Non reactive hypoglycaemia

[eggyg]

I’m probably over reacting here but I’m concerned Mr Eggy may have this. I’m sure someone’s partner on here has it. Is it @TheClockworkDodo?
Some mornings only two hours or even less, after his breakfast he is absolutely starving. He always has cereal, Shredded Wheat or Weetabix, always with some sugar.
One day last week he was literally shaking, feeling weak and again absolutely starving. He’d had three Weetabix just two hours earlier. I decided to test him. 4.2. Taking into account a -15% discrepancy, that could take him into hypo land. He had something to eat and I tested him a couple of hours later. Just over 5.
Never thought much about it until today. Same thing happened two hours after a bowl of Shredded Wheat, again shaking, weakness and hungry. 3.5 this time. I gave him a jelly baby, ginger nut, bowl of soup and two slices of granary bread. He felt fine afterwards.
I’ve consulted Dr Google and it seems it’s quite rare and can be linked with various things one being heart disease, which he has, and pre diabetes. At his last vascular review in June his Hba1c was 34. He hates me fussing and thinks I’m worrying over nothing. I can’t make him phone the GP. Any thoughts anyone?
PS I am a big worrier especially about his health as he has had a tough few years with his heart problems.

 

[grovesy]

Yes it her husband.

 

[AndBreathe]

I’m probably over reacting here but I’m concerned Mr Eggy may have this. I’m sure someone’s partner on here has it. Is it @TheClockworkDodo?
Some mornings only two hours or even less, after his breakfast he is absolutely starving. He always has cereal, Shredded Wheat or Weetabix, always with some sugar.
One day last week he was literally shaking, feeling weak and again absolutely starving. He’d had three Weetabix just two hours earlier. I decided to test him. 4.2. Taking into account a -15% discrepancy, that could take him into hypo land. He had something to eat and I tested him a couple of hours later. Just over 5.
Never thought much about it until today. Same thing happened two hours after a bowl of Shredded Wheat, again shaking, weakness and hungry. 3.5 this time. I gave him a jelly baby, ginger nut, bowl of soup and two slices of granary bread. He felt fine afterwards.
I’ve consulted Dr Google and it seems it’s quite rare and can be linked with various things one being heart disease, which he has, and pre diabetes. At his last vascular review in June his Hba1c was 34. He hates me fussing and thinks I’m worrying over nothing. I can’t make him phone the GP. Any thoughts anyone?
PS I am a big worrier especially about his health as he has had a tough few years with his heart problems.

Eggy - Would you consider investing in one (or two) Libre for him - to see what his personal modus operandi is? And it would be useful to keep a food diary for the duration too.

I know it's around £100, but what price that sort of of insight and info.

I would say though, personally, I don't consider numbers in the 3s to be an issue for normies (whatever that means), but I do understand your concerns. He's lucky to have you watching his back.

 

[TheClockworkDodo]

R has Reactive Hypoglycaemia, @eggyg if that's what you mean? It's basically a timing issue - when someone with RH eats, their blood sugar goes up too fast, so their body releases too much insulin to deal with it, and then they crash into a hypo. There's a good article about it on Wikipedia here - https://en.wikipedia.org/wiki/Reactive_hypoglycemia

It does sound as though it's possible that Mr Eggy has it, from your description of his symptoms - healthy people do have hypos, but they tend to just think they're hungry and eat a biscuit, not to shake and feel weak. If he does have RH, don't worry, it is relatively easy to treat, but he would need to change the way he eats, the same way a type 2 might (but not to that extent).

The first thing is to have more frequent but smaller meals - R did that just by dividing his meals in half, so instead of having a sandwich and a piece of fruit at lunchtime (for instance) he has the sandwich then and the fruit two hours later. It's sensible to cut down on both sugary and starchy carbs - R started eating tomatoes with his lunch instead of cake - and to have protein and/or fat with every meal, to slow down the effect of the carbs. Switching from white bread/rice/pasta to brown can be helpful. High-fibre foods are also really helpful - R has a spoonful of inulin on his oats at breakfast to help with this. Eating something fatty (like a yogurt) at bedtime can prevent night-time hypos - R also takes a tub with a plain biscuit in it up to bed with him so he has something to eat if he wakes up starving.

Exercise is good, but make sure he has some hypo treatment with him while he's exercising. Not being on insulin he shouldn't need a lot of food to treat a hypo - something like a dried apricot or a small glass of fruit juice should do it, without the need for extra carbs to follow up. If he is someone who snacks between meals, then something like nuts or cheese would be better than carby foods like crisps and sweet biscuits.

If he tries that and none of it helps, then it would be sensible for him to see a doctor, if you can get him to do so (I can't get R to see doctors either, so I know what that's like!). R hardly ever has hypos now - when we were first together I used to find him sitting on the kitchen floor shaking and have to feed him dried fruit - so if it is RH just small changes to diet can fix it.

 

[mikeyB]

There are a lot more causes than the ones you have mentioned, Eggy, most of which can be sorted with relatively simple testing. Low cortisol can do it. Excess alcohol can do it, it’s thought by depleting the livers ability to release glucose while busying itself metabolising alcohol. He must see the doctor to see if there is any easily correctable cause. And how do you think the DVLA might regard his driving ability with assisted hypo corrections? Tell him that, and he’ll be off to the doctors like a shot if he can’t drive the jag.

Though of itself, the hypoglycaemia is not life threatening, it can cause problems driving out for a pint of milk after breakfast. You’ll have to do it.

 

[eggyg]

Eggy - Would you consider investing in one (or two) Libre for him - to see what his personal modus operandi is? And it would be useful to keep a food diary for the duration too.

I know it's around £100, but what price that sort of of insight and info.

I would say though, personally, I don't consider numbers in the 3s to be an issue for normies (whatever that means), but I do understand your concerns. He's lucky to have you watching his back.

I have a reader already as I occasionally “ treat” myself. I’ll see how it goes, Juliet’s suggestions below will probably be our first port of call. Thanks.

 

[eggyg]

R has Reactive Hypoglycaemia, @eggyg if that's what you mean? It's basically a timing issue - when someone with RH eats, their blood sugar goes up too fast, so their body releases too much insulin to deal with it, and then they crash into a hypo. There's a good article about it on Wikipedia here - https://en.wikipedia.org/wiki/Reactive_hypoglycemia

It does sound as though it's possible that Mr Eggy has it, from your description of his symptoms - healthy people do have hypos, but they tend to just think they're hungry and eat a biscuit, not to shake and feel weak. If he does have RH, don't worry, it is relatively easy to treat, but he would need to change the way he eats, the same way a type 2 might (but not to that extent).

The first thing is to have more frequent but smaller meals - R did that just by dividing his meals in half, so instead of having a sandwich and a piece of fruit at lunchtime (for instance) he has the sandwich then and the fruit two hours later. It's sensible to cut down on both sugary and starchy carbs - R started eating tomatoes with his lunch instead of cake - and to have protein and/or fat with every meal, to slow down the effect of the carbs. Switching from white bread/rice/pasta to brown can be helpful. High-fibre foods are also really helpful - R has a spoonful of inulin on his oats at breakfast to help with this. Eating something fatty (like a yogurt) at bedtime can prevent night-time hypos - R also takes a tub with a plain biscuit in it up to bed with him so he has something to eat if he wakes up starving.

Exercise is good, but make sure he has some hypo treatment with him while he's exercising. Not being on insulin he shouldn't need a lot of food to treat a hypo - something like a dried apricot or a small glass of fruit juice should do it, without the need for extra carbs to follow up. If he is someone who snacks between meals, then something like nuts or cheese would be better than carby foods like crisps and sweet biscui
If he tries that and none of it helps, then it would be sensible for him to see a doctor, if you can get him to do so (I can't get R to see doctors either, so I know what that's like!). R hardly ever has hypos now - when we were first together I used to find him sitting on the kitchen floor shaking and have to feed him dried fruit - so if it is RH just small changes to diet can fix it.

Thanks for that insight Juliet. I did mean reactive not non, I think I was thinking non diabetic hypoglycaemia! I did wonder about protein for breakfast. He actually said he was painfully starving at 5am today and nearly got up! I’ll carefully broach the subject with him, he likes his cereal as he needs the fibre ( TMI), he always eats granary/ wholemeal bread anyways. He is quite a healthy eater although since retirement he has gotten a sweet tooth.

 

[mikeyB]

I agree, eggy, Juliet is our expert on the subject, faultless advice. He still needs to see the doctor, mind.

 

[eggyg]

There are a lot more causes than the ones you have mentioned, Eggy, most of which can be sorted with relatively simple testing. Low cortisol can do it. Excess alcohol can do it, it’s thought by depleting the livers ability to release glucose while busying itself metabolising alcohol. He must see the doctor to see if there is any easily correctable cause. And how do you think the DVLA might regard his driving ability with assisted hypo corrections? Tell him that, and he’ll be off to the doctors like a shot if he can’t drive the jag.

Though of itself, the hypoglycaemia is not life threatening, it can cause problems driving out for a pint of milk after breakfast. You’ll have to do it.

Funnily enough Mike, I thought the same, what if he’d popped out after breakfast and drove down the motorway to Tesco? It’s a scary thought. He isn’t a massive drinker, although if I let him he’d drink more but it gives him palpitations. He had one bottle of beer with his tea last night. I can’t think if he’d had a drink when it happened last week, but if he did, it will have only been a glass of wine, albeit a healthy glass full. I will definitely be monitoring him very carefully and will mention the driving part. He is back under the cardiologist now as he has been having a bit of trouble, high BP, irregular heart beat, he’s recently had an echocardiogram which they said didn’t appear to differ from his last one three years ago. He also had a 24 hour ECG fitted a couple of weeks ago. We’ve heard nothing so assuming everything is ok. He’s a worry! Thanks for you thoughts.

 

[nonethewiser]

Whatever it is hope he gets sorted my friend.