for a time in vancouver, i mixed white
rice 3/4 with brown rice 1/4 and ate it
with dishes and had no problem for a week.
I seem to be a bit more sensitive to wheat
though, is something that i noticed, but i
had my disorientations eating rice.
weird.
It's all a mixed jumble of issues in
total. I read alot about hypo. I get the
concentration and the nervousness issues.
Somedays i would get bad anxiety and
nervousness throughout. Abdominal
pains/aches happen alot too. I feel my
best (on the non nervousness-throughout
days) in between meals.
However, i never feel cold chills,
tremors, or get hungry after i eat, or
alot of the stuff listed. Ct scan came
back nothing, except hemangioma which i
knew i had for a while. I also get
diarrhea and gas alot, especially after
bad days. Soft stools, purple nails for
some reason as well, which is very
confusing. I never really saw diarrhea
and stool problems as symptoms of hypo, or
purple nails.
Every week is a bit like a rollercoaster,
some days are so-so but others are
horrible. i have no real idea what is
wrong with me, but it seems to be a
hormonal thing, which is depressing since
they seem to be hard to treat.
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-07-08 14:22pm
I'd ask for a celiac test to check for
wheat intolerance. It's just a blood test
done at your surgery. Stress to your
doctor that diarrhea is a problem after
eating. I have a friend with this
condition and it shouldn't be left
undiagnosed, he's almost a skeleton.
In the mean time, have you thought about
cutting out rice???
I assume you're in the UK as you're using
mmol units. 3.8 is a little low, but not
low enough to diagnose hypoglycemia. I'd
be concerned about the diarrhea,
especially if your symptoms are occurring
within an hour following a meal (rather
than 2-3 hours later).
If I was you I'd get onto your doctor
about the diarrhea and other symptoms. And
as of now, cut out wheat and sugar
completely and see if your symptoms
improve.
PS check the symptoms of celiacs, a lot of
the symptoms cross over. For example,
someone with celiacs can suffer
malnutrition, fatigue, and even low blood
sugar.
|
shawn604
New User, Becoming EHEALTHy
Joined: 30 Mar 2008 Posts: 28
Posted: 05-07-08 15:04pm
Yeah i was thinking about celiac too. But
im not sure what it has to do with blood
sugar. I am from Canada also
I usually only get diarrhea at the days i
feel the worse, then it subsides
progessively. funny thing is, it seems
the more rice i eat the more solid it
becomes too. back in vancouver, when i
ate a lot of white rice and felt fine, i
had perfectly normal stools.
I don't get issues with brown rice, and
since i am actually a bit skinny (have
always been) i am not sure about eating
too much fat or protein. So i am eating a
bit of brown rice with every meal for
energy.
I usually tend to get nervousness 2-3
hours after putting stuff into my mouth if
i eat certain things before it going away
and i will feel ok in between meals.
As for 3.8, i only seen it twice, one was
immediately during waking, and the other
was after moving a lot of stuff into my
new dorm. Both times they up to 4.3ish
after about 5 minutes though. Normally,
my BG never gets below 4.3 during or after
eating or fasting and 4.3 is a bit lower
as compared to my typicals despite my
usual 4.7 fasting/3hrs after eating.
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-07-08 15:28pm
From your blood sugar readings it doesn't
sound like hypoglycemia - rather a
digestive problem like celiac. You may
have a sensitivity/intolerance to any one
of a range of things, wheat, lactose,
fructose, etc.
Make sure your doctor is aware of the
diarrhea and other symptoms. If an
endocrinologist can't confirm a diagnosis
then maybe a gastro would be the next
step.
And cut out the things you know bother
you. If the problem is diet related then
you can start eating right before a
diagnosis.
Don't be afraid of protein and fats, both
are essential parts of your diet. It
sounds to me like it would be worth
cutting down on the rice a little and
adding more lean meats/fish/veggies,
especially if your condition IS blood
sugar related.
Have you tried cutting out rice
altogether? That's where I'd start to see
if it helps.
|
shawn604
New User, Becoming EHEALTHy
Joined: 30 Mar 2008 Posts: 28
Posted: 05-07-08 15:52pm
Yeah, the diarrhea is definitely one of
the stranger phenomenon i have that makes
me think it is not hypo. The purple nails
too.
I will try to gradually cut out rice to
see what happens within the next few days,
im gonna have to find a good filling
recipe with lots of olive oil to get my
energy then too. Would you have any
suggestions?
I checked with my university's clinic
earlier and it turns out my doctor
referred me to an internologist? im not
sure what it is, maybe an enterologist?
apparently its someone who deals with
internal organs. Maybe that will shed
some light on this issue.
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-07-08 16:20pm
I chose not to comment on the purple
nails, I have absolutely no idea on that
one. Have you tried nail varnish remover?
You should be able to get plenty of energy
without the rice. Eat more often, every 3
hours or so, make yourself some nice meat
and veggies (steak, chicken, there's a lot
you can do with those alone). Get some
fruit in you too. Cheese is filling as
well as milk (assuming you're not lactose
intolerant), eggs, peanut butter. A nice
omelet with cheese and ham. At the moment
my favourites are spicy mince with
veggies, or chicken fillet stuffed with
cheese and garlic Broccoli is
great for getting fibre in.
Check the labels on things, especially
sauces, it might be worth sticking to
gluten free foods for a few days.
Eliminate things until you find a diet
that doesn't come with diarrhea, so you
can get back on track until a diagnosis is
made. It'll also help the doctor if you
know what foods upset you.
The key is to eat frequently, this will
keep your energy stores topped up. There's
no need to pile a load of carbs onto your
plate in one go, or you will feel rubbish.
If I did that, I'd be sleeping before I'd
cleared the plate!
An internologist I haven't come across
over here, Google Hopefully
whatever it is, he'll be able to help.
Don't focus on your blood sugar, the
diarrhea (and purple nails?!) seems to be
more of an issue here.
|
Stan
Moderator
Joined: 01 Jan 2006 Posts: 1652 Location: ,
Thanks: 1
Thanked:0
Posted: 05-10-08 09:51am
Have you tried eating wild rice instead of
white or brown? It's a bit more
expensive, but if you like rice you may
have luck with it. Avoiding things that
cause celiac problems is quite easy as
well, you don't necessarily need to be
diagnosed because you'll just be told to
avoid certain foods anyway. Try avoiding
them totally for about four weeks and then
add some back in to see what happens.
You'll know there's a connection if there
is one. If there is, then you may have
it, or it could be something else, but at
least you know how to avoid it. Looking
into sprouted grain products may be a good
idea as well, I was recently able to add
in bread after THREE YEARS because I chose
sprouted grain bread. Very good too.
|
shawn604
New User, Becoming EHEALTHy
Joined: 30 Mar 2008 Posts: 28
Posted: 05-20-08 20:57pm
The diarrhea went away completely as i ate
a more hypo diet in 3-4 days and i have
not had it since. But yeah. Sometimes i
don't have diarrhea and BG still drops
pretty fast. I looked over everything
again, and the sharpest are sometimes
2.4mmol/hr now but it sort of drops 1mmol
and then stabilize 20 minutes and then
drop another 1mmol. Very much like steps
on a ladder.
Anyways, i have some questions.
Would this observation say anything?
After not eating for a while, my BG would
be 5mmol-ish ( 90 ). But when i exercise
afterwards (usually for 15-20 minutes
cardio) i would drop below 4. 3.5 ( 63 )
and 3.2 ( 58 ) the two times i checked.
But the strange thing is, i do not get
nervousness or shakiness at all, or any
issues i usually get. I would only get
light headed and need to rest a while,
which i think would be normal? Would this
indicate anything? Perhaps that my
nervousness is a digestive issue? Can
15-20 minutes worth of cardio really lower
BG that much too? Maybe it suggests a
glucagon issue. Hm...
I also find that i can eat brown rice. I
would eat about 1/2 cup uncooked, which is
about 1.5 cups cooked? brown rice with
chicken/vegetables and the like and have
no issues on good days. I would eat it
rather quickly too, about 15 minutes.
Which is interesting. Although on bad
days i feel weird right after eating.
Another weird thing is on bad days my
blood sugar is pretty normal still. Like
mid 5s and at least high end 4s like 4.8
4.9. Even though i feel nervousness and
such almost throughout the day. Barring
that i am most probably mildly reactive
hypoglycemia IF i am even hypoglycemia, is
this even possible? To feel nervousness
when not eating the whole day sometimes?
|
shawn604
New User, Becoming EHEALTHy
Joined: 30 Mar 2008 Posts: 28
Posted: 05-23-08 21:29pm
I noticed these two days my BG seem to be
strangely high even after eating brown
rice.
Today i had 10mmol/l (180) 1 hour after i
ate 2 cups of brown rice. 2 hours after
was 7.9. Im starting to think i may be
pre-diabetic.
Strangely enough, it was never this high
two weeks ago. It went up to 7.7 an hour
after eating at most. However i was
eating brown rice also. Hm.
|
Stan
Moderator
Joined: 01 Jan 2006 Posts: 1652 Location: ,
Thanks: 1
Thanked:0
Posted: 05-23-08 22:10pm
Your body is adjusting. Hypoglycemia is
considered a prediabetic condition. Just
watch it, being high for a short period is
no danger. If it's like this by next
year, then you start to rethink your diet.
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-24-08 04:45am
shawn604
wrote:
I noticed these two days my
BG seem to be strangely high even after
eating brown rice.
Today i had 10mmol/l (180) 1 hour after i
ate 2 cups of brown rice. 2 hours after
was 7.9. Im starting to think i may be
pre-diabetic.
Strangely enough, it was never this high
two weeks ago. It went up to 7.7 an hour
after eating at most. However i was
eating brown rice also.
Hm.
Those aren't diabetic readings, they're
perfectly normal after eating.
I think, if I can quote my endocrinologist
correctly, blood sugar readings above
11mmol are warning signs and can be
considered borderline.
If you're worried about diabetes, go to
your doctor and ask for a glucose
tolerance test. But with the readings you
gave above, 5-8mmol two hours later is
perfectly normal and your doctor isn't
likely to be worried about diabetes.
You seem to be monitoring your blood
sugars very closely, be careful with that.
You may want to relax a little. To me your
blood sugars seem fine, they're not going
much (if any) higher or lower than
normal.
But you do need to stick with your doctor
until the cause of your diarrhea etc is
found.
|
Stan
Moderator
Joined: 01 Jan 2006 Posts: 1652 Location: ,
Thanks: 1
Thanked:0
Posted: 05-24-08 09:29am
180 is normal? I'm sorry, have to
disagree with you there. I have a chart
given to me by my endocrinologist that
shows starting at 140 after eating as
prediabetic.
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-24-08 10:31am
We'll agree to disagree and leave it to
the professionals then
|
Stan
Moderator
Joined: 01 Jan 2006 Posts: 1652 Location: ,
Thanks: 1
Thanked:0
Posted: 05-24-08 12:00pm
This is from the national diabetes
council, but I will agree that doctors
disagree!
|
VictoriaGB
Supporter
Joined: 25 Apr 2008 Posts: 161 Location: Wales, UK
Thanks: 3
Thanked:0
Posted: 05-24-08 12:29pm
If his blood sugar was 140 in a fasting
test, there'd be a slight concern. Here
it's 8mmol (144) that's the bench mark,
but 140 is close enough. If a patient
having a GTT has a fasting sugar of 144 or
over, the test isn't done. Maybe that's
the value you're referring to.
According to my endocrinologist the bench
mark for diabetes concern is 11 (198), I'm
sure that's at any point not necessarily
fasting.
However, in this case his blood sugar of
142 two hours after eating, wouldn't be a
concern at all. 180 is a little high at
any point, it is close to the mark, but we
don't know what exactly was consumed and
when. If I drink a sugar drink my blood
sugar shoots up to 240 after an hour, but
that wasn't a concern - it comes down
quickly enough.
If there is any concern for pre diabetes
then he should ask his doctor for a GTT
and let them decide. Now if it was 180 two
hours after eating, there might be a
concern as his blood sugar hasn't dropped
back down, indicating diabetes. And to be
honest, from what he's said, I don't think
his problem is blood sugar related at all.
Diarrhea and purple nails? Yes, he needs
to continue to see his doctor, relax a
little, leave them do their job and try
not to become obsessed with his blood
sugar levels. If readings were as low as
50 or as high as 240 then I'd agree he may
have a problem - but they're not.
PS my husband is American and has been
type 1 diabetic all his life, he was
actually a research subject in the
University of Minnesota. He's only
recently moved to Britain so is up to date
with American guidelines. As far as we're
aware, there's no significant difference
in bench marks and guidelines.
|
Stan
Moderator
Joined: 01 Jan 2006 Posts: 1652 Location: ,
Thanks: 1
Thanked:0
Posted: 05-24-08 12:37pm
Oh, you guys must have a different system
there then (god, when will it end?).
Here, prediabetes (meaning just that you
have the potential to get diabetes), is
read as anything above 140 to (I think)
200 1.5 hours after eating. So 240 would
be considered really, really bad if it
keeps happening, leading to diabetes
according to what they go by here.
