Reactive Hypoglycaemia and glucose monitor

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It is difficult when you don't have a diagnosis but many of the people who are Type 2 find that reducing the carbohydrate element and increasing fat and protein does not lead to an increase in weight indeed people lose weight. So having something like full fat Greek yoghurt with berries and maybe seeds or nuts or something with eggs, is a filling breakfast. And as suggested meat, fish or cheese with lunch rather than just carb, crumpets are surprisingly high carb. Meat, fish with veggies or salad for tea and full fat yoghurt or the protein yoghurt for pudding with berries or sugarfree jelly or berries with cream are options.
As said don't worry about the calories, it's all about the carbs, personal opinion having said that. Some people do monitor absolutely everything.
 
The link I put above in an earlier post of mine, has sample menus for the day, if that helps you. Things like choosing the ‘right’ bread, and making sure your meals are a good balance of carbs, protein and fat might help you. I know lunch is often a bit of a rushed meal, but just having something more substantial that includes protein could help you keep your levels steadier eg a chicken salad sandwich plus a plain yoghurt, etc.

Again, apologies if this sounds rude, but you haven’t mentioned your BMI. Are you trying to lose weight and do you need to at all? Is that why you’re limiting calories or are there additional factors at play?
 
NatS said:
They have done a 9am cortisol test. No scans.
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9am cortisol is the first test for Addisons Disease - if your cortisol is low they then do further tests. If you don't know your cortisol result it's worth asking your GP what it was, but if you haven't heard it probably means it was OK.

To add to what others have been saying, fibre is also good for RH, so even though it doesn't sound as though you have that, if you do, increasing fibre in your diet should help!
 
NatS said:
Don't worry I'll not take anything as a dig. All insights are very welcome. The endo hasn't been much help and I don't have the dietician appointment until November.

I'm trying to balance calories and volume of food. I'm only 5ft so don't have a lot of daily cals. I sure I can add in more protein. I forgot but I do sometimes have a protein yogurt mid morning. I usually hungrier in the evenings so have more food after work.
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As a type 2 if I ate that amount of carbs I would be staggering around broken.
I have about 10 gm of carbs in the mornings - so scrambled eggs, with cheese and a tomato would be fairly typical, or a piece of meat with mushrooms and whatever is in the fridge to stir fry. A mug of coffee with cream and I am good for the day.
Eating grain first thing would mean that I felt hungry again in a very short while.
 
Drummer said:
As a type 2 if I ate that amount of carbs I would be staggering around broken.
I have about 10 gm of carbs in the mornings - so scrambled eggs, with cheese and a tomato would be fairly typical, or a piece of meat with mushrooms and whatever is in the fridge to stir fry. A mug of coffee with cream and I am good for the day.
Eating grain first thing would mean that I felt hungry again in a very short while.
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It’s certainly not a large amount of carbs!! It’s a pretty small amount actually and probably in the Low Carb range. Toast and some crumpets is NOT a large amount of carbs. No wonder people develop eating disorders.

The RH diet I linked to has a good amount of lower GI carbs. The OP isn’t a Type 2 - or even diabetic…
 
Inka said:
It’s certainly not a large amount of carbs!! It’s a pretty small amount actually and probably in the Low Carb range. Toast and some crumpets is NOT a large amount of carbs. No wonder people develop eating disorders.

The RH diet I linked to has a good amount of lower GI carbs. The OP isn’t a Type 2 - or even diabetic…
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I never wrote that it was a large amount of carbs, just contrasting my diet - I thought the R in RH was 'reactive' as in reacting to eating carbs - but if it isn't then I stand corrected.
 
Drummer said:
I never wrote that it was a large amount of carbs, just contrasting my diet - I thought the R in RH was 'reactive' as in reacting to eating carbs - but if it isn't then I stand corrected.
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You implied it was too many carbs. The OP doesn’t have a diagnosis and the specialist suggested it might not be RH. Your scare-mongering about carbs is totally unnecessary and contradicts the advice in the leaflet I linked to The OP isn’t Type 2 so why contrasting the amount of carbs you eat is relevant, I’m not sure.
 
Hi All
Thanks for all the advise and links. I need to sit down and read everything properly. I've started adding more fibre and protein.

Calories are a concern for me as I want to maintain weight and adding in more exercise would be challenging. My bmi is in the normal range.

I've never counted carbs I just have always tried to eat protein but didn't realise about fibre also being helpful.

I'm going to pursue the endo for a diagnosis and chat to my gp about other things. The 9am cortisol was ok.

I'm sure I'll have more questions once I've read through all the posts in detail.

Other than RH what sort of problems could i be looking at?
 
You can still maintain your weight and add in protein and fibre @NatS You shouldn’t have to have excessive calories to do so. Just adjusting the proportions of your meals might help. You could look at the sample menu and adjust to suit your needs.

There are various books about the GI diet and maybe you could search out a few at your local library to see if anything in them can help. There’s also a lot of information online.

Good news that your 9am cortisol was ok 🙂 I hope that gets you closer to the answer. Various things can cause non-diabetic hypoglycaemia. Also, I think some people are just more sensitive to missing/delaying meals, not having snacks, etc.
 
I've been adjusting my diet over a few days and had 2 days of no lows 🙂 toast for breakfast this morning and I was at 3.7 within a few hours. So that's quite helpful and definitely looking in to the low GI diet info.

I have a question about the libre. Sometimes when I get a low notification or measure low it later doesn't appear on the daily graph. Is this normal? Or does the low only get recorded if it is for an extended period of time?
 
That’s really promising @NatS 😎 If some diet changes sort this - or at least reduce it down to a very occasional thing - that would be fantastic.
 
The Libre has an algorithm I believe with attempts to predict what your level will be in 10-15 mins ie to predict your BG reading rather than the interstitial fluid that it actually reads. The algorithm isn't perfect and consequently sometimes it corrects itself after it has given you a reading and therefore the graph doesn't show the hypo because the sensor realises that you probably didn't drop into the red after all and it's prediction was wrong. Did you double check the 3.7 Libre reading with a finger prick and if so, what did it show. My Libre will often show me below 4 when I am actually high 4s or low 5s.
 
Additionally in the ‘low events’ report (or whatever it’s called) only BGs that have stayed below 4 for 10 or 15 minites are counted I think.
 
Thanks for the information both.

Not got in to the habit of finger pricking yet. Going to make sure I have the monitor with me this week.

Thought of something else (sorry). My endo has said I don't need to monitor but originally told me to finger prick, hasn't given me a definite diagnosis and I know I go low. Am I right in thinking there are rules around driving and type 1? That people have to check their levels and can't drive below a level? What I'm wondering is if you have a patient who you know is going low for varying amounts of time, should you be advising them not to check their levels even if this would mean sometimes driving low? I appreciate with reactive hypoglycaemia levels will rise but is there a risk while low?
 
Yes, there is a risk if someone were to go so low their responses or alertness was impaired. Although there are certain medical conditions where you have to inform the DVLA of them, everyone - whether they have a medical condition or not - is responsible for ensuring they’re safe to drive.

If I were you, I’d be finger-pricking prior to getting behind the wheel. Apart from the legal implications, it could be dangerous for you and others.
 
Yeah good advice. I always have some easily accessible snacks with me and prior to the libre I'd have my monitor on the seat next to me so I wouldn't need to go hunting for it if I needed to measure but hadn't been routinely checking before driving.

So much to learn and think about, I really appreciate all the responses I've received.
 
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