Hypo School

I have been schooled in hypoglycemia, in more ways than one.

TYPE 2) First off, you were all right, of course: hypoglycemia is apparently often an early sign of Type 2 diabetes.

Excerpts from Connie Bennett’s new carb-bashing book, Sugar Shock!, cleared this right up:Sugar_shock

When the body is resistant to the insulin it makes, the result is “… an ‘overshoot’ phenomenon characterized by a large spike in insulin, followed by a drop in blood sugar. Over time, repeated insulin spikes may lead to a decrease in pancreatic reserve, or more insulin resistance,” Bennett’s experts say. 

Meaning: “The brain craves more glucose so you consume more simple carbs to get your blood sugar back up again.  You get into this vicious cycle of low sugar, high sugar, low sugar, high sugar, low sugar, high sugar. And that taxes your pancreas, which then leads to either insulin deficiency or to greater insulin resistance and, therefore, type 2 diabetes. (Type 2) diabetes really is chronic hypoglycemia.”

Hmmph, so it’s the continual lows that make you high all the time.  Yet another twist to this confounded disease.  So if you feel shaky and ravenous after eating sweets, beware.  You may have — or be headed towards — Type 2 diabetes.  Loverly.

TYPE 1) Back in my world of continually struggling to get the insulin dosing just right, I have hit a new (and quite frightening) record!  Felt a little strange the other day — nothing too alarming, mind you.  Just a sense of some buzzy disorder at the back of my head.  Checked and discovered I was at 36!!  WtF?  Began gorging on raisins immediately as I checked again: 43.  Well now I know I’m not imagining it:  as time goes on, I am most certainly becoming more and more hypoglycemic unawareHypoglycemia How much longer until I land in the ER, I’d like to know?!

To date, I’ve been very lucky.  I’ve only had one instance in which I was truly disabled and needed help — but Oh, Chrissie (in Belgium), I feel for you on the bad hypos! 

Thank you also, Chrissie, for noting why this happens to us: “A hypo normally makes the body react with epinephrine, cortisol and other BG raising hormones. However, this causes toxicity. Your body is merely trying to avoid this toxicity, and therefore you do not produce these hormones so easily…”

The experts put it this way: “Symptoms of a low become less obvious after having diabetes for several years because repeated lows impair the body’s release of stress hormones. The major counter-regulatory hormone that causes glucose to be released by the liver to raise the blood sugar is glucagon. Glucagon secretion is reduced in most people who have Type 1 diabetes within the first two to ten years after onset.”

They also note: “Women are more prone to this problem because they have reduced counter-regulatory responses and reduced symptoms.”  Now isn’t that Loverly, too?

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25 Responses

  1. Chrissie in Belgium
    Chrissie in Belgium January 31, 2007 at 8:09 am | | Reply

    Hmm, quoted by Amy! Not bad. I take that as a BIG complement! Thank you Amy.

    Maybe you and I will end up in a hospital at the same time. Early this morning at 4:30 A.M. I had 35 mg/dl. I felt totally fine. I DID drink coke, swish with water, and return to bed and sleep. I woke up with a 46. Obviously I didn’t drink enough coke. At least I drank some coke, even though my brain was telling me that I felt FINE.

  2. gretchen
    gretchen January 31, 2007 at 8:30 am | | Reply

    Two comments:

    1. You might want to try a continuous monitor again. They’re not terribly accurate in an absolute sense, but they warn you of lows.

    2. Eating fewer carbs results in fewer highs and lows.

  3. Scott
    Scott January 31, 2007 at 9:07 am | | Reply

    Ever wonder why most meters tend to be accurate on the high end of the scale (one meter was reportedly tested for accuracy at readings up to 700 mg/dL!) yet at the low end of the scale, its almost universal that they are seldom tested lower than 40 mg/dL. We should be complaining to the FDA on the reason for these inaccuracies … as if highs are the only danger?!

  4. Bernard Farrell
    Bernard Farrell January 31, 2007 at 9:11 am | | Reply

    Don’t you hate it when you’re SURE that you’re not low and the meter is telling you that you are, but you’re SURE that you’re DEFINITELY NOT.

    I hate how lows make me question my sanity like this.

  5. Kim
    Kim January 31, 2007 at 9:15 am | | Reply

    Interesting to see this documented. I was diagnosed hypoglycemic at 19. Mom had me tested as Type 2 runs rampant in her family and I guess I was exhibiting some symptoms.
    Over the years I have been told by doctors variously that hypo doesn’t exist, that it doesn’t mean anything, yada, yada, yada. Anyway, over the years I could definitely feel it getting worse. If I only drank coffee with sugared creamer in the morning morning, I would be passed out asleep by noon or very, very mean. Unfortunately no one ever warned me what it would lead to.

  6. shawn
    shawn January 31, 2007 at 9:34 am | | Reply

    oddly enough i was having hypoglycemia for years, before finally being diagnosed as a type i
    for as long as i can remember, about 1.5-2 hours after a very high carb meal, i would get sweats, shakey, anxious etc, and crave sweets, drink a soda or eat candy, and soon after feel better
    it happend after eating chinese food and i thought it was a msg allergy
    it happened after a bkfst of oatmeal,with sugar, and a fruit yougurt etc
    one day i told my doctor
    he suspected it was reactive hypoglycemia
    i experimented with low carb meals and i rarely had a problem
    he tested my blood and said i was showing signs of insulin resistance, called me pre-diabetic, and said i should watch my carbs, and continue my exercising etc
    well 3 years later, i became a type 1, although we suspected i would become a 2

  7. Tim
    Tim January 31, 2007 at 1:00 pm | | Reply

    I think that the response to the lows and being able to physically feel it is relative to where your blood sugars have been lately. My wife (the one with the D) feels the lows less as she hover around her goals on the low end. But if she is having a bad week or so and has been around the top end of the hundreds too much, a 75 can wreck her as much as a 40 would normally.

    We have also noticed the yo-yo in her Type 1. We call it “chasing the sugar”. We have to resort to tight eal management and known quantities

    Ditto the accuracy. If you check the officlal accuracy period it can be a +- 20 easily.

  8. Linda
    Linda January 31, 2007 at 1:11 pm | | Reply

    Let me just say that after being diagnosed with type1 almost 29 years ago, I have been from one end of the glucose spectrum (bg of 19) to the other (bg of 800) and I have to say every time is different for me. In the bg of 20 range I have been coherent and talking and acting normal at another low say 56 I have been laid out on the floor in a seizure and not able to communicate at all. The same holds true for the other end of the spectrum.
    I can’t explain it and my endo is baffled sometimes as well. I guess what I’m saying is YOU are you are your own best doctor and
    after living with this for as long as I have 99% of my health care providers are not diabetic and haven’t a clue. My best example in my lifetime was when I was 12 and my pediatric endo told me and I’m quoting here, ” you can eat 12 applepies if you want ,
    You will pee alot, take some extra insulin, nothing is going to happen to you.” So here I am now good buddies with most of the
    “opathies” related to diabetes.
    Get to know yourself and how your
    diabetes affects you. Knowledge is power!!!

  9. Kate
    Kate January 31, 2007 at 3:37 pm | | Reply

    I second Bernard’s comment about hating how those lows that sneak up on you and you don’t *initially* feel make you question your sanity- or your meter or eyesight for that matter! “That can’t be a 45, I’ll test again! Oh, it says 40 now…hmm maybe it was right the first time and I should eat some glucose tabs or something.” I also don’t like how I feel coming up from those lows- because if I haven’t felt the low on the way down for some reason I’ll feel the sypmtoms- sweating, shaking, etc on the way up.

  10. Lili
    Lili January 31, 2007 at 3:38 pm | | Reply

    I had hypoglycemia for many years before being diagnosed Type 1 (LADA), but it was never treated. It seems many doctors think people are *always* making it up, which is unfortunate. Not having health insurance didn’t help either, I suppose. Since I started testing before I was clearly diabetic, I do have data now that shows the hypoglycemic pattern.

    Thanks for posting this! I find it very interesting.

  11. Maureen
    Maureen February 1, 2007 at 3:00 am | | Reply

    Lows, AHHHHHHHHH! My 11 yr old son can normally feel his lows, his legs “feel empty”. 90% of the time he’s right. I remember when he was practicing for FIrst Communion a few years ago and he was fidgety and tired and generally being reprimanded for behaving badly. I took him out, tested him and WOW.. 29. Anything below 60 the BG(blood glucose) becomes BS (no, I mean blood sugar !). After pouring what seemed like a gallon of oj into him, he was back in range only to be sky high later. Then afterwards, you hate that you had to use all of those test strips because the insurance company is going to whine about going over your limit. Diabetes is a cruel game for all, especially for kids. Now if I could get his school to not send him to the nurse’s office alone when he feels low..

  12. vicki
    vicki February 1, 2007 at 9:15 pm | | Reply

    For hypoglycemia: Raisins are not good. Orange juice is not good. Glucose tabs ARE good. This is why: Raisins, orange juice and other such things will shoot you up and up and may bounce you right back into reactive hypoglycemia. On the other hand, glucose tabs will raise your BG the same amount, consistently (test beforehand and you’ll know what the number is). For most type 2s its 10 points.

    For LADAs (type 1) on insulin like me (and you, Amy) it can vary depending on the time of day. So you need to test out glucose tabs at various different times of day to learn what your own parameters are. They when you go low — grab the right amount of glucose tabs, eat’em and within 15 minutes you’ll be right where you need to be. Not too high, not too low.

  13. Maureen
    Maureen February 2, 2007 at 3:09 am | | Reply

    After our experience with the “gallon”of oj, we found that Gatorade works well for my son. The Gatorade that come in the box, six to a pack, has exactly 15g of carb and it contains glucose. Doesn’t seem to have that rebound effect .

  14. EB
    EB February 2, 2007 at 11:18 pm | | Reply

    I agree with Vicki – stick to glucose tablets, not raisins or orange juice. Juice and foods aren’t digested fast enough when you are in a moderate or severe hypoglycemic episode. You can become unconscious waiting for them to work. Not a good idea.

    Put a bottle of glucose tabs on your kitchen counter, and beside your favourite chair where you watch TV, beside your computer, on your beside table, in your purse, and at your desk at work.

    TIP: Mark the lid with indelible marker — print the word SUGAR right across the top, so that even if your sugar goes low enough to make you stupid (and it can), you will understand that THIS is the source of sugar you need to use.

    Read the label and put the number of tablets you need to consume to get 15 carbs, right on the lid, under the word sugar.

    If you are having a hypo your vision may go blurry or you may be unable to think clearly enough to read or remember how many you should take. You may find yourself unable to speak and ask for help. Be prepared.

    If its written in red indelible marker, you will always be able to figure it out when you need to.

    Now if you haven’t done this and orange juice is all you can think of, then grab it, and get it down, but for next time, be prepared and have glucose tabs right where you can’t miss them.

    Don’t forget to wait 15 minutes and retest your blood glucose and see where its at.

    This works for me. I hope it helps someone else.
    EB

  15. EB
    EB February 2, 2007 at 11:23 pm | | Reply

    I had reactive hypoglycemia for over 15 years before I developed type 2, and so did my mom. I really do believe it was a precurser to diabetes in both our cases.

    We both went undiagnosed for a few years too. I wish doctors were better educated about diabetes and knew about the HbA1C test.

    If I’d had this test sooner I could have avoided nerve damage and becoming so ill before finally finding out what was wrong.
    EB

  16. Michelle
    Michelle February 9, 2007 at 7:36 am | | Reply

    ok, now I’m scared. I’ve been having hypo episodes for the past year or more – just in the past year I”ve had my son’s meter to test me so I know what they are. Of course, I have put on a few lbs, sit at my computer with my internet job all day and basically stress and eat my day away. Uggh.

    As for my son and lows – we use strictly glucose tabs because they are consistent. I totally agree with the others who said the same thing. I can’t imagine being alone and trying to treat yourself, it’s scary enough for me to sit with my son while the clock ticks by its requisite 15 minutes hoping that the glucose works. It always does, but it still seems scary.

  17. Jenelle
    Jenelle February 12, 2007 at 11:50 pm | | Reply

    hi there, i just came across this discussion forum and found it very helpful for what I have been suffering from currently. I have always had those shakes and cold sweats after eating pancakes/surup etc in the morning growing up, but never thought anything of it. I have also had horrible migrane headaches. the last few years I have had symptoms of hypoglycemia which have come and gone. Now, @ 25 I am having many problems this last month which now is pointing to diabetes, and this time they aren’t going away. I am currently having some form of protein at a sign of an attack, it this right? If anyone could help me with my symptoms of what I am to do I would greatly appreciate it. Here are my symptoms currently:
    have to eat every 2-3 hrs otherwise I have an low/high blood sugar attack. My first sign of an attack is:
    heart palpitations (heart goes to fast and hard that it vibrates into my throat)
    heart/chest pain
    difficulty breathing
    headache
    dizziness/feeling faint
    cold sweats
    low back pain/kidney pain
    blurred vision
    I get so cold
    Fatigue
    constipation

    I have eliminated all forms of sugars and starches from my diet right now and are strictly sticking to veggies, meat, dairy (mainly proteins)Is this what I should be doing?
    Lately I have been having alot of attacks (1 every 1-2 days).
    I haven’t seen a doctor yet only because I have been doing alot of natural remedies by a herbalist and didn’t know if I am just going to a run around from the doctors (and I have no insurance)
    Thanks in advance for taking the time to read this and give any help.

  18. Rochelle
    Rochelle March 3, 2007 at 4:33 am | | Reply

    I didn’t know what I had until hours of research on the internet. I have been having symptoms for years and everytime I would have a blood test done, it was normal. I must have adjusted naturally to a degree, because I have always eaten something every 3-4 hours.
    I went to my doctor last year because I thought I was allergic to chocolate or some kind of sugary food. He gave me a blood test for allergy to chocolate and it came out fine. He has been NO help. I get up in the middle of the night, the tip of my tongue, fingers, toes and lips tingle and I get shakey and feel very nervous or anxious. I can’t think straight and I feel hungry. I knew it was something I ate, but couldn’t put my finger on it. No doctor I have seen so far has been helpful. My physician keeps putting me off, I
    even asked my gyno and went to a food allergist. AHHHH!! I didn’t know about hypoglycemia until I
    talked to someone at work, she said I might have low blood sugar (which I tested fine for). I researched for HOURS on the internet and finally see what I might have, but NO one to confirm it. I am trying to modify my eating and now have seen my symptoms reduced. I just experimented with taking some chromium after I eat a bit of ice cream. I really need guidance from a professional though. Any advice?

  19. Kelly
    Kelly March 4, 2007 at 9:17 pm | | Reply

    Lili, You need to get a 504 plan or IEP plan with the school. Tell them it is dangerous for him to walk to the nurses office with a low. I made my son’s school agree to never let him walk there when not feeling well.

  20. Kelly
    Kelly March 4, 2007 at 9:18 pm | | Reply

    I mean Maureen…

  21. Mercedes
    Mercedes April 5, 2007 at 3:10 am | | Reply

    I’m reading all your comments and I have a few questins. I had 3/4′s of my stomach taken out 22 years ago and although over the last years I’ve had a few lows in my sugar levels it was only recently I started fainting. Now they’ve told me I’ve got reactive hypoglycemia. I’m meant to eat every hour and a half. To be honest I’m not too sure what to eat…I’ve been told no fruit, no sweets and CArbohydrates with a low GI and proteins low in fat, so as not to put on weight (which I already have). DOes anyone know if this means that I’ll probably end up diabetic? I hadn’t even thought of it until I read some of your posts.
    I’d appreciate any advice, as I’m finding it a little difficult to keep well. I cry easily and have mild panic attacks quite often…and I’m tired and haveheadaches almost constantly. I haven’t stopped working or going to yoga but I don’t go out half as much.
    Thanks to you all and take care

  22. Shaun
    Shaun April 6, 2007 at 2:56 pm | | Reply

    My diagnosis was actually easy if it can ever be. My uncle had diabetes before he passed away and my mom lived with him for 10 years as a child, so she knew all the signs to look for. One day we went to our local pharmacy to have my blood sugar checked, and it was at 24 mmol/l (I dunno what that is in mg/dl, don’t know the conversion :P ) which is very high, knowing that a diabetics sugar must be kept in the range of 5.5 to 10 to be in good health.

    Luckily all the doctors I saw were trained to a certain degree in care for diabetes, the main things they hounded me with was the complications of not looking after yourself, and how you should keep your levels in the acceptable range. This all happened when I was 14, and the doctors said because of puberty and hormonal changes, an average of about 13mmol/l is good during those stages, but I should get it down to normal levels as I reach 18 or so.

    During my puberty years, I had a lot of highs and lows, and discovered many ways to react and control my sugars, these worked for me, and as it has been said all over this site, everyone is unique and they may not work for you.

    When my sugars are high, I was told by a specialist that it can be very dangerous to exercise, which is the logical thing to do when you have a high. But that I should rather drink liters of water. Which actually does help a lot. If my sugars are at 24 for example, drinking 2 liters of water will bring it down to about 18, depending on what took it up so high, if the food hasn’t been absorbed fully yet, then it will just stop my sugars from going higher, and they will stay in that range unless I drink more water. So I have avoided many dangerous highs just by drinking a lot of water, water always helps to bring down my sugars, even when they are in ranges like 12mmol/l. So water has become a vital part in my sugar management, I drink about 500ml of water after every meal, just to help out, since the slightest change in my insulin at the moment has some drastic effects for some reason.

    Then for my lows, I usually feel them come on before anything goes wrong. I catch them at about 3.5mmol/l. Sometimes higher, sometimes lower, it depends on how fast my sugars are dropping. If they drop slowly, then I would take a lot longer to feel something is wrong, and catch it at about 3mmol/l, if it is dropping fast, I can catch it at about 4mmol/l. I always have a tube of glucose syrup in my pocket, and one of these tubes delivers 15g of fast absorbing glucose, which helps me out in a matter of seconds. One tube has always been enough for me, but sometimes I feel the need to take a second tube, only to find that my shakes are happening while my BS is on the rise, like a late reaction to my low. Weird. And that 15 minute checking rule is not set in stone, your BS moves a lot in those 15 minutes. I check like 3 minutes after having a glucose tube, and see what is happening. If all is ok, I will check again about 5 – 10 minutes later, then if it is still fine, then I leave it alone. I then check an hour after having the glucose to see if I have to drink a lot of water to stop my BS from rising too much.

    When you fear you have diabetes, go to a pharmacy and have your sugars checked. Go to that same pharmacy 3 times in one day, spreading the checks evenly across the day, if you have diabetes, you will find out. If you want to make absolutely sure, go and check your sugars in the morning before you eat breakfast, this is your fasting result and should be below 5.5mmol/l. Have your breakfast and then check 2 hours after that, which would be your post meal result and should be less than 7.5mmol/l. These figures are all from a table I have in the Australian aviation medical examiners handbook used when giving out aviation medicals. Different glucose values at different times after and before a meal will let you know if you have frank diabetes, or simply insulin resistance that can be treated with diet and exercise alone.

  23. christian louboutin
    christian louboutin October 12, 2009 at 3:44 am | | Reply

    Anyway, over the years I could definitely feel it getting worse. I can catch it at about 4mmol/l. I always have a tube of glucose syrup in my pocket, and one of these tubes delivers 15g of fast absorbing glucose, which helps me out in a matter of seconds. we use strictly glucose tabs because they are consistent. I totally agree with the others who said the same thing

  24. GL
    GL October 21, 2009 at 8:09 pm | | Reply

    I agree with Vicki – stick to glucose tablets, not raisins or orange juice. Juice and foods aren?t digested fast enough when you are in a moderate or severe hypoglycemic episode. You can become unconscious waiting for them to work. Not a good idea.

  25. RG
    RG October 21, 2009 at 8:10 pm | | Reply

    Then for my lows, I usually feel them come on before anything goes wrong. I catch them at about 3.5mmol/l. Sometimes higher, sometimes lower, it depends on how fast my sugars are dropping. If they drop slowly, then I would take a lot longer to feel something is wrong, and catch it at about 3mmol/l, if it is dropping fast, I can catch it at about 4mmol/l. I always have a tube of glucose syrup in my pocket, and one of these tubes delivers 15g of fast absorbing glucose, which helps me out in a matter of seconds. One tube has always been enough for me, but sometimes I feel the need to take a second tube, only to find that my shakes are happening while my BS is on the rise, like a late reaction to my low. Weird. And that 15 minute checking rule is not set in stone, your BS moves a lot in those 15 minutes. I check like 3 minutes after having a glucose tube, and see what is happening. If all is ok, I will check again about 5 – 10 minutes later, then if it is still fine, then I leave it alone. I then check an hour after having the glucose to see if I have to drink a lot of water to stop my BS from rising too much.

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