At first my doctor thought I might have LADA, then it changed to possible pre-diabetes for Type 2 and then to reactive hypoglycemia. So (thanks to suggestions on this site), I am not worrying about a specific Dx and instead focusing on what to do to feel better. My biggest issue at the moment is a lot of blood sugars in the 60-80 range. I know this is not terribly low but it still makes me feel really crappy, and if I do not eat every 2 hours, I go lower (45-60).
I have been working with a dietitian who has me eating small meals every 2 hours that contain around 30g carbs (low glycemic with lots of protein and some fats). I am eating at 6am, 8am, 10am, 12 noon, 2pm, 4pm and 6pm. My fasting BG is around 75-90 and my post-prandial (at 2 hours) is around 75-95. Trying to eat this frequently is not easy and if I get busy and forget/skip one of these meals my blood sugar will go down into the 50-60 range.
I’d love advice from anyone who has similar issues, especially what foods are helping you keep your blood sugars more stable.
Just a little advice from a low carb T1…protein and fat for me levels my BG - I have fuel for 4-6 hours instead of the 2 hour ride you have described. Couple of good books for you - think like a pancreas and the diabetic solution.
It really sounds like you have Hypoglycemia–the disease, not the temporary diabetic condition. I’m a Type 1, but I do best when I eat every 2 to 2 1/2 hours. Once I reach a certain point, my BG will start to go down if I haven’t eaten in the requisite time. If I wait too long, I can only treat my low and wait for it to come up before I do something about eating.
But the most important thing is don’t worry about the label. Work the problem, whatever it is. You can call me a yack-licking grabilazten as long as I get my insulin and a delivery method that is not leech-based.
Thanks! How much protein do you eat at a typical meal? I’ve been having 2-3 slices of turkey bacon and an egg at breakfast (along with a little steel cut oats and blueberries). I really don’t know that I can cut out the carbs at breakfast completely as I already feel like I am getting low when I wake up and if I don’t eat any carbs, I feel awful. I also really struggle on mornings when I work out - my typical breakfast is just not enough to sustain me and I have to treat a low after about 30 mins of medium intensity exercise.
I still have three major meals, but I add a few snacks. I’ve found a good amount of protein is 8-10g. But, something I have noticed lately is that it’s not just some protein, some fat, some carbs–but a balance. One of my regular snacks (I kid you not) are those Balance Bars. Nothing works as well to give me an extended source of energy. There are bars that have more protein (and invariably more carbs), but they strike the right balance for me.
I’m not shilling for Balance Bars, but the important lesson you can learn from those of us with T1 is that we experiment (on ourselves, who else?) until we find something that works. What I do may not help YOU, but it may help someone else. When it comes to advice, always weigh it yourself and use it if it works. We are not all the same. The saying is YDMV: Your Diabetes May Vary. It always does, in some way. So, this gives us all an out to take advice or not. Your Whatever May Vary.
That’s why I say work the problem: you are the expert on what is working for you. Ask for input from your Doctor and his colleagues. They may have info to help you, and your engagement will often jar loose something for them that may lead you to a better treatment. My doctors know I am serious about taking care of myself. That attitude will instill your medical team with confidence and they are often so happy that someone actually cares that they will go out of their way to help you!
I won’t take you upon that offer. Yack-Licking Grabilaztens of America are known to be highly litigious. The ACLU has won several judgements on their behalf.
Fortunately, @Timbeak48 is of the Yack-licking variety of grabilazten, so he’s completely harmless. Generally speaking, as long as you’re not a yack that doesn’t appreciate PDA.
Gee I despise turkey - I’d go with a couple real slices of good slab bacon and mix in a TBLS of some kind of nut butter in the oatmeal - the fat will fill you up and carry you most of the morning.
There are many of us with Type 1 diabetes who look back many years before diagnosis and have memories of what we now know is hypoglycemia. Trialnet studies show that most people with Type 1 have measurable antibodies for many years before diagnosis and I wonder if some of that dysfunction is manifested in low BG’s. I was diagnosed at Age 24 but have memories of late afternoon shakiness, sweating, and hunger throughout high school.
There is probably some truth to what you’re suggesting. We diabetics tend to focus on dysfunctional beta cells and our lack of insulin (or problems using it efficiently). However, in many of the scientific papers on diabetes of all types, there are persistent discussions of dysfunctional metabolic systems in general. This means that for a certain number of diabetics, their “recovery” systems are also broken: i.e., alpha cells don’t produce enough glucagon.
If you search for “alpha cell dysfunction” diabetes on scholar.google.com, you get a number of papers from many years of research. Alpha cell dysfunction (which affects glucagon production) is affected in animal models, humans with both Type 1 and 2 diabetes, and particularly in those with MIDD or MODY. The following is from an abstract found there (direct link is at end):
To examine the role of catecholamines in glucopenia-induced glucagon secretion, urinary epinephrine and norepinephrine and plasma immunoreactive glucagon (IRG) were measured during insulin-induced hypoglycemia in normal and insulin-dependent diabetic man. Despite equivalent levels of hypoglycemia the mean plasma IRG increment in diabetics was only 15% of normals. - See more at: http://press.endocrine.org/doi/abs/10.1210/jcem-44-3-459#sthash.rpDULJNd.dpuf
The paper is from the 70s, and no distinction is made between Type 2s and 1s in the paper. The distinction is made between insulin-dependent diabetic and “normal.” But having only 15% of available glucagon during a hypoglycemic event seems pretty clearly an issue with the system our body uses to boost BG levels when needed.
So, really, it’s pretty simple: we diabetics (of all types) have not only compromised insulin-amylin systems for curbing high BG, many of us also have compromised glucagon systems for combating hypoglycemia. Diabetes is often a dysfunction of the entire BG-regulating system, including all functions of the pancreas and liver. We just focus so much on insulin and high BGs (and using carbs to treat low BG) that we don’t think about why we have to treat low BG and normal people don’t.
I have had that for years as well, but no antibodies, no type 2 (yet). I suspect it may be reactive hypoglycemia, but I’m guessing that some people get it separate from diabetes, or maybe it’s a sign that my beta cells are just a little bit wonky and mal-coordinated, I don’t know.
I know my friend’s mom had some sort of condition she called hypoglycemia which basically meant she could never eat simple carb or any of the delicious desserts she was always cooking for others. She never developed diabetes as far as I know.
What’s not clear from the poster’s message is whether he has any kind of documented highs. If all he is getting is low with no elevated BGs, then that doesn’t sound very diabetic to me…
I saw an interesting talk by a guy on Diabetes In Control, his company is Diasome. Anyways, they’re creating liver-targeting vesicles to help ferry more insulin directly to the liver before it reaches peripheral tissue, because apparently 80 percent of insulin is processed by the liver before it gets to any other tissue. Interestingly, he said that at least in dogs, this protocol completely eliminated hypoglycemia in dogs who were pancreatectomized. The liver is the primary organ responsible for storing and releasing glucose, so I suspect that sometimes hypoglycemia (especially amongst the T1Ds) is not necessarily a sign of a deficient glucagon response (though it’s that as well, as alpha cells use insulin levels as the proxy for BG levels), but also related to the liver not getting the proper signals from insulin to store and release sugar. Therefore it’s also possible that some hypoglycemia could originate in liver dysfunction somehow.
It’s complicated and IMO people just haven’t done enough research into this area.
I agree entirely. I don’t think it’s a simple matter of alpha and beta cells, I suspect there are probably combinations of various dysfunctions that lead to the famous phrase, “Your Diabetes May Vary.”
I do wonder at someone like myself, though… I get highs (obviously, being a diabetic) because I don’t produce enough insulin. I get persistent lows because my body produces just enough insulin to occasionally be problematic but doesn’t seem to be able to pull itself out of a hole (is that because the liver isn’t responding, because alpha cells are producing glucagon, who knows?). Fortunately, I’m able to currently manage things through a balancing act, but it is interesting. I wish there were (available and affordable) tests for glucagon and other hormones like there are for insulin!
I’m type 1 and also had hypoglycemia years before diagnosis. No advice on what to do except eat more- small meals of fat/ protein/ carbs. That’s what I did.
For me specifically- I had and have a reaction to gluten and other grains. I went to doctors for YEARS with 0 help and advice other than you have IBS (not really a diagnosis) & GERD. I’ve tried many diets but none helped. With my
more recent severe digestive issues I eliminated gluten totally avoiding cross contamination and it seems to be helping. I wish someone had told me to do this years ago because I believe I would’nt have type 1 if I had.
