Hypo rebounds

[bennyg70]

How long can it take you to rebound from a hypo? & What sort of level can you rise by from a hypo.

Yesterday I went low at about 3.30 / 4pm & corrected retested and was at 5.4 before dinner which was fairly healthy and low in fat. Ie I had a peice of breaded chicken (Wasnt too high in fat) a couple of new potatoes, carrots, brocoli, beans, couli and roasted peppers.

I ate at around 5pm & 2.5 hours later I tested @ 7.7 which I thought was great.

At the time I was at welding class, wasnt really stressed about it or anything, was very happy as I passed a test peice though and was doing some serious concentrating.

I got home about 9 but felt like my bloods were a little high so tested and they were 12.

The only explanation to me is that it was a delayed rebound? Can this happen to anyone else, ie 4 - 5 hours later, and a rise of 6mmol/l?

Cheers

 

[Phil65]

How long can it take you to rebound from a hypo? & What sort of level can you rise by from a hypo.

Yesterday I went low at about 3.30 / 4pm & corrected retested and was at 5.4 before dinner which was fairly healthy and low in fat. Ie I had a peice of breaded chicken (Wasnt too high in fat) a couple of new potatoes, carrots, brocoli, beans, couli and roasted peppers.

I ate at around 5pm & 2.5 hours later I tested @ 7.7 which I thought was great.

At the time I was at welding class, wasnt really stressed about it or anything, was very happy as I passed a test peice though and was doing some serious concentrating.

I got home about 9 but felt like my bloods were a little high so tested and they were 12.

The only explanation to me is that it was a delayed rebound? Can this happen to anyone else, ie 4 - 5 hours later, and a rise of 6mmol/l?

Cheers

This is an interesting one Benny, my HCPs always thought my morning highs whilst on MDI were always nighttime hypo rebounds. I was led to believe the same......I'm now less convinced. I never have a rebound during the day, there is always another reason, over correction, wrong type of hypo cure, stress etc,etc. You may argue that the day hypo is treated quickly and a nighttime hypo may be slept through.....and the liver dumps....jury is still out for me!

 

[lauraw1983]

Never had a delayed rebound....but after a hypo you are more likely to have another hypo too because your liver will claw back it's glycogen store at some point! Could you have had another (milder) one that you maybe never felt as you were so busy at your class and THAT has caused the liver to pump out some glucose?

how low did you go at 3.30?

Or maybe the excitement of passing your test caused the high - not unknown!!

 

[newbs]

I have rebounds after hypos (generally if in the 2's) but these tend to occur 2-3 hours after the hypo.

 

[everydayupsanddowns]

There was a very interesting (and quite heated) thread here recently where people who have access to CGMs who used to believe they got hypo rebounds quite regularly have entirely failed to see any evidence of them when they have the CGM data to look at.

This confuses me because I believe I have seen the phenomenon in myself (and even like you Benny, hours later)... But never having had the benefit of CGM data, I am now slightly unsure.

I'm pretty sure my liver does dump annoying amounts of glucose into my system every now and then, but I am no longer sure that a dip to 3.6 (or whatever) would be crisis enough to trigger it - if hypos can even cause dumps at all. As Phil says, the jury seems to be out on this one!

 

[lauraw1983]

I'm pretty sure my liver does dump annoying amounts of glucose into my system every now and then, but I am no longer sure that a dip to 3.6 (or whatever) would be crisis enough to trigger it - if hypos can even cause dumps at all. As Phil says, the jury seems to be out on this one!

Surely it's the glucagon response though? Or am I totally wrong?

 

[everydayupsanddowns]

Surely it's the glucagon response though? Or am I totally wrong?

No I think that's right. Glucagon (which then converts to glycogen... or is it the otehr way around...?) stored in liver and muscles can be released to fuel the body in the absence of food - eg during intense exercise.

I am just not entirely sure what bearing hypos have in this? People on CGM just don't seem to see the hypo-rebound happening in real time - at any time of day.

Having said that all the basal testing stuff still says don't run a basal test after a hypo, because the vaguaries of liverdump/glucagon release might mess things up.

 

[Northerner]

No I think that's right. Glucagon (which then converts to glycogen... or is it the otehr way around...?) stored in liver and muscles can be released to fuel the body in the absence of food - eg during intense exercise...

Just to clarify - glucagon is the hormone produced by the alpha cells of the pancreas (beta cells produce the insulin), and its function is to stimulate the liver to release glucose from its glycogen stores. Glycogen is a sort of 'concentrated' glucose 🙂

 

[lauraw1983]

No I think that's right. Glucagon (which then converts to glycogen... or is it the otehr way around...?) stored in liver and muscles can be released to fuel the body in the absence of food - eg during intense exercise.

I am just not entirely sure what bearing hypos have in this? People on CGM just don't seem to see the hypo-rebound happening in real time - at any time of day.

Having said that all the basal testing stuff still says don't run a basal test after a hypo, because the vaguaries of liverdump/glucagon release might mess things up.

Interesting read - http://www.ncbi.nlm.nih.gov/pubmed/22699295 and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1021855/

http://www.glucagon.com/glucagonhypoandcounterreg.html


So glucagon is released by the Alpha cells of the pancreas...which triggers the liver (and muscles) to produce glycogen which converts to glucose....but everyone has a different threshold of when their body will release it...which I guess is why we need to catch hypos quickly and treat and if we don't, or if it is a particularly horribly low one the body will kick in alongside the hypo treatment too and we get such a huge high now and again?

This is also really interesting... http://forums.childrenwithdiabetes.com/archive/index.php/t-62473.html

 

[bennyg70]

Cheers for the input and the links!
Ill get my head down and do some reading.

Sometimes its so hard to distinguish how my body reacts to certain situations, unless i purposely put my self under strict test conditions.. Ie forcing a hypo to see if theres a rebound I cant see how I can ever know with certain things.

Ie theres so many little factors that could have, unfelt stress from welding college (The pressure to pass one of the units) The excitement from passing? Welding fumes... lol. its funny thinking about it I had a really bad high one night after welding class I just could not explain it apart from a possible bent needle or hitting a rubbish spot or something...! Theres a pattern emerging! Or maybe it was just some kind of rebound from a hypo earlier on.... Not much of a life saving reponse mr liver...!