Dr. Hive - hypoglycemia, endocrinologist, glucose meter...

[Kassia]

I've been having symptoms of blood sugar crashes pretty much every afternoon.  I was at the doctor's office today getting stitches removed and talked to her about my symptoms and she wanted to get a reading from the glucose monitor in the office.  It was 110 - about an hour after I ate lunch.  She thought that was low for eating recently and referred me to an endocrinologist.  

I don't know anything about blood sugar or what an endocrinologist would even do for me.  Can anyone here tell me if 110 an hour after eating is lower than expected?  My doctor thought it should be quite a bit higher.  My blood pressure runs low, too, if that matters - it's always around 98/60.  

[Katy]

No, 110 an hour after eating is not too low.  If it was lower than 70 that would be a concern.

Extremely healthy, fit people typically rarely get above 100.

The guideline for pregnant diabetics is to keep your blood sugar between 70-135.

I wouldn't bother with the endocrinologist just yet.  I would just go get a blood sugar meter at a pharmacy (choose the one with the cheapest strips - Walmart will have the best deals).  Check your blood sugar before and after meals at designated intervals.  Chances are the symptoms you are feeling is the beginning of insulin resistance - your blood sugar goes a bit too high, your body puts out too much insulin, and then you feel those symptoms not because your blood sugar is low, but because it is suddenly rapidly dropping. The solution to that is to use less insulin by either intermittent fasting or eating lower carbs, but again I wouldn't mess with that without using a meter first.  Especially because 30% of people also need to avoid saturated fat, and you cannot know that without a meter to see how a food works for you.

Dr Jason Fung has a couple of books, a blog, and a YouTube channel that can explain the science.

[Pawz4me]

I don't think my blood glucose has ever been above 110. Is that really considered low??? I have a strong family history of diabetes, so I do check it occasionally, both fasting and after eating. It never occurred to me that could be considered a low reading.

I've also always had low BP (I've startled quite a few nurses and CNAs over the years!), although it's steadily rising a bit as I age. It's never bothered me. My understanding is that as long as you're not having any symptoms then it's not a problem, but that if it is causing symptoms it should be looked into.

Edited October 1, 2018 by Pawz4me

[Kassia]

2 hours ago, Indigo Blue said:

 

What does seem to help ME (not saying this would necessarily be good for you) is to drink a lot of water in the morning and eat something salty. It's really amazing how much better it makes me feel. Generally, I've found that staying hydrated, not skipping meals, making sure to get sodium (not too much but a steady amount during the day), taking multivitamins from whole foods (I can't take synthetic ones), iodine and magnesium through the skin, and trying my best to get a regular and adequate amount of sleep helps tremendously all around. I don't have a problem with blood sugar crashing; it seems to be related to low BP for me

I think you should definitely have it checked out. Maybe it's not so much a blood sugar crash as it is a drop in blood pressure that's giving you your symptoms??

 

It definitely feels like a blood sugar crash for me.  I get shaky, irritable, weak, and fatigued.  Sometimes I start getting sweaty and my heart will pound.  And it happens around the same time each day.  My doctor did recommend eating more salt for my BP, though, and I do notice that I feel better sometimes when I start drinking more.  Sometimes I'll even eat Jell-O and it will help - must be the fluids.  I have chronic insomnia so sleep never happens.  

 

1 hour ago, Pawz4me said:

I don't think my blood glucose has ever been above 110. Is that really considered low???

 

She thought it was low because I had just eaten.  Otherwise 110 wouldn't be low.  But I didn't expect 110 to be considered low even if I had recently eaten.  I don't know anything about blood sugar levels.

[RootAnn]

I only know the fasting & one hour post sugar-dump numbers for the glucose test in pregnancy. 110 was in the zone for the one hour test.

I have been thinking of picking up a meter because I feel like my sugars run high in the a.m. Guess I should do that one of these days. (I was supposed to get my dad's meter. I don't know what my mom did with it.)

[Kassia]

23 minutes ago, RootAnn said:

 

I have been thinking of picking up a meter because I feel like my sugars run high in the a.m. Guess I should do that one of these days. (I was supposed to get my dad's meter. I don't know what my mom did with it.)

 

I really hate to purchase the meter and strips just to see if I'm hypoglycemic.  It would be interesting to see what the results are when I feel really bad, though.

 

[AK_Mom4]

1 hour ago, Kassia said:

 

I really hate to purchase the meter and strips just to see if I'm hypoglycemic.  It would be interesting to see what the results are when I feel really bad, though.

 

$20 at Walmart or CVS or Kroger for a meter that comes with either 10 or 20 test strips (depending on the brand).  That’s a pretty reasonable price to find out if your blood sugar is actually going low in the afternoons.  And you can just take the meter in and show it to the Endo at your appointment - they are very familiar with these devices.

”Low” is under 70.  Definitely not 110.

[Soror]

ITA with the others 110 is not low, that's good. If it feels like a crash perhaps your numbers are running higher at other times and it just feel low relative to where it usually is. I think some testing would be a good idea but I sure wouldn't be stressing about it or seeing an Endo, I have a feeling they would laugh you out of their office.

[Kassia]

7 hours ago, AK_Mom4 said:

$20 at Walmart or CVS or Kroger for a meter that comes with either 10 or 20 test strips (depending on the brand).  That’s a pretty reasonable price to find out if your blood sugar is actually going low in the afternoons.  And you can just take the meter in and show it to the Endo at your appointment - they are very familiar with these devices.

”Low” is under 70.  Definitely not 110.

 

28 minutes ago, soror said:

ITA with the others 110 is not low, that's good. If it feels like a crash perhaps your numbers are running higher at other times and it just feel low relative to where it usually is. I think some testing would be a good idea but I sure wouldn't be stressing about it or seeing an Endo, I have a feeling they would laugh you out of their office.

 

I didn't think 110 was low either.  In fact, when the nurse showed me the number, I just got up and was ready to go thinking that everything was fine but she said I had to wait for the doctor.  When the doctor told me she thought the number should be higher and she was referring me to an endocrinologist, I was really confused because I assumed 110 was right where it should be even if I had just eaten.  

[J-rap]

My blood glucose levels have never been low as far as I know (I think I only ever had it checked during pregnancies??), but I do get that sugar crash.  I used to have it regularly.  I'd feel so sick and shaky, I'd have to lie down on the floor and close my eyes and not talk, and my hands would literally shake.  Eating something right away usually helped, along with a glass of water.  That rarely happens anymore though -- maybe once/year now, and I think it has to do with my diet changing.  I eat much less sweets and carbs these days.  Also, I don't need to eat as often.  I used to be a grazer (when I was younger and needed to consume more calories), and if I waited too long between eating, it would also be more prone to happen.  I'm still a little sensitive that way so if I feel a gnawing hunger, I'll have some cheese and crackers or half a piece of peanut butter toast or something along those lines.  I think something with protein helps.

[PeterPan]

Have they run a basic panel on you with fasting glucose and an Hba1c?

[Kassia]

4 hours ago, PeterPan said:

Have they run a basic panel on you with fasting glucose and an Hba1c?

 

Not fasting but that's my fault because I haven't gone in yet for that.  Hemoglobin A1C was normal (5.3%) and nonfasting serum glucose was 100 when I had blood work done in August.  

 

 

[Kassia]

5 hours ago, J-rap said:

My blood glucose levels have never been low as far as I know (I think I only ever had it checked during pregnancies??), but I do get that sugar crash.  I used to have it regularly.  I'd feel so sick and shaky, I'd have to lie down on the floor and close my eyes and not talk, and my hands would literally shake.  Eating something right away usually helped, along with a glass of water.  That rarely happens anymore though -- maybe once/year now, and I think it has to do with my diet changing.  I eat much less sweets and carbs these days.  Also, I don't need to eat as often.  I used to be a grazer (when I was younger and needed to consume more calories), and if I waited too long between eating, it would also be more prone to happen.  I'm still a little sensitive that way so if I feel a gnawing hunger, I'll have some cheese and crackers or half a piece of peanut butter toast or something along those lines.  I think something with protein helps.

 

Yes, that's what happens to me sometimes.  My hands will literally shake, my eyes get heavy, my face feels tingly, and I get overwhelming fatigue and irritability.  I do graze - I have small snacks all day and rarely eat a meal.  Protein doesn't seem to help the symptoms when it happens, though.  I love having eggs for dinner and sometimes I'll actually feel worse after eating than I do before.  And I'm careful to make sure I eat plenty of protein throughout the day.

[umsami]

There's a new type of flash blood glucose monitor which might give you some better answers than the standard finger prick.  It's the Abbott FreeStyle Libre.  It's a sensor that you insert on your arm (not painful) and then you scan it with a device to see your blood sugar.  Sensors used to last for 10 days, but new FDA clearance is 14 days.  There is a savings card (SingleCare --it's free)  that can help with the cost of sensors big time.  Insurance may not pay for it, but it would probably give you the clearest picture of what is going on.  The reader is $60-$80 and then you can get a 3-pack of sensors for about $60 with the card, if memory serves.  You should also order some Skin Tac as well as some Tegaderm bandages or KT tape to go over the sensors.