Is this reactive hypoglycemia?

[sharpiyu]

Hi

During a routine BG check, I was diagnosed with high BG about 6 months back (early May 2008). At that time, I was overweight (75kg) for my height (160cm) and was not careful with my diet, under lot of stress at work and not getting regular exercise. My doctor put me on Metformin (500mg twice a day) and advised me on proper diet and exercise.

I lost about 5kg within 5-6 weeks by simply changing my diet and regular exercise (70kg by mid June). However, at the same time I began feeling hypoglycemic after everytime I took Metformin. So my doctor advised me to stop taking it and continue with my diet + exercise, and to also monitor my BG regularly.

Since then my BG has been tested regularly (every week) and it has been normal (around 6 mmol/dl). My HbA1c dropped from 13.7 to 7.3 in the first 3 months and is now 6.2 after another 3 months. In fact, I have lost a further 3kg in the last few months with regular exercise (67kg by mid Oct). I have also reduced the amount of food I eat at each meal especially the carbohydrates. I have cut out simple sugars from my diet completely.

However, for the last couple of months I have begun feeling mild hypoglycemic symptoms (nervousness, shakiness) especially a few hours after my breakfast, which goes away after I suck on a regular candy (2-3g sugar). Rest of the day I'm mostly fine although sometimes I feel a bit lightheaded after meals esp. if I had a bit more carbohydrates than normal e.g. an extra slice of bread.

My doctor thinks its nothing serious and my body is reacting to all the changes I have made to my diet and my weight loss etc. He says the symptoms are typical in people with insulin resistance and will go away with time. However, a specialist I saw seems to think it could be hyperinsulinism or reactive hypoglyecmia. I wonder if anyone has had a similar experience and could help me understand what I am going through.

[WaveRider]

Congratulations on getting your health close to normal - losing weight, and reducing glucose levels. You appear to be playing a guessing game with your glucose level by checking only weekly. As the previous poster stated, you need to obtain a home glucose meter. When should you check your glucose?

1. Right after waking and before eating breakfast. Do not eat anything at least 8 hours prior. This is called preprandial (before eating) level.
2. Then postprandial (2-4 hours after eating). The latter is when glucose levels peak from the food you have consumed.
3. Repeat this throught the day to see how and where your levels are. The more energy you use the more glucose you burn. Eating improperly (restrictive diet) may not replace the glucose needed for more energy and one may feel lethargic (tired). Keeping simple (refined) sugar out of your diet is good.
4. If low, eat something sugary.
5. Again, watch your diet and eat accordingly. Going from high to low and back to high (high/low/high/low) is very unhealthy.
6.  Keep a record/log of the test values. Give this to your doctor to review.

You are assuming the incorrect numbers too. Here's why; 6.0 mmol/l and an A1c of 6.2 are NOT normal. Normal mmo/l is 3.8888 to 5.5555 mmol/l. A1c is below 6%.

Hyperinsulinism? That's hard to say since your body has been going through radical changes lately. I feel your immediate goal should be to maintain a steady glucose level, without the ups and downs. Next visit to the doctor ask to check your thyroid and pancreas for other issues.

[pramodka]

I have never experienced this although i am taking almost the similar medication. i was taking 2 tablets of 500mg Metformin and 7.5 mg of Piopar(glutaizone-not sure of the spelling) , i was 70 kg , height 169cm. I had a CABG done 3 months back and lost about 7kgs. my Post prandial  glucose levels  were still on the higher side 175-190mg/dl and the Dr has increased my medication by 1 additional tabletof Metformin. NOw i take 3 tablets of 500mg.
Before the surgery, i used to feel very hungry 2 hrs after breakfast this is quite normal. Therefore he has advised me to carry a candy or biscuits which is handy and taken everytime i got this hunger feeling or shakiness.
I suggest you keep checking your Post prandial glucose level using a Glucometer, record it and see a doctor.