Hypoglycemia or is it brittle diabetes?

[Satan’s little helper]

they may be errors with your meter (e.g. not enough blood on the strip) or with your strips.

Isn’t there normally an error code or in the case of my meter a message stating so, if this was the case?

dehydration can cause false lows, for example.

Hello, it’s my understanding that dehydration causes an elevated BG level due to the concentrate in a abnormally hydrated blood sample?

 

[helli]

Isn’t there normally an error code or in the case of my meter a message stating so, if this was the case?

It depends upon the meter.
Some (mostly the cheaper ones) will not report the error but just give you a false lo.

 

[Lucyr]

I'm using GP given one which is glucoRX Q. I'm not sure how this monitor could be faulty; maybe one or two readings off slightly... But I'm guessing. I just don't think that it is faulty. Even if some are out a bit, if I still read LO a fair bit in the day, then it would have to be off by a lot for me not to be experiencing very low, lows.

Could be user error rather than the meter itself being faulty. Has someone shown you how to use it or have you watched videos to learn how to use it? Worth rewatching or asking again if not. Not drying your hands properly, out of date strips, not enough blood, could all cause falsely low readings.

 

[Satan’s little helper]

It depends upon the meter.
Some (mostly the cheaper ones) will not report the error but just give you a false lo.

maybe. I have known in the distant past just “waiting,” if not enough blood Is applied.

 

[helli]

maybe. I have known in the distant past just “waiting,” if not enough blood Is applied.

Not "maybe".
Some meters definitely report Lo when they do not have enough blood.

Different meters behave in different ways.
Some report errors
Some just wait (although all the ones I have used time out)
Some report Lo.

There may be other was that respond in different ways. I have not tried all meters.
But the comment above from @rebrascora is not the first time I have read about some meters reporting Lo when they do not have enough blood.

 

[Inka]

Isn’t there normally an error code or in the case of my meter a message stating so, if this was the case?




Hello, it’s my understanding that dehydration causes an elevated BG level due to the concentrate in a abnormally hydrated blood sample?

From the GlucoRX instruction booklet:

“Severe dehydration and excessive water loss may cause false low results.”

 

[Satan’s little helper]

From the GlucoRX instruction booklet:

“Severe dehydration and excessive water loss may cause false low results.”

Thanks for the tip off on the booklet. Insufficient blood sample could just cause the test not to start. https://www.glucorx.ie/error-messages/

I’ve taken my steer from places like here on the subject of BG level readings. https://www.medicalnewstoday.com/articles/can-dehydration-cause-high-blood-sugar

By the same token with interstitial fluid too. “ Severe dehydration and excessive water loss may cause inaccurate results.”. https://www.freestyleprovider.abbot...llary blood,loss may cause inaccurate results.

 

[everydayupsanddowns]

I'm using GP given one which is glucoRX Q. I'm not sure how this monitor could be faulty; maybe one or two readings off slightly... But I'm guessing. I just don't think that it is faulty. Even if some are out a bit, if I still read LO a fair bit in the day, then it would have to be off by a lot for me not to be experiencing very low, lows.

It is confusing for sure! Loss of hypo awareness tends to happen in insulin users over many years. Over time the body adapts and changes to try to ‘perform better’ at low levels - if you have had (non-diabetes) hypoglycaemia for some time it is possible that this may have happened, but it’s striking that lots of people with diabetes with decades if experience with insulin under their belts are shocked (and slightly confused) by the 1s and LOs you mention as these are usually rare, frightening, and extremely unpleasant experiences if any of us have had them.

I wonder of you might consider getting one of those starter kits of a premium brand meter which are sold in pharmacies and generally come with a pot of 10 strips. Brands like Accu-Chek and Contour (with Next XT strips) tend to perform well for accuracy in lab tests, and would allow you to check the same drop of blood on 2 separate BG meters to see if the results were comparable?

 

[Satan’s little helper]

It is confusing for sure! Loss of hypo awareness tends to happen in insulin users over many years. Over time the body adapts and changes to try to ‘perform better’ at low levels - if you have had (non-diabetes) hypoglycaemia for some time it is possible that this may have happened, but it’s striking that lots of people with diabetes with decades if experience with insulin under their belts are shocked (and slightly confused) by the 1s and LOs you mention as these are usually rare, frightening, and extremely unpleasant experiences if any of us have had them.

I wonder of you might consider getting one of those starter kits of a premium brand meter which are sold in pharmacies and generally come with a pot of 10 strips. Brands like Accu-Chek and Contour (with Next XT strips) tend to perform well for accuracy in lab tests, and would allow you to check the same drop of blood on 2 separate BG meters to see if the results were comparable?

Would it be appropriate to (add & also) suggest @martinajane12 could try obtaining a “control solution” from the Gluco manufacturer to check for the meter reliability? These companies (though I’ve never dealt with this one.) tend to “pride” themselves on the product for the sake of further sales with strips.

 

[martinajane12]

Thank you for the clarification.
Unfortunately, many of us do not fully read long messages and will focus on the subject.

Sorry, for missing the detail in your message.

I know my message was really long ...sorry to everyone... Just all seemed possibly relevent

 

[martinajane12]

Absolutely not this is an immediate or shortly after problem. As I say people with ME struggle to metabolise fatty acids and glucose. So it may be this.
"Are you underweight (what’s your BMI)?"
yes I am. Which also can be a factor for experiencing hypos (malnutrition, underweight, long term fasting, long periods of not eating enough…

I agree. Being underweight could be a factor affecting how you’re feeling. Quite apart from the ME, it kind of puts someone on more of a tightrope with tiny things affecting them more than if they were a normal weight. If your digestion is also affected, that could be a factor.

You’ve clarified above that your ‘crash after eating’ is immediately or shortly after. Reactive Hypoglycaemia happens within four hours of the meal rather than immediately after. I wonder whether your feelings are something to do with your digestion or your blood pressure. There’s a condition that causes low blood pressure after eating.

However, you also say you you can read LO “at the start of the day”. This doesn’t sound like RH and you also say you ate a carby meal and didn’t crash, with your blood sugar being a perfectly normal 7.

Now you’ll quite rightly point to the LOs on your meter as contradicting that, but LO signals less than 1.1mmol. At that level someone wouldn’t just be feeling extreme tiredness, if they were still conscious they’d likely be having a seizure and/or very obvious severe symptoms. So, I still think there’s something off with the readings. As well as too little blood, dehydration can cause false lows, for example.

You do mention cortisol. I presume you were worried about Addisons?

"Reactive Hypoglycaemia happens within four hours of the meal rather than immediately after. I wonder whether your feelings are something to do with your digestion or your blood pressure. There’s a condition that causes low blood pressure after eating."


I explained to the GP that it happens shortly after I eat - in the first instance.
And they still suggest reactive hypoglycaemica even though what I read all over the internet is it causing symptoms typically 2 - 4 hours after eating (as opposed to within 4 hrs you say)....
It could easily be ME inability to cope with any energy use, such as digestion...
But didn't explain the low readings after 2 hours or drops like 6 or 8 immediately before eating then reading LO (as I say that list doesn't show readings immediately before eating to get a comparison)

 

[martinajane12]

Absolutely not this is an immediate or shortly after problem. As I say people with ME struggle to metabolise fatty acids and glucose. So it may be this.
"Are you underweight (what’s your BMI)?"
yes I am. Which also can be a factor for experiencing hypos (malnutrition, underweight, long term fasting, long periods of not eating enough…

I agree. Being underweight could be a factor affecting how you’re feeling. Quite apart from the ME, it kind of puts someone on more of a tightrope with tiny things affecting them more than if they were a normal weight. If your digestion is also affected, that could be a factor.

You’ve clarified above that your ‘crash after eating’ is immediately or shortly after. Reactive Hypoglycaemia happens within four hours of the meal rather than immediately after. I wonder whether your feelings are something to do with your digestion or your blood pressure. There’s a condition that causes low blood pressure after eating.

However, you also say you you can read LO “at the start of the day”. This doesn’t sound like RH and you also say you ate a carby meal and didn’t crash, with your blood sugar being a perfectly normal 7.

Now you’ll quite rightly point to the LOs on your meter as contradicting that, but LO signals less than 1.1mmol. At that level someone wouldn’t just be feeling extreme tiredness, if they were still conscious they’d likely be having a seizure and/or very obvious severe symptoms. So, I still think there’s something off with the readings. As well as too little blood, dehydration can cause false lows, for example.

You do mention cortisol. I presume you were worried about Addisons?

Mentioned cortisol because it's relevant in ME (we have reverse cortisol, which is also what helps to make people feel more awake in the morning). And cortisol is very relevant due to high stress and also long term issues with chronic stress. Stress obviously has a part to play in being the opposite to insulin.

 

[martinajane12]

Absolutely not this is an immediate or shortly after problem. As I say people with ME struggle to metabolise fatty acids and glucose. So it may be this.
"Are you underweight (what’s your BMI)?"
yes I am. Which also can be a factor for experiencing hypos (malnutrition, underweight, long term fasting, long periods of not eating enough…

I agree. Being underweight could be a factor affecting how you’re feeling. Quite apart from the ME, it kind of puts someone on more of a tightrope with tiny things affecting them more than if they were a normal weight. If your digestion is also affected, that could be a factor.

You’ve clarified above that your ‘crash after eating’ is immediately or shortly after. Reactive Hypoglycaemia happens within four hours of the meal rather than immediately after. I wonder whether your feelings are something to do with your digestion or your blood pressure. There’s a condition that causes low blood pressure after eating.

However, you also say you you can read LO “at the start of the day”. This doesn’t sound like RH and you also say you ate a carby meal and didn’t crash, with your blood sugar being a perfectly normal 7.

Now you’ll quite rightly point to the LOs on your meter as contradicting that, but LO signals less than 1.1mmol. At that level someone wouldn’t just be feeling extreme tiredness, if they were still conscious they’d likely be having a seizure and/or very obvious severe symptoms. So, I still think there’s something off with the readings. As well as too little blood, dehydration can cause false lows, for example.

You do mention cortisol. I presume you were worried about Addisons?

Ah dehydration? And of course also not enough blood on strip? I wish it just said ERROR if that was the case! Of course dehydration also causes the blood to not come out as well, which I told the nurse about this problem BEFORE we even went down the route of me seeming to have an issue with readings. So it wasn't like I didn't express a problem there.

They don't think, actually it could make readings off, do they. It only takes one person to not be on the ball in not explaining....
See the GP knows I struggle with eating enough, every single day (and includes sometimes dehydration, which you also get moisture from food).

And not yet been any suggestions to make sure I drink more water if blood is not coming out so well or to take readings with more blood on the strip to be accurate.... Tbh I don't think they will think of that as a possible reason for these readings! .... I wish they would make sure to tell patients who suffer with eating problems especially, when they give the device, rather than going down this rabbit hole, potentially for no reason.... I really wish I had the perfect person to treat me and tell me everything that I should know, having ME is awful.

 

[martinajane12]

It is confusing for sure! Loss of hypo awareness tends to happen in insulin users over many years. Over time the body adapts and changes to try to ‘perform better’ at low levels - if you have had (non-diabetes) hypoglycaemia for some time it is possible that this may have happened, but it’s striking that lots of people with diabetes with decades if experience with insulin under their belts are shocked (and slightly confused) by the 1s and LOs you mention as these are usually rare, frightening, and extremely unpleasant experiences if any of us have had them.

I wonder of you might consider getting one of those starter kits of a premium brand meter which are sold in pharmacies and generally come with a pot of 10 strips. Brands like Accu-Chek and Contour (with Next XT strips) tend to perform well for accuracy in lab tests, and would allow you to check the same drop of blood on 2 separate BG meters to see if the results were comparable?

"Over time the body adapts and changes to try to ‘perform better’ at low levels - if you have had (non-diabetes) hypoglycaemia for some time it is possible that this may have happened"

Yes this is exactly my notion. GP also said this could be the case. I have had horrendous symptoms over my lifetime and chronically - every day for years - so it is possible. I mean horrendous and too many to list.

 

[martinajane12]

It is confusing for sure! Loss of hypo awareness tends to happen in insulin users over many years. Over time the body adapts and changes to try to ‘perform better’ at low levels - if you have had (non-diabetes) hypoglycaemia for some time it is possible that this may have happened, but it’s striking that lots of people with diabetes with decades if experience with insulin under their belts are shocked (and slightly confused) by the 1s and LOs you mention as these are usually rare, frightening, and extremely unpleasant experiences if any of us have had them.

I wonder of you might consider getting one of those starter kits of a premium brand meter which are sold in pharmacies and generally come with a pot of 10 strips. Brands like Accu-Chek and Contour (with Next XT strips) tend to perform well for accuracy in lab tests, and would allow you to check the same drop of blood on 2 separate BG meters to see if the results were comparable?

Thanks for the suggestion. I have no idea about the performance of other brands

 

[martinajane12]

Ah dehydration? And of course also not enough blood on strip? I wish it just said ERROR if that was the case! Of course dehydration also causes the blood to not come out as well, which I told the nurse about this problem BEFORE we even went down the route of me seeming to have an issue with readings. So it wasn't like I didn't express a problem there.

They don't think, actually it could make readings off, do they. It only takes one person to not be on the ball in not explaining....
See the GP knows I struggle with eating enough, every single day (and includes sometimes dehydration, which you also get moisture from food).

And not yet been any suggestions to make sure I drink more water if blood is not coming out so well or to take readings with more blood on the strip to be accurate.... Tbh I don't think they will think of that as a possible reason for these readings! .... I wish they would make sure to tell patients who suffer with eating problems especially, when they give the device, rather than going down this rabbit hole, potentially for no reason.... I really wish I had the perfect person to treat me and tell me everything that I should know, having ME is awful.

Some fingers I really struggled to get blood out.
Some I got enough blood out and the strips just didn't seem to pick it up, although it covered the length of the strip sensor. My pinky finger gave me way too much blood, like what the hell. Must be softer skin or something that makes the needle go in better. All my blood life is in my smallest finger!

 

[helli]

Some I got enough blood out and the strips just didn't seem to pick it up, although it covered the length of the strip sensor.

Test strips work via capillary action. It is not about covering a strip. You place the tip of the strip into (or very close to) the blood and it will “suck it up”.

 

[rebrascora]

Ah dehydration? And of course also not enough blood on strip? I wish it just said ERROR if that was the case! Of course dehydration also causes the blood to not come out as well, which I told the nurse about this problem BEFORE we even went down the route of me seeming to have an issue with readings. So it wasn't like I didn't express a problem there.

They don't think, actually it could make readings off, do they. It only takes one person to not be on the ball in not explaining....
See the GP knows I struggle with eating enough, every single day (and includes sometimes dehydration, which you also get moisture from food).

And not yet been any suggestions to make sure I drink more water if blood is not coming out so well or to take readings with more blood on the strip to be accurate.... Tbh I don't think they will think of that as a possible reason for these readings! .... I wish they would make sure to tell patients who suffer with eating problems especially, when they give the device, rather than going down this rabbit hole, potentially for no reason.... I really wish I had the perfect person to treat me and tell me everything that I should know, having ME is awful.

Medical professionals often don't know about these limitations of the devices they are supplying. The reps pushing them are certainly not going to tell them such negative issues if they even know about them themselves. It takes people using them regularly ie diabetics to figure out such problems and a forum like this to share them with others, so I would be extremely surprised if your GP or nurse were aware of issues like false low readings caused because you don't get enough blood on the test strip.
My meter will sometimes give a false low if I reuse a strip that I have used previously but accidentally got put back in the pot with the used ones. I have certainly had occasional readings like 1.7, a few days after spilling some test strips and then putting them back in the pot and this is the theory I have come up with. I put used strips in one side of my meter case to dispose of when I get home and if I spill some new, unused ones it is not impossible for them to become mixed up.

If you are having difficulty getting enough blood then this would also suggest that not enough blood would be the cause of those low readings. I totally agree with you that the meter should display an error message and some do but, unfortunately not all.

How are you applying the blood? The test strip should be above the drop of blood at a 45 degree angle upwards to the meter and the very tip of it should just touch the blood so that capillary action sucks the blood upwards into the sampling channel of the test strip. Watching You Tube videos is a good way to understand how it works and improve your technique.

If you were suffering Reactive Hypoglycaemia your levels generally go very high first and then come down very rapidly. Even if you were not going below 4, that feeling of levels dropping fast from a high level would make you feel hypo.

 

[Inka]

@martinajane12 I know you said there were many reasons why you weren’t eating properly, and obviously don’t want to pry, but if you could get support, whether medical or psychological and could eat better, you might well find you feel better and some of these feelings you’re suffering with ease up. Regular meals sounds trivial and boring, but it can really make people feel better, as can maintaining a healthy weight and being well-hydrated.

 

[Inka]

Mentioned cortisol because it's relevant in ME (we have reverse cortisol, which is also what helps to make people feel more awake in the morning). And cortisol is very relevant due to high stress and also long term issues with chronic stress. Stress obviously has a part to play in being the opposite to insulin.

Stress can cause high blood sugars but it can also cause low blood sugar too - or have no effect on blood sugar at all 🙂 It isn’t the opposite of insulin. If insulin has an opposite, it would be glucagon.

I hope you’re getting good support with your ME.