Worrying this may mean my levels have crept up again

[Jenny65]

OK, so I wont know for sure until my blood test next week, but I fear my HbA1c may have crept up again as despite eating a healthy low carb diet and maintaining my weight loss some of the old symptoms have re-emerged again.

So today after lunch (omelette and veg) I couldn't keep my eyes open, I work from home and was meant to be at a teams meeting, but felt so weak and tired I had to excuse myself and then fell into a deep sleep, I woke up at 4pm and felt really shakey and hungry, I went down and had a low Cal chocolate options drink and a slice of rye seeded sour dough with some peanut butter and cheese, this will mean I have had closer to 1400 calories today rather than 1200 but I am happy with my weight loss, but what worries me that this sleeping after lunch is one of the things that happened before I lost the weight.

One other thing is I am waking up early, like 4-5am and wanting my breakfast, normally I would prioritise the extra sleep over eating but again this is what I did before I was diagnosed, I would wake up absolutely starving and go to the kitchen in the middle of the night to eat whatever I could find. I cant find my meter or would check it myself. but I am bracing myself for some bad results next week despite being very slim and healthier than I have been in a long time.

I wonder if the rose glow of following this has now gone, I never felt hungry for the last few months, in fact having to remind myself to eat I wonder if its a thyroid issue or maybe my body has woken up and thought, "hang on a minute this woman needs a good meal! lets release the ghrelin hormone and increase her appetite and make her shake until she eats something.

 

[Jenny65]

Im still waiting for my lipid clinic appointment too, which is a concern I was told it would be 6-8 months but its been almost 12 months now!

 

[Jenny65]

I googled my symptoms and it came up with this. I dont have any medication but have had very low carbs for the last few weeks, about 30g a day, and I craved the sourdough which I felt really guilty having but had a very small slice of it with the peanut butter. So it looks like my shakiness and hunger, also pounding head and sweating, could be the opposite of high blood sugar, but I thought you cant get this if not on medication and a type 2.

I know its probably not this but it did happen within 3 hours of eating my lunch.

Reactive hypoglycemia, sometimes called postprandial hypoglycemia, happens when blood sugar drops after a meal — usually within four hours after eating.

Symptoms of hypoglycemia may include:

• Shakiness.
• Dizziness or lightheadedness.
• Sweating.
• Hunger.
• A fast or uneven heartbeat.
• Feeling weak or tired.
• Feeling irritable or anxious.
• Headache.
• Confusion.

In people who have diabetes, insulin or other medicine that's used to lower blood sugar sometimes can lead to hypoglycemia after eating. A change to the medicine dosage may help.

In people who don't have diabetes, the cause of reactive hypoglycemia often isn't clear. But symptoms may be connected to what and when a person eats.

Other possible causes of reactive hypoglycemia include:

• Alcohol.
• Some surgical procedures, such as gastric bypass or other bariatric surgery.
• Metabolic conditions that are passed down in families, also called inherited metabolic disorders.
• Certain types of tumors.

 

[Callista]

I'm only writing this off the top of my head, and I'm a newbie to the whole Diabetes-world, but...

To be honest, wouldn't it be sensible to get another glucose monitor off the Internet and get it delivered ASAP, so you can start seeing what is objectively going on inside your blood?!

That way you have some objective measurements to go on, that may map to the symptoms you are experiencing and the food you are eating (or not eating.)

Please take this next bit cautiously, and I'm prepared to be shot down in flames by the experts and far more experienced folk on this list but...

Even if you are still overweight, even if you want your Hb1AC to come down, would it not be sensible/wise to eat far more 'normally' for the next three or four days, to see if those troubling symptoms abate. Maybe don't make a sudden big change, but just 'ease off' the hardline low carb etc?? Only do so with the glucose monitor, however, so you can make sure that you are not going hyper on the G front??

If you eat higher carbs in the next few says, it can't make much difference to your Hb1Ac test next week, as whatever glucose has bonded to your redblood cells has probably already done so - a few days isn't goin to make a massive amount of difference surely?

To my mind, it's the symptoms you are describing that are more worrying. I would do whatever it takes to moderate them and allay them.

Anyway, just my very 'inexpert' thoughts. Others here may have much more valuable and experience based suggestions/advice.

 

[Jenny65]

I'm only writing this off the top of my head, and I'm a newbie to the whole Diabetes-world, but...

To be honest, wouldn't it be sensible to get another glucose monitor off the Internet and get it delivered ASAP, so you can start seeing what is objectively going on inside your blood?!

That way you have some objective measurements to go on, that may map to the symptoms you are experiencing and the food you are eating (or not eating.)

Please take this next bit cautiously, and I'm prepared to be shot down in flames by the experts and far more experienced folk on this list but...

Even if you are still overweight, even if you want your Hb1AC to come down, would it not be sensible/wise to eat far more 'normally' for the next three or four days, to see if those troubling symptoms abate. Maybe don't make a sudden big change, but just 'ease off' the hardline low carb etc?? Only do so with the glucose monitor, however, so you can make sure that you are not going hyper on the G front??

If you eat higher carbs in the next few says, it can't make much difference to your Hb1Ac test next week, as whatever glucose has bonded to your redblood cells has probably already done so - a few days isn't goin to make a massive amount of difference surely?

To my mind, it's the symptoms you are describing that are more worrying. I would do whatever it takes to moderate them and allay them.

Anyway, just my very 'inexpert' thoughts. Others here may have much more valuable and experience based suggestions/advice.

Thank you for replying, I have found my meter, I am just waiting for the rain to stop so I can pop to the shop and get a new battery.

I have lost all the weight I needed to over the last 10 months and am now eating a healthy balanced diet, I mainly have 130g or less a day of carbs and 1200 - 1400 calories, I am 58 and quite short (5ft 4) so this amount is maintaining now, I fluctuate a little, go up a pound and then down the next week but on the whole I am around the 9 stone mark (I was 14 stone.4 in July 2022) and I have got my waist down from 41 inches to 30 so happy with how I am in that respect.

Over the last few weeks I have eaten the same calories but focussed on protein and fats and as a result had less carbs but this wasn't on purpose, just that I found they fill me up more and I haven't been checking with a meter as my HbA1c is now 40, so I suppose I am just wondering if this sleeping urge in the afternoon is a bad sign or just one of those things.

 

[Bloden]

Maybe eating more carb and using your BG meter, as @Callista suggests, are the way to go @Jenny65. Is 30g of carb too low? Or too low for your body and it’s letting you know? I hope a few simple tweaks to your diet stop the extreme tiredness. Well done for the weight loss, btw. 🙂 Brilliant!

 

[AndBreathe]

Thank you for replying, I have found my meter, I am just waiting for the rain to stop so I can pop to the shop and get a new battery.

I have lost all the weight I needed to over the last 10 months and am now eating a healthy balanced diet, I mainly have 130g or less a day of carbs and 1200 - 1400 calories, I am 58 and quite short (5ft 4) so this amount is maintaining now, I fluctuate a little, go up a pound and then down the next week but on the whole I am around the 9 stone mark (I was 14 stone.4 in July 2022) and I have got my waist down from 41 inches to 30 so happy with how I am in that respect.

Over the last few weeks I have eaten the same calories but focussed on protein and fats and as a result had less carbs but this wasn't on purpose, just that I found they fill me up more and I haven't been checking with a meter as my HbA1c is now 40, so I suppose I am just wondering if this sleeping urge in the afternoon is a bad sign or just one of those things.

I think you need to take a step back, start testing and make a few notes of what happens when. It is perfectly feasible you're just a bit off colour.

Alternatively, you could just have run out of fat to metabolise. As you know, I have long held concerns you aren't eating enough.

 

[Dragonheart]

I’ve got to say I agree that those calories sound very low and hunger and lack of energy would seem to back that up. I also agree and get testing to see what your levels are doing when you feel off and also what the carbs you are eating are doing pre and post meals to see if you’re happy at the current level of carbs. It may well be that you need to increase proteins and fats more if you’ve now lost the body fat you were previously using for fuel. Remember you need in date strips not just a new battery.

I’d do that this week as your diet stands now for a few days so you know what your baseline is to compare against changes otherwise you won’t know what difference the changes make

 

[Lucyr]

Have you considered that waking up at 4am might be why you’re getting tired in the afternoons rather than it being diabetes related problems etc?

 

[Lucyr]

Also, unlikely to be reactive hypoglycaemia. That happens when you spike high after a carby meal (ie not an omelette) and then crash too low afterwards.

 

[Callista]

Glad you found your monitor!

If you are now at your target weight (ie, have 'eaten' all your previously excess fat), then perhaps now you need to be in 'steady state' mode when it comes to food intake? (Sorry if I'm misunderstanding you and you already are?)

I assume for myself (pre-D too) that there will be two stages post-DX - the first (I'm still in it!) is to get my Hb1AC level down (ideally out of pre-D), by eating low-cal, low-carb to reduce my weight/fat, and to lower my BG levels. But once I'ce eaten all my excess fat (!) then I'll need to go into stage two (steady state), and find the right balance of cals and carbs to keep me stable and out of pre-D. I'm assuming (I hope!) that I can eat some more carbs than I currently do, and recognise that my body has no more 'spare fat' to munch on if my cals are low.

I'm not sure how many cals are 'steady state' for the 'average woman' (c 2k, is that it?) but of course each of us has our 'specific number' given our height/build and, crucially, activity level (ie, 'burn rate'!). I would think cals of 1200-1400 pd is 'under' but not by that much?? I tend to think it's doable without too much ghastliness - whereas dipping down to 1000 or under is pretty damn grim to achieve/sustain.

I definitely think that mapping food intake/exercise output to BG levels, and, of course, to your symptoms would be helpful.

I also agree that weird sleep patterns can be caused by other things!

 

[AndBreathe]

Glad you found your monitor!

If you are now at your target weight (ie, have 'eaten' all your previously excess fat), then perhaps now you need to be in 'steady state' mode when it comes to food intake? (Sorry if I'm misunderstanding you and you already are?)

I assume for myself (pre-D too) that there will be two stages post-DX - the first (I'm still in it!) is to get my Hb1AC level down (ideally out of pre-D), by eating low-cal, low-carb to reduce my weight/fat, and to lower my BG levels. But once I'ce eaten all my excess fat (!) then I'll need to go into stage two (steady state), and find the right balance of cals and carbs to keep me stable and out of pre-D. I'm assuming (I hope!) that I can eat some more carbs than I currently do, and recognise that my body has no more 'spare fat' to munch on if my cals are low.

I'm not sure how many cals are 'steady state' for the 'average woman' (c 2k, is that it?) but of course each of us has our 'specific number' given our height/build and, crucially, activity level (ie, 'burn rate'!). I would think cals of 1200-1400 pd is 'under' but not by that much?? I tend to think it's doable without too much ghastliness - whereas dipping down to 1000 or under is pretty damn grim to achieve/sustain.

I definitely think that mapping food intake/exercise output to BG levels, and, of course, to your symptoms would be helpful.

I also agree that weird sleep patterns can be caused by other things!

Maintenance eating is very personal - governed by all manner of factors, from the volume of the person, to metabolic rates, to pre-existing challenges and activity levels.

I'm short at 160cm, weigh under 50kg, but consume 2000-2500 calories a day, in a reduced carb way of eating. I routinely eat more than my OH, even though he plays golf 3 times a week and goes to the gym another 3.

When I up my activity levels, as happens when overseas and in summer (well, it's warmer and more comfortable to be outside for protracted periods), my requirements increase and/or I lose weight. On my return from a recent 3-month trip to SE Asia, I was averaging walking 10km a day, eating like crazy, but still came back at 44kg. Thankfully, I'm clawing back a little as that's too light for me.

The challenge of maintaining, whether it be weight or blood glucose ranges (and we should have an HbA1c range we can run in, in my view) is working it out in the first place, then sense checking it from time to time.

Almost 10yrs in, I'm getting the hang of it.

 

[EmmaL76]

If it helps, I have days like that all the time and my hba1c is fine. You could do with getting some bloods done. Thyroid, vit d, b12 and vit d. Also you don’t have to answer this but are you on any hormone replacement as that could be an avenue to explore. Can I just say that I’m absolutely disgusted that you still haven’t had your lipid clinic appointment. It’s really no where near good enough. I’m not surprised you’re tired. The amount of mental and physical effort you have put into yourself it’s must be exhausting… so if you wanna sleep through a zoom call, you do just that girl and give yourself a break you have been working so hard xx

 

[Jenny65]

If it helps, I have days like that all the time and my hba1c is fine. You could do with getting some bloods done. Thyroid, vit d, b12 and vit d. Also you don’t have to answer this but are you on any hormone replacement as that could be an avenue to explore. Can I just say that I’m absolutely disgusted that you still haven’t had your lipid clinic appointment. It’s really no where near good enough. I’m not surprised you’re tired. The amount of mental and physical effort you have put into yourself it’s must be exhausting… so if you wanna sleep through a zoom call, you do just that girl and give yourself a break you have been working so hard xx

Thank you for your lovely kind words Emma, you have a unique way of making people feel better about themselves and their situation.

The omelette I had yesterday was made by someone else and I discovered was a spanish omelette so had potatoes in it, it did feel very filling so maybe thats what caused me to feel so sleepy.

Today is a new day and I am back to my usual energetic self, managed to sleep in until 6.30am today! So no craving breakfast at 4am! I have had greek yoghurt and berries plus benecol for breakfast, I have allowed some carbs in the form of brown rice with some tandoori chicken and veg for lunch, for dinner I am having a home made veg soup and a small square of chocolate. This although comes to 1200 calories as I am maintaining I am allowing myself coffees etc with milk and possibly a glass of red wine and a cube of cheese. I have stopped losing now and only eating 1200 - 1400 a day which makes me think I have found my maintaining energy requirement.

I am not on HRT, I was put off going on this as my mum was on it for 20 years, was amazing for her AND gave her back her oomph but sadly she got ovarian cancer and I know there is a link to people on HRT for longer than 5 years but when this became known my mum had sadly been on it for 20 years from 50 - 70

I have been fairly lucky with the menopause to be honest, I have slightly dryer skin and the weight gain around my middle I beleive was connected too but in all honesty I havent really struggled with it. I sort of planned that my life would be different, I think the main issue I had was accepting I was now officially old! 🙂

On the shakey, hunger I woke with, this is something I recognise from when I was much younger, I also used to feel sick if I had a lie in, my sister was the same. She is the opposite of me though, she has always been very slim, 7 stone 4 and 5ft 5, can eat what she likes so I always assumed her shaking hunger rages were her fast metabolism, I was only in the 7 stone area up to 19 and then after that, went on the pill and went up to 8 stone and then got pregnant at 24 and gained 5 stone in weight, up to 13 stone, then lost 2 stone but always hovered around 10.10 - 11.10 until the menopause then I went up to over 14 stone and got diagnosed with diabetes. Sorry that was a long paragraph, I feel 9 stone is my perfect weight, I have a different figure to my sister, I have quite a large bust and slim hips but when overweight I had a huge tummy! now thats gone and I am just left with some loose skin but in clothes look OK.

 

[Jenny65]

Maintenance eating is very personal - governed by all manner of factors, from the volume of the person, to metabolic rates, to pre-existing challenges and activity levels.

I'm short at 160cm, weigh under 50kg, but consume 2000-2500 calories a day, in a reduced carb way of eating. I routinely eat more than my OH, even though he plays golf 3 times a week and goes to the gym another 3.

When I up my activity levels, as happens when overseas and in summer (well, it's warmer and more comfortable to be outside for protracted periods), my requirements increase and/or I lose weight. On my return from a recent 3-month trip to SE Asia, I was averaging walking 10km a day, eating like crazy, but still came back at 44kg. Thankfully, I'm clawing back a little as that's too light for me.

The challenge of maintaining, whether it be weight or blood glucose ranges (and we should have an HbA1c range we can run in, in my view) is working it out in the first place, then sense checking it from time to time.

Almost 10yrs in, I'm getting the hang of it.

I agree I think maintaining is harder than losing, its like holding your foot on the pedal to maintain a speed. I knew my energy maintenance would be lower than some as I am nearly 60 and quite sedentary, I do take walks and dance to a few youtube work outs but on the whole I am a sofa sloth 🙂

I weigh myself daily and the scales are staying around 9 stone now with my current intake of 1200 - 1400 calories, however having said that I do have the odd day, like special occasion where I will eat more. I am going to the Ivy with my daughter on Friday to celebrate her 28th birthday whilst her boyfriend attends a football party thing, so its a girls night out in Brighton, I am sure a cocktail or 2 will be consumed and maybe even something for dessert but back on track afterwards. I believe with the number of occassions in my family, birthday meals, weddings, parties, BBQs, Christmas etc, I will have one day a month when I eat a little more and relax my intake. I think it could be this that makes the 1200-1400 on other days work out. The meal I had last month was more than a days calories alone just for the main course!

 

[Callista]

I agree it's hard to 'steady state' ourselves. Shows, ironically, how hard the body can find it too, ie, to maintain homeostasis - especially when the variables start changing. And one variable that is never constant is, of course, our age....

 

[Sussexmax]

I weigh myself daily and the scales are staying around 9 stone now with my current intake of 1200 - 1400 calories, however having said that I do have the odd day, like special occasion where I will eat more. I am going to the Ivy with my daughter on Friday to celebrate her 28th birthday whilst her boyfriend attends a football party thing, so its a girls night out in Brighton, I am sure a cocktail or 2 will be consumed and maybe even something for dessert but back on track afterwards. I believe with the number of occassions in my family, birthday meals, weddings, parties, BBQs, Christmas etc, I will have one day a month when I eat a little more and relax my intake. I think it could be this that makes the 1200-1400 on other days work out. The meal I had last month was more than a days calories alone just for the main course!

Glad to hear that you think it was only a’blip’ and you’re feeling better today! You’ve clearly done brilliantly well and have got some fantastic results. I agree with you on weighing daily… I find it keeps me in touch with how I’m doing on the weight loss, and I find that really motivating even when I’ve seen a pound or two go back on! Like you my HbA1c has come down, but unlike you it’s been down with some meds! Also think that you’ve got to have nice occasions and meals out to look forward to! So enjoy the Ivy!!

 

[Jenny65]

Glad to hear that you think it was only a’blip’ and you’re feeling better today! You’ve clearly done brilliantly well and have got some fantastic results. I agree with you on weighing daily… I find it keeps me in touch with how I’m doing on the weight loss, and I find that really motivating even when I’ve seen a pound or two go back on! Like you my HbA1c has come down, but unlike you it’s been down with some meds! Also think that you’ve got to have nice occasions and meals out to look forward to! So enjoy the Ivy!!

Had a brilliant night but rather a lot of cocktails and kept getting lost coming back from the toilet

 

[Sussexmax]

Had a brilliant night but rather a lot of cocktails and kept getting lost coming back from the toilet

Great photos and I’m sure it was a lovely meal and evening! The food looks delicious!