Hypo-Glyceima ?

[Sacamuelas]

Reading Eagle's post made me think my original post might have been misinterpreted or just explained poorly by me.

What I meant in that post about being slightly overweight was referring to the timeframe before her recent 30+ lb weight loss. 5'5" and 135 works for me. I didn't want you to think I was criticizing your squeeze Joe.

Does that help clarify what you were asking about as well Bdonham?

The 5'5" and 175+ consistently for several years as a teenager/young adult is more in line with a typical type II/pre type II profile. As far as age, it seems to be a trend that the onset age is getting lower.... that age part is speculation based on my experience-not scientificly proven fact FWIW.

As to hypoglycemia in nonmedicated Type II's, it can and does happen. This is especially true in someone who is exercising, drinking caffeine products, and skipping a meal or two time. I agree though that it is more common in your listed examples.

Again, I wish her the best Joe.

[DoctorDoom]

x

[Smokin Joe]

Thank you all very much.

Your advise has helped put alot of myth and speculation on our part to rest.

She got to see her doctor ealier than expected. He basically said that seeing how she has lost so much weight in 8 to 9 months and that this was not an issue until she lost her weight that he would keep an eye on it but that is should really scare her b/c its just her body adjusting to the weight lose while trying to maintain so sort of routine and stability. Or something to that effect.

Unfortunatley I wasn't there I got a ragging case of the flu and my head still isn't totally straight.

I will post more when I'm more coherent.

Thanks again for everything guys you seriously put a big calm on my nerves

[Smokin Joe]

NDD,

I she shoots me in that ass with a bb gun you will be the first person I call and Roguish Lawyer with be the second person I call.

[Smokin Joe]

Okay guys here are the results that I got (from the missus).

Gulcos tolerance test.
she had to fast.
It took about 3 hours.

70 when she walked in the door
drank glucose
she spike at 135
then hit 120
then dropped to 70
then dropped again 55 (which was the last reading) she said when she was at 55 she thought she was going to pass out.

Eagle she is not pregnant, well if she is she hasn't told me yet.

Sacamuelas,

She is not taking any diet pill she lost all of her wait on the weight watchers diet/plan.

[18C/GS 0602]

The American Diabetic Association criteria for diagnosing diabetes include three different ways to make the diagnosis

1. symptoms of diabetes (increased urination, increased thirst, and unexplained weight loss) and a random glucose over 200 mg/dl
2. a fasting glucose (no food intake for over 8 hours) over 126mg/dl
3. a 2-hour glucose above 200 mg/dl during a oral glucose tolerance test (OGTT) using a 75 gm oral glucose load.

Your wife does have symptoms that are seen in diabetes but does not have a random (no relation to meals) glucose test that is above 200 so she does not meet criteria 1. Before OGTT you have to fast, and from your post her glucose value when she walked in the door was 70 which is below the 126mg/dl limit so she does not meet criteria 2. None of the values that you listed after she got the oral glucose load was above 200mg/dl cut off that is listed in criteria 3 so she does not meet that criteria either. So by the ADA guidelines she does not have diabetes.

Common factors that non-specifically deteriorate the OGTT include (1) carbohydrate restriction (150 g for 3 days), (2) bed rest (days) or severe inactivity (weeks), (3) medical or surgical stress, (4) drugs (5) smoking during the test, or (6) anxiety from repeated needlesticks. If any of these factors apply the OGTT she took may not be accurate.

In addition to diagnosing frank diabetes the OGTT can also diagnose something called impaired glucose tolerance which is defined as a fasting glucose less than 126 mg/dL and a 2-hour OGTT level between 140 and 200 mg/dL. Although your wife does not meet these criteria, her high value of 135 does come close to the cut off of 140. Impaired glucose tolerance (IGT) is thought of as a precursor to frank diabetes, but we can not reliably predict which people with IGT will go on to develop diabetes. The treatment for IGT is a good well balanced diet, exercise, and continued surveillance for any signs that things are progressing towards diabetes. Given what you have already said she is already doing these things, so she is ahead of the game so to speak when it comes to preventing diabetes.

Normal blood glucose ranges from 70 to 100 and her last value of 55 is considered hypoglycemic. I don’t really understand why it keeps dropping so I will do some reading and maybe one of the other health professional can enlighten us.

[Smokin Joe]

Thanks bdonham

[18C/GS 0602]

When her glucose was 55 during the OGTT and she felt like she was going to pass out did anyone give her glucose and if they did, did it relieve her symptoms? When she had the other low readings 40 and 55 did her symptoms get better when she was given some glucose?

[Smokin Joe]

She has never recieved any glucose.

When she was at 43 when she first went in for a needle stick, it was a bad read they didn't cover the slide (or whatever you call it) with enough blood.

When she bottomed out at a 55 she said she felt like she was going to pass out she barely made it to her car where she at a fruit granola bar. Then went home and had lunch.

[Smokin Joe]

My personal feeling is that all of the tests that she has gone through have had half-ass'd supervision. Meaning they haven't watched here closely nor did they ask her how she felt when she was at a 55. It pissed me off when she told me she thought she was going to pass out just walking to her car to get her fruit garnola bar. I mean damn she's in a hospital you would think they would ask her how she felt when they saw her glucose level at 55 but they just sent her on her way.

[18C/GS 0602]

Smokin Joe-

Sorry to hear about your bad experience with the hospital. Unfortunately some hospitals are better run than others and you might be well advised to look for a different hospital.

I did some reading a maybe some of this will help. To meet a medical definition of hypoglycemia you must meet 3 criteria. First you must have a symptoms of low blood glucose. Second you must have a low blood glucose reading before any administration of glucose (anything with sugar in it), and third the symptoms of low blood glucose must go away when glucose/sugar are administered. It sounds like your wife might actually meet these criteria if when she had this most recent episode of low blood glucose.

If this is the case there are many different causes of diabetes that your doctor should rule out.

One thing I did find in my reading that does seem to fit the picture is something called postprandial reactive hypoglycemia. This is hypoglycemia that occurs after meals. Essentially what happens is that after a meal your blood glucose levels go up and your body overreacts and releases too much insulin which causes the glucose level to go down below normal. This can be seen in people that have recently lost weight which causes them to become more sensitive to insulin. The treatment for this is a good diet and time to allow your body to adjust. This is only my interpretation of what you have told me and you definitely should talk to and follow your doctor’s advice.

Here is an abstract of a relevant article.


Authors
Brun JF. Fedou C. Mercier J.
Title
Postprandial reactive hypoglycemia. [Review] [148 refs]
Source
Diabetes & Metabolism. 26(5):337-51, 2000 Nov.
Abstract
Postprandial reactive hypoglycemia (PRH) can be diagnosed if sympathetic and neuroglucopenic symptoms develop concurrently with low blood sugar (<3.3 mmol). Neither the oral glucose tolerance test (OGTT) nor mixed meals are suitable for this diagnosis, due to respectively false positive and false negative results. They should be replaced by ambulatory glycemic control or, as recently proposed, an hyperglucidic breakfast test. PRH patients often suffer from an associated adrenergic hormone postprandial syndrome, with potential pathologic consequences such as cardiac arrhythmia. PRH could result from (a) an exaggerated insulin response, either related to insulin resistance or to increased glucagon-like-peptide 1; (b) renal glycosuria; (c) defects in glucagon response; (d) high insulin sensitivity, probably the most frequent cause (50-70%) , which is not adequately compensated by hypoinsulinemia and thus cannot be measured by indices of insulin sensitivity such as the homeostatic model assessment. Such situations are frequent in very lean people, or after massive weight reduction , or in women with moderate lower body overweight. PRH is influenced by patient's alimentary habits (high carbohydrate-low fat diet, alcohol intake). Thus, diet remains the main treatment , although alpha-glucosidase inhibitors and some other drugs may be helpful. [References: 148]

[Smokin Joe]

Thanks bdonham, I will pass this on to her and have her pass it on to her DR.

Thanks again for the help.