I'm Confused About Reactive Hypoglycemia

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I'm Confused About Reactive Hypoglycemia


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Old 11-16-2012, 17:54   #1
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Default I'm Confused About Reactive Hypoglycemia

I've been reading about reactive (postprandial) hypoglycemia and I'm just confused as ever. Here's why...

Doctors and science professionals (in the articles that I've been reading) seem to all agree that a normal A1C value means that you cannot be having any trouble with sugar or insulin in your body.

But if that is the case, why do I sometimes experience what feels to me like reactive hypoglycemia (see below examples)? And why do I seem to have Acanthosis nigricans (darkening under the armpits and inner thighs)? Acanthosis nigricans means that you have higher than normal circulating insulin levels.

Please note that I do not take insulin, Metformin, or anything like that. My A1C is 5.2%.

Example #1 (this has been going on for over 10 years):
After I eat 3 to 5 large chocolate chip cookies or a few brownies or a big slice of cake or a big slice of pie, etc, I will get very tired within an hour (usually in the first 30 mins). Sometimes I will become so tired that I need to take a nap, which lasts for about 2-3 hours. Besides the immediate fatigue, I will also experience confusion, inability to concentrate, difficulty remembering anything, inability to make decisions, blurred vision and general brain fog.

Example #2 (this has been going on for over 10 years):
If the first thing I eat in the morning is 2 cups of wheat bran flakes I will feel absolutely horrible for up to 6 hours afterwards, with the worst of it occurring within the first 3 hours of eating it. The sleepiness/drowsiness will not be intense enough to need to take a nap, but I will feel irritated, cranky, confused, out-of-it, dizzy, and will be incapable of making decisions, forgetful, have difficulty concentrating, have blurred vision, etc.

Example #3
After an intense cardio workout, I get the same symptoms as in Example #1. (Slow response of the liver to release glucagon?)

Example #4 (this has been going on for over 3 years):
I have darkening of the skin in my armpit region and inner thigh region. This has been confirmed by my fiance.

Now, here's where I'm confused. If I really am experiencing reactive hypoglycemia and acanthosis nigricans, doesn't that seem to contradict this idea that a normal A1C of 5.2% means that all is well in the world of blood glucose and insulin levels?

What is going on here? If I really do have normal insulin levels and normal blood sugar metabolism, what is causing the symptoms in the four examples above?

I have already made the decision to buy a meter and strips and start testing. This will happen starting next week.

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Last edited by Seeking; 11-16-2012 at 18:09.
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Old 11-16-2012, 18:25   #2
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My take on it is that docs are wrong to consider only A1c and fastings levels - absolutely unequivocally wrong.

The first place this metabolic issue raises its ugly head is postprandial. You can still have good fasting numbers, and you can have horrible swings in postprandials and still have a good A1c, because the lows you are suffering cancel out the highs.

You're wise to get the meter and start testing - be sure you log everything so you can take to your doc a comprehensive account of what, when and how much you ate, and what effect those meals had on your blood sugar.




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Last edited by Shanny; 11-16-2012 at 20:16.
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Old 11-16-2012, 18:27   #3
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I'm another non-diagnosed diabetic. My A1c and fasting blood sugars are close to normal, but with the exception of the Acanthosis nigricans, I have the same symptoms as you.

Some of the testing strategies I used might be helpful to you, but then again, maybe not. We're all so maddeningly different, LOL!

Try testing before a meal, 1 hour after, and 2 hours after the meal. Start timing at the first bite, not when you finish eating.

I didn't find much out from those tests, but eventually started testing at the 90-minute mark. That showed a huge spike. (Now my spike is at 45 minutes.) So, give it some time, but if you don't find anything unusual at 1 and 2 hours, try 45 minutes and 90 minutes.

For exercise, I tested before, right after, and 1 and 2 hours after that. Didn't see anything really conclusive, but then one day a couple of weeks ago, I was participating in the Big Blue Test and tested before (101) and 15 minutes into the exercise (67!) So, you might try something like that.

You might want to look at my posts elsewhere in the forum. Seems like we have similar presentations.

Good luck!

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Old 11-16-2012, 19:10   #4
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Reactive hypoglycemia is a funny beast, being a retired hypo myself I have been through all of the symptoms you speak of.

What happened to me and other former hypoG people is like your BG climbing a ladder.

In the beginning you take 5 steps up, 5 steps back. Then as you progress towards Diabetes you take 10 steps up, 5 steps back, but you feel the same as if you took 10 steps back. Further progression, now you are already 5 steps up the ladder and you take another 10 steps up and only 3 steps back. This continues until your body can no longer take any steps back, you have arrived at your destination (D).

Very wise on your part to get a meter and test as MARA above has said.

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Old 11-16-2012, 19:28   #5
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~ Seeking ~

About 15 years before developing full-fledged diabetes, I suffered from hypoglycemic episodes just like you describe. I remember in particular one morning I ate a huge cinnamon roll, and about an hour later I had this crushing need to sleep, fuzzy brain etc. I realized then not to eat sugary things by themselves and not in the morning. Because I was also ADD, I learned to eat protein in the morning to help me focus, with no fuzzy brain.

What happens is your system is flooded with glucose from the high carb meal, and your pancreas over-reacts with too much insulin, dropping your BG really low. It is the beginning of "metabolic syndrome" and pretty much follows the path MCS described. I should add that at this point I had already started to develop the fat deposits in the abdomen that is common to diabetics.

I think you find that many of us in here report that prior to our DX with diabetes, we often fell asleep after meals, especially those high in carbs.

I, too, encourage you to test around your meals as Mar2a suggested.
Good luck to you.

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Old 11-16-2012, 20:03   #6
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You guys are so much more helpful than doctors. The doctors just tell you that if your A1C is normal and 1 random blood test a few hours after eating seems normal then all is right in the world and you have absolutely nothing to worry about.

But according to you guys, I am--as I had suspected--on that path towards diabetes. I could be anywhere from 1 to 20 years away from it! I have this intense urge to stand up and shout "I KNEW IT!!"

Well, the time to act is now. I'm going to be testing my blood sugar and making graphs of it in Excel, I'll post them once I start testing next week. This will help me develop an idea of what I should and shouldn't be eating.

I think I'm going to do something akin to the ketogenic/low carb diet but that is for another thread. I have so much to read about and learn.

Thanks again guys! Will post my BG results when I start testing!

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Old 11-17-2012, 05:53   #7
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There is a disorder known as hypoglycemia. It is not diabetes. Some people who develop it go on to become diabetic, others don't. Hypoglycemics don't have problems with elevated blood sugar but with it going to low. The A1C would be basically useless to detect it. Even though they suffer from lows, they wouldn't normally have abnormally low A1Cs and certainly not high, diabetic ones.

Hypoglycemics can have clinical lows which reach actual life-threatening levels. Diabetics generally never have these.

There are many theories about exact causes and there are probably different types of hypoglycemia. Among them are:

1) Hypersensitivity of the pancreas to glucose. When it detects glucose in the blood it over-reacts and secrete too much insulin causing the low.

2) Hyper insulin sensitivity of the peripheral cells. When glucose is detected and the pancreas secrete insulin accordingly, the cells over-respond to the insulin taking in too much glucose and creating the low.

3) The bursting dam theory. The pancreas responds to glucose by secreting insulin. But, for some [unknown] reason, the signal is somehow "blocked" and cells don't respond in a timely manner. The pancreas senses the continued presence of glucose and pumps out additional insulin. At some point, whatever the obstacle is gives way and the cells respond suddenly to too much, drawing too much glucose out of the blood and causing the low. Seems a little far-fetched and I've never seen any explanation of exactly what this "dam" is, but it does seem to explain the chain of events.

(Notice that #1 and #2 are OPPOSITES of what defines T2 diabetes.)

Last week, I met another pure hypoglycemic (not diabetic). This is the third one I've known closely in my life. Got all the details of his story. He adopted a "paleo" type diet very much LC/HF and the entire issue disappeared.

The good news is that the needed course of action is the same for either T2 diabetes of hypoglycemia. You simply need to increase the role of fat in your diet. Carbs and protein are both sources of glucose in your blood. It is the flood of incoming glucose from what you eat which causes the problem. By minimizing this as much as possible, you can completely eliminate the problem.

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Old 11-17-2012, 06:28   #8
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In the early days, just after diagnosis, I used to feel the same symptoms of sleepiness, fatigue etc when my blood sugar was high (hyper not hypo). I also know that I'm not alone in this and these are quite common symptoms of a high. So I would suggest to test before arriving at a verdict.

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Old 11-18-2012, 22:10   #9
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Seeking, I've also read that there is a type of non-diabetic hypoglycemia and one that occurs as one is heading toward diabetes.

I don't know enough to guess which yours is. Since my blood sugar often goes higher that the "norm" of 120 or 140 after meals (over 200 many times), I'm guessing I'm in the "heading toward diabetes" department. Either way, adding fat to my diet does prevent alimentary hypoglycemia (that is, going low after a meal because the meal made me spike first).

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Old 01-02-2013, 19:00   #10
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Quote:
Originally Posted by Mar2a View Post
Seeking, I've also read that there is a type of non-diabetic hypoglycemia and one that occurs as one is heading toward diabetes.

I don't know enough to guess which yours is. Since my blood sugar often goes higher that the "norm" of 120 or 140 after meals (over 200 many times), I'm guessing I'm in the "heading toward diabetes" department. Either way, adding fat to my diet does prevent alimentary hypoglycemia (that is, going low after a meal because the meal made me spike first).
According to what I've read, if your BG goes to 200 or above even one time, you are full-fledged diabetic.

I think you are right about another type of hypoglycemia that leads to diabetes. I'm still confused about it all though. It seems that there is a type that is being caused by insulin resistance and it goes like this: When you consume a meal high in carbohydrates/sugars, the body responds by pumping out too much insulin. The excess insulin is produced because you need more insulin to metabolize/store/get rid of that sugar than a normal person does. The body has a difficult time gauging exactly how much insulin it needs to secrete, and often overdoes it.

But again, I'm confused, because this is essentially called "hyperinsulinemia" or "hyperinsulinism," but what exactly does that mean? Does it mean that there is only excess insulin within a short time frame after consuming the high-carb meal? Or does it mean that a high level of insulin remains in the blood on-going, permanently?

Still seeking answers...

Need to know because I plan on doing an insulin blood-test soon and C-peptide, and if insulin blood levels change often like BG then I need to make sure to eat a ton of carbs/sugars before I do this test...

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