What is going on?

Hey everyone, I apologize I am new on this, and trying to figure out how everything works. I have reactive hypoglycemia. I had really bad numbers about a year and a half ago. So bad I had panic attacks over each one. Going from 125 to 27 in about an hour after eating. Henceforth, reactive. In any case my numbers are kinda funny. They do not drop that low anymore. However on this Metformin my numbers barely go up after eating a good 50-60 carb meal. For example, I might be at 88 before I eat, 30 minutes later at 90, and hour later at 88. What in the world is going on? anyone ever heard of this?

Sounds like your pancreas, with the help of the metformin, is working very well. Reactive hypoglycemia tends to be driven by pancreatic overcorrections to post-prandial spikes (even small ones), so maybe the metformin is keeping you from rising after eating, thus keeping you from falling as well.

Sounds like you know your stuff, and thank you for the reply. A normal
person after eating seems to go up about 20 or 30 points, which it does
that to me in the morning, but at dinner it shows odd numbers. However,
when it starts dropping in the 70 80 range I get real nervous

It sounds like it might not be dropping so much as not rising though—80-90 if you’re flat is perfect. You prob want to get pre-meal, and do 1 and 2 hour post meal—if it’s all 80-90s, you’re doing very well! Also, keep in mind, home glucose meters are simply not that accurate—a reading of 85 could in theory be anything from a 73 to a 97. If you feel ok (no hypo symptoms) and your trend seems to be flat, I wouldn’t worry about it, but also check in with your doctor if you’re concerned.

Thank you. Would you be willing to peruse my numbers.

What’s going on is… do you want to trade your pancreas for mine? :slight_smile: I’d love to have a flatlined BG after eating a 60g carb meal haha! I’d be lucky for that not to raise my BG by over 120 mg/dL.

Generally speaking, 70-90 mg/dL is “normal” blood glucose for most non-diabetics. If you are eating significant carbs and not having even a small spike above that range, it means your pancreas is very well attuned to your carm metabolism. And long may that last! Metformin is awfully useful for many different situations, but this is the first I’ve heard of it being used for reactive hypoglycemia (the usual “prescription” for that is reducing carbohydrate consumption). I second Carda’s suggestion of doing some comprehensive finger sticking, using the “bracketing” technique: pre meals, 1.25 hour postprandial (the timing of the natural high point of the “spike” for most people), and 2 hours postprandial. That’ll give you an idea of how your body is really responding.

I don’t have reactive hypoglycemia, but the “normal BG curve” I aim for is 1.25 hour postprandial no higher than 126 mg/dL, 2 hour postprandial back to pre-meal BG. Doesn’t always happen, but that’s my goal.

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Hello David,

Thanks for the reply. I believe in my case my pancreas was was releasing
too much insulin perhaps by a misfire or what not. Literally, I would go
from 125 to 27 in an hour. End up at the hospital, etc. My endo was
surprised I had not passed out yet or had a seizure. Although, I don’t know
your story, I might trade you lol. They did put me on a low carb diet, and
I got really sick. So they started Metformin.

My Endo informed me that reactive hypoglycemia is one of the hardest things
to control. Those flatline numbers are pretty rare for me. Mostly I go way
up and then crash. Been trying to control this for 3 years now with
Metformin, exercise, and diet.

The problem seems to be that my pancreas just won’t quit producing insulin. Therefore, continuing to drop my sugar. I just wonder why my liver is not kicking in?

I don’t understand—if all that’s happening is you’re in the 80s following a meal with no further hypoglycemia, that’s not a problem, that’s success. It doesn’t seem like there currently is any problem from what you’re posting. Seems like the metformin is treating your problem, which is probably caused by insulin resistance and then your pancreas overcompensating for that.


Your results after eating are totally normal! A person without diabetes will basically have their blood sugar tightly controlled within a very narrow range (something like 70 - 90).

Seems the metformin is working well for you. Metformin is an insulin sensitizer (ie. it makes your own insulin work better in your body).

To help combat hypoglycemia, eating a lower carb diet may also be helpful, and particularly avoiding any rapid acting sugars.

This is because when one eats high carb one needs more insulin. If your body secretes too much insulin (which can happen in early diabetes / metabolic issues), then you run the risk of your pancreas overshooting your insulin requirements, and then you going low later.

hope this helps

@Reactive_Hypo - have you had a full liver workup?

That 80-90 after eating that was posted is rare as I stated to David.
However, If I let it go for about 2 hours it will continue to drop, until I
drink or eat something. Henceforth, the problem. My pancreas seems to still
produce insulin after digestion. Thus, reactive hypoglycemia. Furthermore,
why my liver is not compensating for the drop is not understandable to me.

The problem is I did not divulge the whole story. I was questioning a set
of numbers that did not rise after eating. That was my main question that
started this post.

Thank you for your kind, and intelligent response. I do believe my pancreas is overshooting. I am trying to work on diet, exercise, and taking metformin. It seems that my pancreas still keeps going even after digestion.

Hey Tim,

I sure have not. Is this something I should consider?

I would. The Pancreas and the Liver work together to stabilize blood sugars. Either one (or both) not working properly can cause problems.
Really no downside to having your liver checked out and potentially it could provide some insight to what you have going on.

Thanks Tim, I will definitely check it out.