Hypoglycemia

I have been running in the 200’s for awhile and now I am suddenly having low bg. I am not on any meds at this point because the endo feels that I don’t need it yet. I am eating low carb and walk 3 miles a day. I was 52 the other day and my vision got blurry and I felt weak. what gives? Is it from going low carb? I think low feels a lot worse than high! what can I do to avoid the lows? Thanks!

Odd that your endo doesn’t think anything is needed with numbers in the 200s. Wonder how high he think you should be before prescribing meds.

Lows feel worse than highs when you’ve had high BG for a while. Normal can also feel weird & like a low until our bodies adjust to more normal ranges.

How many carbs are you eating daily? Eating lower carb & exercising has probably given your pancreas a needed rest from churning out a lot of insulin, which is good. Great work there! With diabetes, glucagon response from the liver is also usually impaired. Our bodies don’t compensate for lows.

There was a discussion about chronic hypoglycemia before diagnosis. Quite a few replied they had low blood sugar for years before diabetes. This was my situation since I was a kid. No doctor told me to be concerned about this or that it was a forewarning of things to come decades later.

If you’re consistently going low at certain times of the day, try getting a few more carbs at that meal. Or, if lows happen from walking miles, eat a protein snack before or during.

Important to correct lows the right way by knowing how many grams of pure glucose raise BG how many points. Easy to over correct lows & go high. Test this by taking 1 gram of glucose & testing 15-30 minutes after. It can take up to an hour to know the full effect. Things with one gram of sugar include one jelly bean, some hard candies, Skittles, gummy candies. Let the candy slowly dissolve in your mouth.

The endo says I have one of the types of MODY and that since my fasting numbers are ok and still produce my own insulin that medicine is not needed at this point. To be honest with you I am glad about that because now that I am having these lows being on meds would scare me. I have been reading up on this MODY and there is not a lot of info about it. I will be doing the genetic testing to find out the specific (sp) type.

first, i think you need a 2nd opinion from another Endo. 200 is unacceptable. above 140 is where nerve damage starts. I am trying to keep my peaks below 140, it’s tough. Try eating walnuts as a snack. keep some jelly beans handy for the lows.

When are you going low? Is it without food or after you eat? If after you eat - at what point do you go low?
What are your triglycerides and rest of lipids? What are your insulin levels when you eat and fasting? Etc, etc, etc. These are all things your endo should be looking at closely. Only a good doctor can answer that for you / help you based upon your specific case.
I also don’t understand why your endo said no meds. My FBS is normal (mid 80 to 90) and my endo wanted me on meds (I have a diabetic glucose tolerance without IR). In my case I tried a little metformin then got off of it - started to bounce again then against the endo’s wishes the GP put me on Levemir (I only take 3 to 5 units total a day - during the day - once in am and then again in the pm about 1 hour before dinner).
Before I started the Levemir - I could go low (mid 50’s but more like mid 60’s to 70’s after eating or at times fasting) or high but not generally in the 200’s unless I eat something like a couple of cookies.
For my case, the very small amount of Levemir has had a leveling effect. I’ve been more normal but I do have to stick to a regular eating schedule - small meals often works best.
I have no clue if this would work for you and I’m only giving information. I was the first person my GP tried this on - ever. The endo thought it would cause more lows. I’ve been doing this for 50 some days now and so far it’s been working. But that’s not to say it won’t work in the future.

I am going to 2nd Will’s suggestion that you need to get a second opinion. Running constantly in the 200s is not acceptable and is damaging your body. There are more studies out there showing that it is better to start people on medicine early. I really would get a second opinion.

I don’t stay in the 200’s all the time it is just after eating that i spike that high and than in a few hours it comes back down on its own.

I’m With Alan, BG of 200 is way to high, even for spiking. read this link, i found it helpful
http://www.phlaunt.com/diabetes/14046702.php
I would suggest eating more often, but smaller portions. 5-6 meals a day, or 3 meals and 2-3 “snacks” but that is more of something oyu need to talk with a dietician and your Endo about, but seriously, consider a 2nd opinion. Remember 1/2 of all doctors graduate in the bottom half of the class. Diabetes managment is about having your BG fairly steady, spikes are bad!

a lot of people, doctors and lay persons alike, think that people with diabetes did something to deserve it, that we all have candy fetishes or can’t control ourselves. My mother was diagnosed about a week ago, my father 6 years ago, and i was 2 months ago. 3 of my grandparents have/had diabetes. Sometimes, it’s just in your genes. Maybe your doctor needs a new career?

Im a type 2 and I suffered from some nasty lows at night. I had to lower my meds because the lows were killing me taking 500mg of metformin a day. I excercised right after dinner so I could go from 200 down to 70 in 20 minutes while working out. I adjusted what I ate so that I would not peak out at 200 and i dont take the night time metformin. I like to be very active towards the end of the day and I eat a small snack with some protein at night.

I am still waking up around 120 but I did some tests and I would be at 90 at 5 am but then I would be at 120 at 7:30

People without diabetes don’t spike. So your insulin production is high and low, unpredictable, it sounds like. Spiking in the 200s normally requires medication.
Your lows can be due to low carb dieting and the exercise you’re doing. But the spikes need treatment. Keep real good track and take your record to the doctor, or a second one.

As the others have stated 200’s is not normal, even if it does come down. These highs are also unnecessarily stressing & helping burn out your beta cells.

are you on Metform XR or IR, if oyu are on IR (immeadiate release, it might be burning off fron heavey, whereas the XR (extended release) should give you a flatter bg burn. sounds like your liver is reacting too, making sugar. Good luck.

I think your lows might be related to your highs. They were for me. I had impaired first phase insulin release long before I saw any increase in my fasting numbers. (I have LADA). I would go up to 200 after eating and then come down pretty hard because the second phase would kick in and I’d get an extra large release of insulin because my numbers were high. I also went low with exercise. I agree with the person who said that a small amount of insulin will smooth out your numbers. Basal probably will not do it alone if the spike is causing the low, then you would need to deal with that by taking a fast acting insulin such as Novolog. Jenny has MODY and is a fount of information. Check out her blog at Diabetes http://diabetesupdate.blogspot.com/