Non-diabetic hypoglycemia

I know! Ive been trying to get help for almost a year and no one knows whats going on. They run a bunch of tests and they come back clear. Im a little overweight 240 lbs 5’11, so snacking often is what I have to do but its not a good thing either, ive already gained 15-20 pounds since I got this. 

Hey Wes, that's probably more than a little overweight, by modern standards, unless you're built like a bull.

I had a situation for a couple of years before I was diagnosed diabetic.  My BG numbers weren't bad, but I gained twenty pounds and just could not lose them.  Then I had a crisis, my numbers went crazy very suddenly.  Started taking metformin and insulin for a while, and lost the weight, quickly.  Was able to stop the insulin but stayed on the metformin.  So the lesson here, I think, was that my metabolism was just screwed up.  In my case probably should have started on the metformin - and carb counting - a lot earlier.

So let's see what else we can ask.  WHAT do you eat and snack on?  Have you learned how to count carbs like a diabetic?  There's something called the "glycemic index" which is kind of secondary but seems to be involved with "reactive hypoglycemia" that I think is more common with diabetics - but you might have something like it.  You want to avoid "fast" sugars, avoid white bread and white rice and white potatoes - and anything fried.  Avoid candy of course, also avoid fruit juice.  Somehow whole fruit, in modest amounts, is OK.

It's the fast spikes of sugar that seem to trigger excess insulin and can send the BG down too low.

So protein is fine, salad is fine, cheese is fine, eggs are fine, one or two pieces of whole wheat bread are fine, a tiny amount of brown rice is OK, corn chips, especially blue corn, has a higher index, that is slower to digest and safer to eat.

And ALL meals should be kept to a rather low carb limit.  Diabetics usually try to keep the number really low, but not always.  My theory (!) again is that it's the BIG spikes that cause problems.  Keep your carb count below 100 to start, below 75 is better, and below 60 probably getting into a good range.

How much of a change from your current diet do you think that all would be?

I said a little because despite my bmi I don’t look overweight and I have an athletic build. Yes, I do eat a lot of carbs, and I’ve also tried a keto diet (low carb, high protein) for a couple of weeks,  I cut out a lot of the foods you mentioned.  Everyone said it was supposed to help my situation, but it made it worse. Once I began eating carbs again I felt a little better. I should also mention I got the drops when I go for 4-6 hours without eating, if i eat a meal (even a high carb meal) I’m ok afterwards. It seems to be more of a fasting issue. This morning I had one serving of oatmeal and an ensure, An hour or two later I walked about a 1 mile and then bam  Sugar drop .

Wes, ouch!  Well, that's probably about 40 carbs total.

So let's see, you say "sugar drop", is that from an actual measurement, or is it because you felt horrible?  Just have to ask, y'know.

So that can be because you have too much insulin, or because you have not enough sugar - or the sugar is being removed somehow.  Hmm.  There are drugs that they give diabetics to facilitate this, and here you have it going on naturally. Too bad you can't sell some on Ebay or something, LOL. 

And you are gaining weight, so it's not like it's somehow all dumping right back out again.

Is the weight at least evenly distributed, or is it excessively in the waist?  Belly fat, the brown fat in the belly, is the worst kind.  And I gather from my endo that there are specific treatments for it.  Although you can also try eating avocados for this, apparently it seems this might be a specific for reducing belly fat.  Strange as that sounds.

Even more speculatively there are all kinds of talk now about intestinal bacteria that we all have, that does a lot of our digestion and immune functioning, and is only barely understood.  I wonder if some kind of "cleanse" might be worth a try.  Or at least a few probiotics.  There are even resets with "clean" bacteria, used experimentally for some issues.

So IOW I really don't know.  Can you get your doctor to somehow escalate your case up to some major center or university that might know or care about such cases?

 

I'll tell you what though, on the diet, if 40 carbs are not doing it for you, have a little more.  My endo put me on a 60-75 carb diet and you're a bit (!) larger, so you should need like 70-90 carbs per meal, easy.

Would suggest some more protein too, and a bit more fat.  An egg or two, even a breakfast sandwich.

And most important, at least as an experiment - some fruit, an apple or some watermelon especially - I'm suggesting some high fructose fruit.  Fructose is processed differently from glucose (and sucrose - white sugar, is an equal amount of both).  Fructose is processed through your liver more slowly, and does not use insulin.

I don't know the glycemic index for Ensure.

Oh wait, I just looked it up - OMG, it says 50 carbs and all sugar!  That is JUST WHAT YOU DON'T NEED.  So you were getting 50 + 20 carbs, but BAD carbs.  Check the specific kind you had, of course.  But the site I looked at has a very high glycemic index, which you need to avoid.

Thanks for the tips! Im going to try the high fructose and try to balance those carbs.  Yes it is in fact dropping usually it’s around 60 or sometimes 50-something but Ive never really checked when I start shaking because I can only think about eating food, It happens so fast. I’m moving out of state so I’ll be getting a second opinion when I find a new doctor.  Thanks again! 

And no more ensure for me!

Wes, one or two more things, then.  First don't go overboard on the fructose, just an apple or one-cup serving of watermelon, per meal.  Too much fructose apparently is a bad thing, diabetic or not.  There was a lot of fuss about fructose about fifteen years ago.

I should have asked earlier, do you have numbers for your cholesterols, triglycerides, and uric acid?  All should be checked with any kind of sugar conditions, they are standard blood test items.

 

Ok, noted. No I have no idea. I’m not even sure if anyone checked for that, will ask doctor. Thanks again jx.