Dealing with hypoglycemia

[[DHT]Osiris]

Alright internet dieticians, I've got something I'm wrestling with that I'd love some anecdotal accounts, or suggestions for, ahead of a visit to an endocrinologist I've got coming up.

I get extremely hypoglycemic ahead of meals, mainly if I'm eating late, even by just a few minutes. When I say hypoglycemia I'm talking queasy, borderline vomiting, bout to pass out, shakey, tingly skin... Eating little bites of things (nuts, cheese, etc) sometimes staves it a bit, generally just makes be feel sicker though (stomach cramps, indigestion). Drinking something sugary doesn't help, just makes me feel more gross.

Doesn't stop until I eat an actual meal, like with heat applied to it, served on a plate, etc. Then I'm usually good within a few bites.

Now I don't have a history with diabetes and I'm not showing specific symptoms of prediabetes/diabetes, though I'll let the endo investigate that one. The fact that I can eat an equivalent caloric content of little nibbley things to an actual meal and still feel sick sounds a lot like something physiological but I can't put my finger (or Google) on what.

I'm familiar with things like pre-meal insulin dumping, and as a general rule I avoid heavy carb meals (the occasional pasta plate notwithstanding), so I'm not overly confident that's a factor here but I'm open to suggestions. Most of my meals lean heavy on fat and protein. I'm not currently keto but I'm closer to that than a standard American diet. My average daily calorie intake is in the 1500 range (currently working on losing some extra lbs). 5'9", around 205lbs, working out 6x a week (as injuries permit).

So what gives? Am I prediabetic with non-classical symptoms? Am I dying faster than expected?

 

[Pohemi]

Doesn't stop until I eat an actual meal, like with heat applied to it, served on a plate, etc. Then I'm usually good within a few bites.

Immediately feeling relief within the first few bites? If so, that doesn't strike me as remedying hypoglycemia, it doesn't happen that quickly (though as a T1D, I wish it did). Even when I use glucose tablets to remedy a low, it still takes at least 10-15min for me to start feeling better. And that's the fastest option other than a glucagon injection or glucose through an IV. In the meantime, I want to eat my entire kitchen.

I recognize some of the symptoms you listed though, and they track. I'm curious what your endo will say about it.

 

[[DHT]Osiris]

Immediately feeling relief within the first few bites? If so, that doesn't strike me as remedying hypoglycemia, it doesn't happen that quickly (though as a T1D, I wish it did). Even when I use glucose tablets to remedy a low, it still takes at least 10-15min for me to start feeling better. And that's the fastest option other than a glucagon injection or glucose through an IV. In the meantime, I want to eat my entire kitchen.

I recognize some of the symptoms you listed though, and they track. I'm curious what your endo will say about it.

Thanks for commenting. Yeah that was my understanding about glucose tablets as well, hence my confusion. To be clear if I end up in that state it takes hours before I feel normal again, but I have relief almost as fast as I can swallow my first bite.

Side note, I can't eat fruit (fructose allergy) and basically never have exclusively sugary stuff (desserts once or twice a year, very few things like potatoes, pastas, zero sodas, candy, etc).

 

[Heartbreaker]

Get glucose monitor and check that it's blood sugar. Maybe it's just some kind of hunger hormone overload.

 

[Pohemi]

I second that idea. Worth it to potentially eliminate a possibility (or to confirm it).

If your Endocrinologist doesn't have a meter that they can give you in-clinic, you can probably get one covered through insurance if they send a script for one to your pharmacy. Worst case, Walmart has 'Reli-On' branded meters for super cheap. I believe they're made by Freestyle. Strips are always the biggest expense with a glucose monitor.

 

[[DHT]Osiris]

Strips are always the biggest expense with a glucose monitor.

I see what you mean, printer ink syndrome, cost of test kit and strips is almost the same.

 

[Heartbreaker]

Test kit usually has a few strips to get you started, which should be enough to get some idea what is going on.

 

[igor_kavinski]

Keep dates handy. Quickest way to get some energy production going in your system. Bananas are also good but may take a little more time than dates. (Sorry. Just read about your fructose allergy)

I hope the endo doesn't find anything bad. Seems like a symptom of something not good, having to do with pancreas. Sometimes tiny tumors on pancreas can cause it to excrete too much insulin.


If that's the case, it's probably inoperable (though I hope not for your sake). You could go on a keto diet for a few weeks. That should be enough for the tumors to shrink. But again, this is all speculation. Stay positive and hopefully it's just something easy to fix.

 

[[DHT]Osiris]

Keep dates handy. Quickest way to get some energy production going in your system. Bananas are also good but may take a little more time than dates. (Sorry. Just read about your fructose allergy)

I hope the endo doesn't find anything bad. Seems like a symptom of something not good, having to do with pancreas. Sometimes tiny tumors on pancreas can cause it to excrete too much insulin.

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If that's the case, it's probably inoperable (though I hope not for your sake). You could go on a keto diet for a few weeks. That should be enough for the tumors to shrink. But again, this is all speculation. Stay positive and hopefully it's just something easy to fix.

Yeah, sucks because I used to like dates and bananas, lost that one about a decade back.

I suspect it's not something as dire as that but I'm of an open mind. Occam's razor, I likely need to restrict my carb intake to limit how much my insulin spikes prior to meals, and get my weight down.

 

[igor_kavinski]

get my weight down.

If your work involves doing something mind numbingly boring and involves a lot of sitting and you don't really need to think fast, it's pretty easy to lose weight by just eating green salad (without starches) and nuts (walnuts/macadamia/pistachios are best) and drinking lots of water. It will be hard sticking to just these foods but you will lose weight quite quickly this way. Important thing is not to fill your tummy. Eat just to quench hunger, even if it's five meals a day, each about one third your regular meal.

 

[Pohemi]

Occam's razor, I likely need to restrict my carb intake to limit how much my insulin spikes prior to meals, and get my weight down.

Restricting carbs is a good plan in any case. If you're consuming carbs at mealtime, your pancreas should be giving you insulin within 10-15min or less. There's no reason it should be spiking your insulin hours later.

The thought did occur to me though, perhaps your pancreas isn't "shutting off the insulin drip" after it's secreted enough. It does seem odd to me that it's always just before mealtimes that you feel like it's dropping. That's why I'm curious about what your endo might say.

 

[[DHT]Osiris]

If your work involves doing something mind numbingly boring and involves a lot of sitting and you don't really need to think fast, it's pretty easy to lose weight by just eating green salad (without starches) and nuts (walnuts/macadamia/pistachios are best) and drinking lots of water. It will be hard sticking to just these foods but you will lose weight quite quickly this way. Important thing is not to fill your tummy. Eat just to quench hunger, even if it's five meals a day, each about one third your regular meal.

Oh trust me I've been doing right by myself for a while now, diet for three years (calorie restrictive, around 1250/day), working out for a year now or so (str training, yoga, pilates, light cardio, etc). I was down about 40lbs at one point, back up about 10 now though.

Dieting sucks, the consequences are worse though.

Restricting carbs is a good plan in any case. If you're consuming carbs at mealtime, your pancreas should be giving you insulin within 10-15min or less. There's no reason it should be spiking your insulin hours later.

The thought did occur to me though, perhaps your pancreas isn't "shutting off the insulin drip" after it's secreted enough. It does seem odd to me that it's always just before mealtimes that you feel like it's dropping. That's why I'm curious about what your endo might say.

Sorry, to be clear I don't feel low for hours, I just feel like crap... Like flu symptoms, general fatigue, post-harsh-workout kind of crap.

If I ate more carbs I'd say it was predictive insulin dumping but I don't really. I'm curious what they say too.

 

[igor_kavinski]

If I ate more carbs I'd say it was predictive insulin dumping but I don't really. I'm curious what they say too.

If you were eating more fat, you would be in ketosis with a 1250 calories diet. But I suspect you eat protein more. The bad thing about that is it stresses your liver more, probably stresses your pancreas too due to creating more protein digesting enzymes and protein is more likely to cause cancer: https://thepaleodiet.com/protein-fasting-and-the-mtor-pathway/

A 2014 study published in Cell Metabolism drew similar conclusions: the authors suggested that moderate to high protein consumption increased the activation of mTOR (via IGF-1, an “upstream signaler” [7]) and the likelihood of cancer for individuals aged 50-65. However, it also stated that this finding changes at age 66. Above that age, the authors noted a 28 percent reduction in all-cause mortality, and a 60 percent reduction in cancer mortality, also irrespective of protein source, in the high-protein cohort.

Your protein powered diet would be more beneficial at and after age 66.

 

[[DHT]Osiris]

If you were eating more fat, you would be in ketosis with a 1250 calories diet. But I suspect you eat protein more. The bad thing about that is it stresses your liver more, probably stresses your pancreas too due to creating more protein digesting enzymes and protein is more likely to cause cancer: https://thepaleodiet.com/protein-fasting-and-the-mtor-pathway/


Your protein powered diet would be more beneficial at and after age 66.

Calorically it's probably leaning more in the direction of fat over protein if I were to add it up I'd wager. I've done keto and my body responded very well to it. It's harder to do at this stage of my life because it would necessitate me making completely separate meals at all times, in addition to the energy drop being non-conducive to my duties at home. That said I don't restrict my carbs enough to go fully keto (<25g roughly/day) but I'm probably close to it.