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Reactive hypoglycemia.....diabetes?

by soooconfused, Apr 07, 2006 12:00AM
I struggle with palpitations - an intense pounding in my chest and a rise in pulse AFTER eating. Yes, I've had a full cardiac workup and been told that the heart is not the cause. Heart monitors confirmed that my pulse rises anywhere from 30 min. to a couple of hours after eating and can stay there for hours, but the monitors also show that the palps are the symptom of something else and not caused by the heart. My cardiologist is confused and wants me to look into other causes as the heart is being greatly affected. Even my mood changes after eating - irritable, nervous, lethargic, anxious, weak and generally uncomfortable - lasts for several hours after food. Had to go on beta blockers as precaution. Can't determine specific food triggers other than wine which I've stopped drinking as it intensified the symptoms. Only 1 glass with dinner would rev up my entire nervous system. SO uncomfortable. Don't drink any other type of alcohol. I've had a fasting glucose test (normal) but wondered why I would get a fasting glucose when I feel best in the AM before eating/between meals. As soon as I eat something, my body, metabolism, nervous system etc. goes into overdrive. Insulin reaction?? Diabetes runs in both sides of my family.



Questions: 1) Could I have REACTIVE hypoglycemia? If so, what is the best test for that?  2) Don't get hives/rash after food so my Doctor won't test for food allergies. Should I?



No, I don't smoke or consume caffeine. Have normal blood pressure (more on the low side of normal), no heartburn/GERD, no anxiety/depression. I've covered the basics.

by JDRF-Team-cb, Apr 07, 2006 12:00AM
Hi soooconfused,

I am a volunteer not a doctor, but I can try and help. I have been a Type I diabetic for 25 years.



It sounds as if you are going in the right direction with seeing your cardiologist and getting a variety of tests.  I do have one question, when you went for your fasting glucose test, did they have you drink a glucose solution after the fasting test.  This would let you know how your body reacts after eating. This is similar to what pregnant women get at 28 weeks.  



I was on beta-blockers during my first pregnancy because of high blood pressure. During my second pregnancy I watched my sodium intake and it helped so much that I did not need to take the beta-blockers. Do you eat a lot of salt?



Also, do you have a lot of stress in your life?  My blood sugar is much harder to control and widely varies when I am under a lot of stress and pressure.

I hope this helps and you figure this out.
Member Comments (7)

by soooconfused, Apr 07, 2006 12:00AM
To: JDRF-Team-cb
Thank you for your response. My fasting glucose test was only a blood test. I did not drink anything. It was a simple blood test and off I went. My GP told me that is the test to diagnose hypoglycemia, but his response sounded wrong to me as my symptoms are in relation to food. I am more interested in knowing how my body reacts to food since that is when I am symptomatic. From what I have read, reactive hypoglycemia is not diagnosed by a fasting glucose blood test alone but rather a GTT/OGTT. Is this your understanding? (If this is a test that women get during their pregnancy, I am surprised that my Doctor didn't suggest it as he delivers babies!)



I eat very little salt. My blood pressure is normal (more on the low end of normal). I am taking beta blockers not for high blood pressure (as in your case and with most other people) but to help with the palpitations/tachycardia episodes after food. No stress, other than the constant physical reaction to food. I don't take any stimulants (coffee, chocolate, alcohol, etc.) so reactive hypoglycemia seems to be a good lead....if only I had the correct test to diagnose it.

by JDRF Volunteer AJ, Apr 08, 2006 12:00AM
Dear soooconfused:

I read your post with some interest in that I had not heard this term before.  Like cb I am a volunteer and certainly not qualified to give you any medical information and have no first hand experience. But I did do a search on Reactive Hypoglycemia and found several interesting sites you might want to check out.  Keep in mind most of these sites are trying to “sell” something and I am in no way endorsing any of this.  You might want to check out these sites and then do your own search, if you haven’t already.

I know when my son was diagnosed with type 1, which I knew nothing about at the time, the first thing I wanted to do was arm myself with as much information as possible in order to make good choices regarding the management of the disease.

Good luck to you, I can understand why you are so confused…



http://www.sover.net/~devstar/hypogly.pdf  interesting paper with reference to the Zone Diet



http://www.mts.net/~baumel/hypoglycemia.html talks about RH and depression suggest some books to read

by JDRF Team SGG, Apr 08, 2006 12:00AM
The test you need to ask to have done on you is a glucose tolerance test. This test starts out with a simple blood test to determine your resting glucose levels. Then, you drink a sweet syrupy drink and blood is drawn at different times after this to see what happens to your glucose levels. If you have an episode of reactive hypoglycemia during this test, it will show up. I am a very tightly controlled diabetic, and because I keep my baseline glucose levels low, I often have slight drops in glucose or mild hypoglycemia. Sometimes when this happens, I have the same symptoms you describe. Like you, my heart has been checked out by a cardiologist and is healthy. This, in my case, is just a reaction to the drop in glucose levels. I don't always have these symptoms, but it can happen.

by soooconfused, May 11, 2006 12:00AM
To: JDRF Team aj
Thank you SO very much for your response. I have read the articles and find them very interesting. I have also had a 3 hour "Glucose Tolerance" test with the following results:



Fasting  4.6 (< 6.1)

0.5 hr   8.3 (< 11.1)

1   hr   9.5 (< 11.1)

1.5 hr   9.5 (< 11.1)

2   hr   9.1 (< 7.8) HIGH

3   hr   6.8 (< 7.8)



I'm not sure how to read these results or if they are helpful to my investigation in any way, but I did notice that my palpitations came on at the 2 hour mark, which is when my levels were out of the range. The Doctor says that all of the numbers need to be out of the range in order to diagnose anything relating to diabetes/hypoglycemia - he says that one out of range number is not significant enough. What is interesting to me is that I was symptomatic (rapid pulse/palpitations) at the 2 hour mark/the time that I was out of the range. Can you give me any feedback on these results? Was this the correct test?



Many thanks.

by soooconfused, May 11, 2006 12:00AM
To: JDRF Team SGG
Hello "SGG". Please see my post above (dated May 11, 2006). I couldn't figure out how to reply to both you and "aj" at the same time so I'm sending messages separately.  If you have any feedback on my above post/test results, I would very much appreciate it.



Thank you in advance.

by pinkmartini