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Prediabetes, hypoglycemia, and American healthcare
Darkewolfe
Registered User regular
Registered User regular
I went to the doctor recently and walked out having some blood and urine tests run. A few days later when the results came in, my doctor was too busy to talk directly to me (and I fully intend to change doctors, but this is a recurring trend I have had with primary care) but the nurse relayed the test results. The nurse said, and I pretty much quote, "Your tests came back normal, no infections. You have pre-diabetes. Cut carbs, exercise more, and come back in three months." That was the extent of her advice and the end of the conversation. So, while I set out to find a different, more helpful doctor, I also figured this was a fairly well covered topic online and did my research.
I'm a pretty active guy in pretty reasonable shape, a little pudge but not a ton. I often cycle at least 60 miles a week, and I run 5k's occasionally. So my research suggests I've got a crap diet and I just got lucky with a genetic predisposition to insulin resistance/diabetes. So I've been aggressively eating healthier, completely cut beer and added sugars out of my diet, drastically reduced carbs, stepped up the green veggies, switched most meat to smaller portions of chicken or fish. I also started running a minimum of 1 mile, usually doing an hour of cross fit at least 3 times a week. So I've been making good progress, I think, for about two weeks now (so not a long, long time.)
I decided to get a blood testing kit, since I'm insanely curious at this point how I'm doing and whether I ought to go back to the doctor, like, next week, or in a month when I've given the lifestyle changes more time to work. I just tested my blood having eaten a meal about 5 hours ago, and I have a glucose level of 65 mg/dL. The internet tells me this is hypoglycemic, and possibly the result of my exercise and eating. This morning I had an hour long crossfit class and my heart rate monitor suggests I burned about 1000 calories.
So... here's my question. What's the deal with hypoglycemia? I'm going to call my existing doctor this week, since getting a new one wouldn't get me any answers for more than a week. I know the automatic response is "talk to your doctor," which I absolutely intend to do, but does anyone have any background info/wisdom to dispense here?
tl;dr 65 mg/dL glucose level after 5 hours of fascinating during aggressive diet monitoring and workout. What it do?
I'm a pretty active guy in pretty reasonable shape, a little pudge but not a ton. I often cycle at least 60 miles a week, and I run 5k's occasionally. So my research suggests I've got a crap diet and I just got lucky with a genetic predisposition to insulin resistance/diabetes. So I've been aggressively eating healthier, completely cut beer and added sugars out of my diet, drastically reduced carbs, stepped up the green veggies, switched most meat to smaller portions of chicken or fish. I also started running a minimum of 1 mile, usually doing an hour of cross fit at least 3 times a week. So I've been making good progress, I think, for about two weeks now (so not a long, long time.)
I decided to get a blood testing kit, since I'm insanely curious at this point how I'm doing and whether I ought to go back to the doctor, like, next week, or in a month when I've given the lifestyle changes more time to work. I just tested my blood having eaten a meal about 5 hours ago, and I have a glucose level of 65 mg/dL. The internet tells me this is hypoglycemic, and possibly the result of my exercise and eating. This morning I had an hour long crossfit class and my heart rate monitor suggests I burned about 1000 calories.
So... here's my question. What's the deal with hypoglycemia? I'm going to call my existing doctor this week, since getting a new one wouldn't get me any answers for more than a week. I know the automatic response is "talk to your doctor," which I absolutely intend to do, but does anyone have any background info/wisdom to dispense here?
tl;dr 65 mg/dL glucose level after 5 hours of fascinating during aggressive diet monitoring and workout. What it do?
What is this I don't even.
Darkewolfe on
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Posts
The ~60 number is actually out of spec on the wrong side for type 2 diabetes, though just barely. With Type 2 your sugars usually stay way too high and never dip low which causes all the damage. You get into hypoglycemia typically by fucking up managing type 1 with insulin or being stupid and not eating.
Pro side: Fixing hypoglycemia is easy, drink some OJ or other simple sugar thing.
Con side: Hypoglycemia imposes mental debilitation, good luck spotting it accurately.
I'd basically take a good long deep breath, realize that around eating and exercise your blood sugar should show considerable variation.
Sugar management isn't really about highs and lows but about averages. It's a marathon, not a sprint.
Actually, there's a type of hypoglycemia known as reactive hypoglycemia that you see sometimes in pre-diabetics, as the Pancreas has trouble regulating insulin amounts after meals. It can sometimes be hard to pinpoint if this is the case though, because it can take place anywhere within the four hours or so that you have a meal. I don't believe at-home testing devices will help much determining if that's what it is-- only an endocrinologist can really give you this information.
All that being said, the advice here is sound. Get a doctor that makes you feel comfortable, maybe see if you can make an appointment with an endocrinologist as well. The fact that you eat well and exercise can only benefit you at this point, but if you find yourself getting those borderline lows after meals take a sip of some juice and maybe try snacking a bit every couple of hours if you've been spreading your meals out.
I'd probably stop using the glucometer. It's not really going to do you much good. Did they check HbA1c? Have you done any fasting panels? You're using a device that isn't really meant to diagnose something like this.
It sounds like your doctor sucks, but that's a really common thing doctors tell patients. A lot of people end out with doctors saying, "Adopt a mediterranean diet and lose some weight."
I'd say relax, take a breath, put up your glucometer, keep working out and if you feel weak or fuzzy, drink a glass of orange juice and back off a bit.
Edit: If you go into your new doctors office with a big thick log of your glucose levels don't be surprised if you get an epic eyeroll. Put that thing away, stop poking yourself.
And hypoglycemia is as hypoglycemia does: if you don't feel faint, weak, or nauseated even when your sugar is 65 (which is borderline at best for someone who is not diabetic), you're pretty much good. Hypoglycemia causes symptoms, hyperglycemia causes problems. If you feel fine then in all likelihood you are fine. Your body may be a bit thrown off by your new diet (I'd bet on that) but if it gets overwhelmed it will tell you, and at that point you can tell your doctor.. Glucometer readings just by themselves mean nothing, and yes you would get an eye roll from somebody at the clinic while your back is turned.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
I came in to post a bunch of stuff re: how to test for diabetes and take accurate glucometer measurements
find a new medical practice and make sure to rate this one poorly
that is amateur hour stuff
of course you fast before a blood glucose test!
(not call you amateur, calling the practice amateur)
Oh no, you started eating healthy for no good reason!
Yeah. I was already on an improvement track, but it was good motivation.
Having low blood sugar roughly five hours after eating seems pretty normal. I was diagnosed in childhood because my sugar levels will drop to that level after just a couple hours.
But if you're still worried, it's pretty easy to tell when you're having blood sugar problems when you're hypoglycemic. Partially because it's usually preceded by hunger. But not always, so just familiarize yourself with the symptoms and do a self check when you're concerned. (I usually know what's going on because I generally get serious mood changes, start tripping over things, and go numb. But when I think I've been caught off guard, I look to see if my hands are shaking. Then I make sure my thoughts are coherent, and I don't feel lightheaded or floaty.)
The one thing to be careful about, is not confusing hypoglycemia with anxiety and tricking yourself into over-eating.