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Hi everyone

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sb87

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At risk of diabetes
Hi everyone.

I am new here.

I have been for the last couple of years experiencing fatigue, shakiness etc. Ive had bloods etc done for thyroid, early menopause, other hormones etc, adrenal insufficiency and everything normal.

It was suggested that I could be having hypoglycaemic episodes so i started to finger prick. This showed that 2 hours after meals, my sugars were either between 3 and 3.7 or up above 9. It has also showed that my fasting glucose is about 6mmols each morning.

Having done some reading this suggests pre diabetes and or insulin resistance. The hypos stop me in my tracks, I really struggle with them. When the sugars are high, I feel sick and need to pee more. My fasting glucose at the doctors was 5.9 but my hba1c is 35. I was able to have a libre for a short period (purchased online) and this has showed that whenever i eat carbs, even a small amount i.e. less than 15g, i have a spike where my sugars go up from 4-5 to about 9-11 then either drop straight back down in to hypo ranges or stay elevated at 2 hours.

Metformin has been discussed but now my doctors surgery has no GPs in it! I have been on a low carb diet for over a year. I walk 3-4 miles a day and i swim 3x a week. None of this has made any difference - oh, and i cannot lose weight. Ive done slimming world, weight watchers, shake diets, calorie restriction, carb restriction - you name it, I have probably done it and I cannot shift any weight.

Has anyone else experienced this? Not sure what my next move should be. GP surgery have suggested getting an appointment with an online GP to get 'another point of view'.

Feeling lost but sick of feeling the ups and downs and sick of not being able to lose weight.

Thanks
 
Are you saying that you can’t get an appointment with your own NHS GP??
 
Yep! There is no GPs at my surgery now. Just locums sporadically and the reception staff don’t know in advance when they are there.
 
sb87 said:
Yep! There is no GPs at my surgery now. Just locums sporadically and the reception staff don’t know in advance when they are there.
Click to expand...
That’s awful.
 
Your HbA1C of 35 is non-diabetic @sb87 When you finger-pricked, what meter did you use? You mention you’re avoiding carbs - how many carbs a day do you eat? Eating minimal carbs can cause a temporary form of insulin resistance (because your body thinks it’s ‘starving’) so perhaps your diet is having an effect on things too and might be counter-productive.

In people without diabetes, blood sugar can go down to the low 3s. Usually hypos are caused by medication, eg insulin. Also, remember too that the glucose meters aren’t for diagnostic purpose and have a margin of error up to 15%. The HbA1C is the diagnostic test for diabetes and pre-diabetes. In people without diabetes blood sugar can also go up to the 10s on occasion. In the past, I’ve tested friends’ blood sugar after meals and seen this myself.

If you’re happy to say, how much over your ideal weight are you - ie what’s your BMI? Who suggested you were having “hypoglycaemic episodes”?
 
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ColinUK it’s not great is it. Has been an ongoing problem for months.

Inka thanks for your reply. My BMI is 36 which I know needs much improvement. I’ve struggled to lose weight for a couple of years. I’ve been referred to weight management classes and still haven’t managed bar a lb or two!

My meter is a caresens one but I can’t remember which model number.

I eat less than 130g carbs a day. I aim for around 100. The doctor was the one who called the hypo episodes ‘hypos’. I do get symptoms when my sugars are low though.

This might be a naive question but, would the hypos bring my hba1c down as I have a couple a day about 3-4 hours after meals?
 
100g carbs is ok and wouldn’t cause the temporary insulin resistance I mentioned above. There is something called Reactive Hypoglycaemia but people who have that generally drop much lower than you’re dropping. You could try eating a Low GI diet maybe. If you wanted to, you could also try something like 80g carbs a day. It’s hard to recommend a diet as different diets suit different people. It’s just a case of experimenting to see what works for you.

The HbA1C could be affected but it could also just be that your blood sugar is rising and falling a bit ‘unevenly’ (sorry, I can’t think of the right word) and so you’re feeling it more. Looking at your diet - all components not just carbs - would be sensible.
 
Thanks Inka.

Reactive hypoglycaemia is a phrase that was mentioned now you say it. Having had a look at that I do fit the description. My lowest sugar when having the episodes has been 2.9 but I start to feel shaky and unwell under about 3.7 which I know is still quite a ‘normal’ reading for most.

I will look more in to the GI of foods and see if that helps at all.

The GP I did see a couple of months back did suggest that as the hba1c is an average that my hba1c could be affected but he didn’t elaborate further and I didn’t think to ask at the time and now there is no one there to ask. I always just thought your hba1c was affected with high sugars. I don’t really know much about it to be honest.
 
The HbA1C gives a kind of average idea of your blood sugar over the preceding 3 months. Eating a low GI diet should help as it slow down your blood sugar rise and hopefully that will also soften your drop. I’d concentrate on that if it was me. You might also find having small snacks between meals helps eg nuts or something not mega-carby. Avoiding high GI foods should help you a lot.
 
If you have been having a low carb diet for some time and are still not able to lose weight it could suggest a endocrine or hormonal issue so if you aren't able to see a GP then try to get the surgery when they do have a GP there to refer you to a specialist at the hospital.
You are taking the Total carbs in foods not just the sugars in your daily carb amount, sorry if that sounds like a silly question.
 
Thanks Inka. I’m dedicating this afternoon to some relaxing and low GI research. Unfortunately I can’t have nuts but I will look up things I can have. Thanks for all the info this morning. I really appreciate it.

Hi Leadinglights. That’s a good idea - I’ll ask if the surgery can leave a request for a doctor to do that for me. I did wonder if it was more hormonal/endocrine complications. Yes I am checking the total carbs not a silly question at all.
 
Hope you manage to develop a way of eating which helps you reduce your glucose variation and helps you manage your symptoms.

HbA1c is a measure of how much glucose has ‘stuck’ to your red blood cells. Higher concentrations mean that more cells become glycated (and lower concentrations mean that fewer cells become glucated). Glycation is a one way street. Once it has happened the red blood cell can’t switch back… and since red blood cells live for around 120 days before they are recycled, measuring how many cells have been changed by exposure to glucose gives an approximation of average glucose levels over the previous 3-4 months.

There’s a bit more about HbA1c here if it helps

What is HbA1c?

HbA1c is your average blood glucose (sugar) levels for the last two to three months. If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below. If you're at risk of developing type 2 diabetes, your target HbA1c level should be below 42mmol/mol (6%).
www.diabetes.org.uk www.diabetes.org.uk

Do you think smaller meals - more of a grazing approach - might be worth considering?
 
If you aren’t satisfied with GP availability at your current GP practice then can you not switch to a different practice?
 
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