Lightheaded feeling with Low Blood Sugar

[WandaB]

About 4 months ago while I was in the car I felt a numb feeling in the top of my head that did not go away for quite a while.  I also have been having a tight feeling around my eyes, feeling weak in my legs and arms, my knees feel like rubber sometime when I try to walk.  I also have been havig a feeling that I was going to pass out.  I have been to the Emergency Room Several times along with seeing my own Doctor.  I have been told that I have hypoglycemia that in the next year of so will turn into full Diabetes.  I have also seen a Cardiologist and had a EcoCardioghram (not sure of spelling), I have had a brain scan along with blood work.  Was diagnosed with low blood sugar, a heart valve leak and a heart mumor and Anxiety Disorders.  I do not feel as if I am getting any better, every day I feel awful.  My Blood sugars when tested at home have been testing between (70's to 272 at highest) a couple of times 56 and 69.  I am seeing a Nutritionist along with a Endocrinologist, but do not feel as if I am getting anywhere.  The weak feeling is getting me down I do not feel as if I am human anymore.  Please help.

[JDRF-Team-CDB]

Dear Wanda,
I don't blame you for feeling overwhelmed-- clearly you have an awful lot on your medical plate. But it's good that you are seeing the appropriate specialists, and I would urge you to be patient and keep focused on getting better. As for the hypoglycemia turning into diabetes, I'm not a doctor, so I don't know for sure, but I don't think having hypoglycemia is any guarantee of getting diabetes. Some people are just hypoglycemic.

Because we are not MDs on this forum, we can't offer specific medical advice, other than to say keep seeing your doctors and working to get control of these symptoms. Our thoughts are with you.... best of luck.

[WandaB]

Thanks for the reply.  I just had another attack this morning, went to the hospital and was told that I am suffering from anxiety disorders.  I just had a MRI on my abdominal area about a month ago, everything was OK (my pancreas was unremarkable).  I am trying to keep a positive outlook with my health, sometimes it is very hard.  I am beginning to think that I have been labeled as someone with anxiety disorder and cannot get very much help with my health.  I am not sure where else to turn.

[JDRF-Team-JW]

Hi Wanda,

I am a volunteer here and not a medical professional, but I can sympathize with your pain and frustration.

I have had Type I Diabetes for 12 years now. In that time I've had various symptoms, which I'm still not sure what caused them. I've had problems with my stomach, breathing problems (which the doctors didn't think was due to my asthma) and many times when no definite diagnosis was given, I was just told it's "nerves" & anxiety. I know it must be frustrating dealing with this and not being sure what's really happening and why. I

agree with the comment above that you should continue to see your endocrinologist and nutritionist and be patient (however hard that may be). I encorage you to try and keep a log of your health and how you're feeling, even if it's just for a week. Write down your symptoms, your sugar levels, activities, stresses: anything that can affect your health. Then take a look at your log and share it with your doctor. Maybe there will be a pattern or some other explanation for how you've been feeling.

As a teenager, before I was diabetic, I suffered from anxiety and panic attacks and they were very difficult to deal with, so I truely feel your pain and understand your fears.

Hypoglycemia is a condition that many people struggle with. It is by no means pleasant and it can be scary, but it can be controlled, just like diabetes. It just takes time. There are also many factors that can affect your health, which is why I'm suggesting you keep a log for a while and really pay attention to your body. You may be hypoglycemic but there can also be other factors underlying how you feel.

I know it may be frustrating to always have your symptoms categorized as resulting from anexiety and I'm sure that's not always the case. However, the stress and fear associated with not feeling well all the time and not knowing why, can greatly contribute to and worsen the symptoms themselves. Try to stay calm, pay attention to your body, don't worry too much and don't give up. You know your body best so if you're feeling something, tell your doctor and don't let them trivialize it (and if they do, ask for proof that it is in fact nothing serious -it will make you feel better). Trust your instincts and stay in control. This kind of stuff happens to all of us at one time or another. I have been worried about unexplained health matters in the past and I know it's difficult but everything has alwyas turned out fine. Good luck and please let us know how you do!

[JDRF Team SGG]

I don't believe any of the responders so far have mentioned that one of the very symptoms of hypoglycemia is a feeling of anxiety or of being overwhelmed. So some of your anxiety is very likely due to the very condition that is worrying you. You are NOT going nutty -- your anxious feeling is a very physical reaction to low blood sugar. I am a tightly controlled diabetic, and I drop into the lower glucose levels occasionally. I have been tightly controlled for many years, and so I know from experience that a feeling of worry can be due to the low glucose situation and it will go away as soon as glucose levels rise to normal. It is PHYSICAL and not emotional. Other people get grumpy or irritable when hypo. So the symptoms can be different in different people. I, like you, feel anxious when low.

So the solution is for you to learn how to raise the sugar levels when you are low without causing them to spike high and then drop lower later in a vicious circle of ups and downs. I would encourage you to sit down with a good cup of tea or something DECAFFEINATED (did you know that hypoglycemia can be made worse in folks whose pancreases react too strongly to stimulus by caffiene???) and spend some time doing Google searches on hypoglycemia and diets for hypoglycemia. There is a lot of good information out there on this subject and you need to educate yourself about it so you know what to do to help get this under control. Just take it one step at a time, and it will be manageable.

As for those actual hypo episodes, they do make you feel like you have been run over by a truck. Been there, done that. For me, personally, I find that I do much better drinking a small amount 4-6 ounces) of juice immediately when I feel my glucose dropping, and then, depending on how low I actually am, I eat a very small snack. The juice is digested very quickly and will help stave off the dropping sugar, while the snack is digested slower and helps stabilize the levels. I keep 6-oz cans of juice in my purse when I go out so that I always have a little something with me to protect myself if I start to feel 'funny'.

I had a sister-in-law who was a classic hypoglycemic person, and I learned through her research that many doctors tell people who suffer from this condition to:
1. Stay completely away from all caffiene.
2. Stay away from foods containing simple sugars, for they stimulate the pancreas too quickly, and the result of even one chocolate-chip cookie for my sister-in-law could be a deep sleep that bordered on passing out.
3. Eat your carbs in the form of complex carbs such as whole-grain breads and oats.
4. Snack often on proteins such as nuts and cheese... these foods help slow down the digestion time of your carbohydrates so that the pancreas is not overly stimulated.
5. Some suggest that people who are hypoglycemic should drink MILK instead of juice when low... both have carbohydrates, but the milk digests a little slower and is less likely to stimulate the pancreas further to produce even more insulin. I personally like skim or 1 percent milk mixed with sugarfree Nestle Quik for flavor, and I can attest to the fact that one cup of this mixture will bring my sugar levels up when I am low without spiking a high. You may have to try both this and juice to see which works best for you without causing more problems an hour later.

Much of what you will do is going to be through trial and error,  for each person is different and there are no blanket solutions that work for all people. My main advice is to treat each low as soon as you feel it happening -- don't try to ignore it or wait it out, for you will feel awful. Experiment with small amounts of juice or with milk and if one works for you, use it. You may find that you do better nibbling constantly rather than eating large meals, for constant nibbling keeps the stimulus to your pancreas in small doses and may keep your sugars more even-keeled than large meals. Many people find that low-carb diets seem to help the situation, for the stimuli to the pancreas is not as great in a low-carb diet as in more regular diets. Some people find that there are not enough carbs in the low-carb diets, though, and if you try this and find yourself low more often, then drop it and add some high-fiber carbs.

In time, you will learn how to keep it manageable. Hang in there!

[WandaB]

This morning I was seen by another doctor, I explained to her my symptoms and also showed her all of my labs and MRI of my abdominal and prancreas, her statement to me was that she thought that I am suffering from Hyperventilation and not so much low blood sugar, she also wants to run a 3 hour glucose test on me and also check for a Insulinnoma, (which she thinks that I do not have) she said that the only way to tell if I do have the insulinnoma is through blood work up.  I thought that when I had my MRI of my pancreas that it showed whether I had this or not.  Does anyone know for sure how you are tested for an Insulinnoma  I am so confused right now.  When I had the MRI I was told that there was no sign of any tumors that my pancrease was unremarkable.

[WandaB]

Question?  

I have a MRI done of my abs, with special attention to my pancreas - (dr. looking for Insulinoma) MRI came back with no tumors etc. unremarkeable - I saw another Dr. for another opinion on my health and was told that you had to do blood work up to find an Insulinoma - is this correct.

I am feeling awful today, my blood sugar keep droping to 65+, any suggestions

[JDRF-Team-JW]

Hi Wanda,

I'm sorry to hear you're not feeling too well. Please hang in there and try to stay positive. I've done a bit of research on insulinoma. Basically what I found was that both a blood test and a CT scan or MRI may be used to diagnose or rule it out. There have also been articles regarding the 72-hour fast, which has now been reduced to 48 hours, to test for insulinoma and hypoglycemia. Below are some links and excerpts from the websites I consulted. Other than wikipedia.org (which is not an authoritative site) the websites include information from medical professionals. However, I would still encourage you to speak with your doctor about any concerns you may have.

1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10999812&dopt=Citation
Information about the clinical trial of the 48 hr fast test for insulinoma.

2. http://www.endotext.org/protocols/protocols5/protocols5.htm
info about the 72 hour fast:

"The “gold standard” test in the evaluation of hypoglycemia is the 72-hour supervised fast. The purpose of the fast is twofold. The first is to diagnose hypoglycemia as the cause of the patient’s symptoms. The second is an attempt to determine the etiology of the hypoglycemia. Due to the risk of hypoglycemia, patients should be admitted to the hospital to undergo the fast in a monitored setting. The fast could be initiated in a carefully monitored outpatient facility, with the patient entering the hospital if the fast is not terminated prior to the closing of the site. Baseline bloodwork can also include cortisol, growth hormone, glucagon and catecholamines if deficient counterregulation is suspected.

During the fast, patients are allowed no food but can consume non-caloric caffeine-free beverages for up to 72 hours. Simultaneous insulin, c-peptide and glucose samples are obtained at the beginning of the fast and every 4-6 hours thereafter. Once the plasma glucose falls to <60 mg/dl, specimens should be taken every 1-2 hours under close supervision. Patients should continue activity when they are awake. The fast continues until the plasma glucose falls below 45 mg/dl (2.5 mmol/l) and symptoms of neuroglucopenia develop, at which time, insulin, glucose, c-peptide, sulfonylurea/meglitinide, proinsulin and beta-hydroxybutyrate levels are obtained and the fast is terminated (28). Additional samples for insulin antibodies, anti-insulin receptor antibodies, IGF-1/IGF-2 and plasma cortisol, glucagon or growth hormone can also be obtained at this time if a non-islet cell tumor, autoimmune etiology, or hormone deficiency is suspected.

The diagnosis of insulinoma is likely if the patient, at the conclusion of the fast, has neuroglycopenic symptoms, a fall in plasma glucose to <45 mg/dl (2.5 mmol/l), inappropriately elevated beta-cell polypeptides (insulin, proinsulin and c-peptide levels; see below table), beta-hydroxybutyrate level <2.7 mmol/l, and undetectable sulfonylurea/meglitinide levels (28)."

3.http://en.wikipedia.org/wiki/Insulinoma
info about insulinoma:

"The following blood tests are needed to diagnose insulinoma:

glucose
insulin
C-peptide

The insulinoma might be localized by non-invasive means, using ultrasound, CT scan, or by MRI techniques.
Sometimes, angiography with percutaneous transhepatic pancreatic vein catheterization to sample the blood for insulin levels is required. Calcium can be injected into selected arteries to stimulate insulin release from various parts of the pancreas, which can be measured by sampling blood from their respective veins. The use of calcium stimulation improves the specificity of this test."

I hope things will work out for you. Please let us know the outcome and hang in there!