Having hypos as a type 2. Too low carb?

[Emilymay]

Diagnosed in October last year with a HBA1C or 58 and 54. I’ve been wearing a CGM since last Monday, which was the day I started the keto diet and drastically cut my carbs. I’ve never cut carbs out of my diet and this is the first time.
I’m concerned because I keep having hypos? As shown on my CGM, I don’t carry around my finger prick machine but the one time I did check my blood sugar while having a hypo it was only 0.3 mmol higher (CGM showed 3.4 and finger prick showed 3.6) while having these hypos my eye sight goes blurrier and my legs feel like jelly, I also feel ‘out of body’. I eat half a banana and that normally perks me up. These hypos are also happening at random times of the day, not at any one time.
Is this normal to be having so many hypos, been keeping my carbs below 20g, should I up this amount? I meant to start Metformin but concerned I will ‘hypo’ even more.

 

[everydayupsanddowns]

Sorry to hear about the low BG symptoms you have been experiencing. Do you have a means of checking the sensor performance eg a fingerstick meter? Some sensors can run a few points below reality, and show readings in the 3s that are actually low 4s. It would be unusual (though not impossible) for someone not on glucose-lowering meds to experience full hypoglycaemia.

It does seem like your BG levels have been running towards the lower edge of the range though, and it is possible that your very low carb eating plan is contributing to that. Perhaps a more flexible low carb menu, that isn’t aiming for keto would suit you better?

Below 4.0 is a warning, but some experts suggest true hypoglycaemia (where the brain function is impaired) only occurs nearer 3.5 or below. Nevertheless, I can see why you’d be troubled by the symptoms you are getting.

If your body has been running at higher levels for a while, then it can take a while for your ‘glucose thermostat’ to reset, and you might be getting fairly full-on warning signs triggered in the low 4s high 3s.

Hope you can find a balance of carbs that reduces your exposure to these unpleasant symptoms, while still keeping your BG levels in check 🙂

 

[Drummer]

You might find that you need to drink more due to the diuretic effects of low carb, and that should help in getting over the shock of lower blood glucose levels.
Personally I used three grapes and some warm water (it was winter) to get over the transition to no more than 50gm of carbs a day. Many people find that 50 gm is the level they can maintain - even Dr Atkins recommended increasing from 20gm if there were unpleasant sensations.

 

[Emilymay]

Sorry to hear about the low BG symptoms you have been experiencing. Do you have a means of checking the sensor performance eg a fingerstick meter? Some sensors can run a few points below reality, and show readings in the 3s that are actually low 4s. It would be unusual (though not impossible) for someone not on glucose-lowering meds to experience full hypoglycaemia.

It does seem like your BG levels have been running towards the lower edge of the range though, and it is possible that your very low carb eating plan is contributing to that. Perhaps a more flexible low carb menu, that isn’t aiming for keto would suit you better?

Below 4.0 is a warning, but some experts suggest true hypoglycaemia (where the brain function is impaired) only occurs nearer 3.5 or below. Nevertheless, I can see why you’d be troubled by the symptoms you are getting.

If your body has been running at higher levels for a while, then it can take a while for your ‘glucose thermostat’ to reset, and you might be getting fairly full-on warning signs triggered in the low 4s high 3s.

Hope you can find a balance of carbs that reduces your exposure to these unpleasant symptoms, while still keeping your BG levels in check 🙂

I don’t carry my finger prick test around with me so tricky to always check accuracy. The few times I have checked while having a ‘hypo’ it’s a few 0. Mmols higher but still under 4.
I have been thinking of upping my carbs by eating more fruit and veg. Perhaps I’ll try that and see what happens. Although I’m happy with running low 4’s, Libre have my estimated HBA1C at 5.0% at the moment which is nice.
Thank you for your response!

 

[Emilymay]

You might find that you need to drink more due to the diuretic effects of low carb, and that should help in getting over the shock of lower blood glucose levels.
Personally I used three grapes and some warm water (it was winter) to get over the transition to no more than 50gm of carbs a day. Many people find that 50 gm is the level they can maintain - even Dr Atkins recommended increasing from 20gm if there were unpleasant sensations.

I have been slacking in terms of my water. Been drinking a lot of 0 calorie soft drinks to help with those sugar cravings. Perhaps I need to drink more water alongside the soft drinks.
I think I might up my carbs with fruits and vegetables. Probably eaten about 3 portions of the stuff since last Monday, it’s all so carby.

Thanks for your response.

 

[Leadinglights]

If you cut carbs to keto level very quickly then your body has a lot of adjusting to do, even when people opt for a low carb approach of 130g per day then it is suggested they do that gradually by reducing their carb intake over a number of weeks to minimise the impact on their eyes and nerves.
Managing your condition is a long term thing not a quick fix.
Perhaps what you are doing is too extreme for your body to cope with. It does not sound as if you really need metformin until you have a least had another HbA1C test.
Many do get Hypo symptoms even if blood glucose is actually not low when they modify their diet and start medication as blood glucose can dramatically reduce and the body has to adjust having run at high levels for possibly some months.

 

[Drummer]

I have been slacking in terms of my water. Been drinking a lot of 0 calorie soft drinks to help with those sugar cravings. Perhaps I need to drink more water alongside the soft drinks.
I think I might up my carbs with fruits and vegetables. Probably eaten about 3 portions of the stuff since last Monday, it’s all so carby.

Thanks for your response.

Try carrots, swede, onion, snowpeas, kohlrabi, sweet pepper, turnip, leek, spaghetti squash, bamboo shoots, celeriac, cabbage, green beans, aubergine, tomato, kale, rocket, sprouts, radish, cauliflower, cucumber, lettuce, bean sprouts, courgette, asparagus, okra, artichoke hearts, celery, chard, avocado, bok choy, curly endive, mushrooms, beetroot, berries, rhubarb, or anything else with 10 percent carbs or less.
I drink a glass of water first thing in the morning and last thing at night, amounting to one pint, and have several drinks during the day - otherwise I get cramps at night.

 

[everydayupsanddowns]

I think I might up my carbs with fruits and vegetables. Probably eaten about 3 portions of the stuff since last Monday, it’s all so carby.

More fruit and veg sounds like it would be really helpful.

Any potential benefits of low glucose levels will be compeltely wiped out if your body it repeatedly throwing its emergency switch because your BGs are running too low - repeated mild hypoglycaemia can be associated with an increased risk of cardiac arrythmia I think (at least that’s what a consultant has told me in the past)