Friend - 25, symptoms but shaky too

My daughter called me today with a friend’s story: She’s 25, normal weight, is tired, incredibly thirsty and peeing a lot. Ok that’s a no brainer - get tested.

What has me confused is that she often feels very shaky and says she has some jelly beans and within 10 minutes to half an hour that goes away. I can understand it if what she has is Type 2, but she’s young, fit and normal weight. She does have Type 1 in her family.

So, yes, she will be tested in the next few days, but… if it’s at all possible that it’s early Type 1, no DKA yet… I’ve seen one symptom is being shaky. Anyone understand why?

And, why do the jelly beans help if one assumes a lack of insulin? Or is there just enough insulin left to make a difference?

I did not ask if the friend had vision problems or is losing weight. And yes, she’ll get tested, but I would like to understand why she has these shaky symptoms and why it goes away with jelly beans. Is this possible if it’s T1?

I’m just guessing here, but it sounds like your friend is having a low and aren’t both highs and lows a part of Type 1? Or LADA/Type 1? I would think if, for example, she hadn’t eaten for awhile her blood sugar might drop. Or even that (if she is LADA) her pancreas kicked in and produced some significant insulin to counteract highs. LADA’s often have significant insulin production remaining at diagnosis.But the jelly beans would help her low if she had insulin production or not.

Hi Zoe! Thanks for your response. You and I have LADA on the brain! LOL

It doesn’t make sense that her blood sugar would drop that much. Why would she go low? Yes, maybe in T2 with overproduction of insulin producing hunger, but surely not T1. Even in LADA, one shouldn’t be seeing an over-production of insulin unless there’s insulin resistance as well. I did ask if it’s possible she has PCOS, but my daughter asked and the girl said no. She’s also has 2 kids.

Ok maybe the whole process is impaired, but I want to understand the science of it. Can one be high, but still hungry and shaky in T1?

I would suggest she go to someplace like WallyWorld and get a cheap meter to test until she can get to a doctor.

If she is getting some kicks from insulin, it is possible that the shakes are not necessarily from a low like we consider a low, but just being lower than what she has become used to. If I get sick for a week and am running higher than normal, once my BS goes back to what I was used to before being sick, I feel low for a few days.

I know being hypoglycemic is a pre-cursor to becoming diabetic, but I don’t that the running to the bathroom and drinking all the time would be related to that.

Perhaps reactive hypoglycemia. In this scenario she spikes, in response to a carby meal, but her insulin response lags. When her insulin response finally kicks in it over reacts because she is so high at that point, she then produces too much insulin and she goes low. I believe reactive hypoglycemia can have nothing to do with diabetes but then again it can.

This was my thought. That the lows aren’t lows, but just her blood sugar dropping to a more normal level temporarily (maybe when she’s fasting), that feels low to her because she’s running high all the time.

I know if I run high for even 1-2 days non-stop, a normal blood sugar will often make me feel low even though it’s nowhere near it.

Hi Kelly WPA, thanks for the response. Yes, I also suggested a meter, but we’re in Australia, and they’re not cheap, plus if you don’t have a diabetes card, the strips are really expensive. I have a spare meter which I will offer, or they can come here and I’ll test, but with kids and work - she can’t get to a blood test until next week, so I doubt she can get here.

It’s actually sad in a way but also wonderful that my non-D daughter recognised the symptoms and called me.

Yes, true if she’s used to being high and some insulin kicks in (odd when she hasn’t eaten) she’ll feel low and shaky.

It’s the reverse for me, I feel high when I’m in the upper end of normal range these days. Years ago, when I was still misdiagnosed, should have been on insulin, and was running really high, trying to kill it with stupid tablets, I used to feel really hypo at the mid and lower end of normal. But that was the tablets. I never was or felt low when I wasn’t taking them.

I’m trying to figure out why insulin would suddenly kick in when she hasn’t eaten - at least that’s what I got from the conversation. I think it’s after the jelly beans she gets the usual symptoms of being high.

I’m really hoping it’s just a strange bladder infection or something unrelated to diabetes.

I kinda think that too.

I guess we are lucky that we can get cheap meters - I know that has saved a bunch of people so they can test before getting to a doctor.

Yes, it is wonderful that your daughter recognized the symptoms - lucky for her friend also that she has someone that recognized the problem!

I don’t know why insulin would kick in either when she isn’t eating, but I worked with someone that was hypoglycemic and she had to eat a bunch of small meals.

My first thought too was reactive hypoglycemia, but her other symptoms sound diabetic.

But I do think the insulin could kick in in response to the highs and send her low.

It does make more sense that her lows were more perceived lows in comparison to running very high than actual lows. It will be interesting to hear what she finds out.

I was having low like symptoms in the few months before my real diabetes symptoms set in, when I was 22 and normal weight. I was working at a library and I used to keep fruit snacks in my pocket because I would suddenly get these panic-y feelings like low blood sugar. A few months after that, I got a desk job and started noticing the drinking and the eating of massive amounts of food but not gaining any weight and the peeing 2-3x a night. I think it was pancreatic death throes.

“Pancreatic death throes” - love it. Yes perhaps that’s what it is happening, although I hope not. Thanks for the input guys. It might be a week or so before we find out, and in the meantime I might get to ask some questions. I’ll update when I can.

Something I was wondering is whether there’s thyroid involved somehow, especially with the shaky stuff. Is an overactive thyroid associated with D? Or do the beta cells and thyroid go a little nuts before they clap out completely?

I had the same symptoms as Jackie described in the weeks leading up to my diagnosis. The reason that this happens is because your body has been in high BG for such a long time that it starts considering this as normal and when BG drops below that new normal level the body sees that it is much lower than it’s new normal BG and sends out the hormones to tell you that you need sugar (extreme hunger, weakness, shaky hands, etc). It is similar to people feeling lows and highs less severly if they are constantly in that range, you body starts seeing these new conditions as normal and no longer sends out the warning signs to alert you that something is wrong.

I wanted to clarify…

Apparently the low symptoms happen when she hasn’t eaten for a while, so she has some jelly beans and an hour later she’s ok, but then starts with the high symptoms. So without the high symptoms, hypoglycaema makes sense.

The typical weariness, peeing and thirst doesn’t go with hypoglycaemia.

Apparently she’s slightly underweight, so my daughter can’t tell if she’s lost weight recently. Another thing is that she’s complaining of being unable to concentrate and that she feels “weird”. She says, you just know something’s up because I feel so different.

She went for her blood test today, but won’t get results until next week.

I’m still wondering if there are thyroid issues in the mix as well as D.

For the moment, I’ve suggested grazing with lots of little meals and easy on the carbs, with very complex carbs rather than sugary simple carbs. If nothing else, before she gets results, that should even things out a little. What do you think?

Not sure about overactive but i know it is very common for underactive (hashimotos) to trend with T1. Both are autoimmune

I was diagnosed with an overactive thyroid (graves disease) and type I diabetes at the same time. For me, the overactive thyroid made my sugars run high. I took PTU treatments for two yrs before I could get my thyroid back into the normal range. Currently, I’m on NO medicines for my thyroid.

Thanks for that Sportster! This was part of my query, whether an overactive thyroid is possible.

Interesting that now you don’t need meds.

I had anti thyroid antibodies 20 years ago, but my thyroid function tests keep coming back normal, although I’d swear they should be off (underactive) because that’s exactly how I feel and the symptoms I have.

I have an underactive thyroid (hashimotos) diagnosed within a year of my diabetes. What are they checking about your thyroid?

TSH, T4, Free T4, T3, Free T3 apparently some can show normal while others are off and drs do not always check all of them.

Just recently checked Free T3 & Free T4, and TSH. All normal. I’m told that T3 & T4 are no longer tested routinely. Total T3 & Total T4 was not in the results, which I have here. My endo ordered the test.

Susi, it’s been a long time since I’ve read up about thyroids but, if I remember correctly, it’s common for Type I’s to have overactive thyroids.

Some of the side affects that I remember are…very fast beating heart (my Endo said I was lucky I saw him when I did because I was fixing to have a heart attack), actually everything in your body works faster than it needs to, shaky hands, diarrhea, sweats even in cold weather. These are some of the things I remember. Hope it helps.