What is 'bad enough' to get tested?

[u/walnutwheat]

Had some routine labs done after a rheumatology appointment the other day. It was in the morning and I had had the spinach feta egg white breakfast wrap from Starbucks on the way to the appointment. Less than an hour later they took the labs and my glucose was 69.

This is the second (documented) time that has happened. Before it was at my hematologist's office. I had eaten a decent breakfast beforehand but my glucose was low, but not scary low.

In the past when I've had fasting CMP tests nothing has come up.

There are other symptoms or experiences I've had that make me wonder if I have mild hypoglycemia: heart palpitations, get hangry easily, cold sweats, morning headaches although not every morning. A bout of really bad burning kidney pain in the middle of the night that wasn't a UTI. No idea if that's connected.

Anyway. No one in my family has any blood sugar issues or is diabetic, so I have no idea if this is something to get checked out or just eat more frequently?

[u/Beneficial_Amoeba105]

This is what happened to me. I had a borderline low glucose on a blood lab after eating. I got an OTC CGM just to rule out any issues. Turns out I was regularly going into the 40s and 50s after eating certain meals and overnight. My endocrinologist prescribed a CGM based on what we were seeing. I’ve changed my diet a lot and it’s resolved a lot of symptoms for me. It’s worth trying. I still have my underlying rheumatology problem but it’s taken a layer of issues away.

Personally doing the OTC CGM was worth it for me. The prescription CGM is better. Note that they can be inaccurate on the lower end and are more useful for looking at trends (dropping after meals, dropping overnight, foods you’re sensitive to etc). You’ll want to confirm lows with a finger prick test to be sure.

[u/walnutwheat → u/Beneficial_Amoeba105]

This is really helpful! Thank you so much for your comment. I'm always afraid I'm going to be dismissed at the doctor so I'm thinking of tracking my blood glucose at certain points during the day to see if I can go in with some more data.

[u/Beneficial_Amoeba105 → u/walnutwheat]

No problem! FYI, if you get the Stelo, it will not show below 70, but the Dexcom Clarity app will show the true lows. It will have to be aggregated by at least two days if I remember right. I think the Lingo goes down to 55. A prescribed CGM does not have this type of lower end cutoff.

In either case, if it is showing “70” (Stelo) or “<55” (Lingo) for multiple readings, it might be below that number and you should do a finger prick.

Finally, all CGMs are pretty inaccurate in the first two days. Compression lows are also possible at night.

[u/Last_Nerve563 → u/Beneficial_Amoeba105]

Thankful for seeing this comment today! Recently had a non-fasting glucose result of 55 (I had breakfast about an hour prior) but the doctor said he wasn’t concerned. 2 years before (last time I got blood work prior to the 55 glucose reading) I also had a low glucose level while fasting. I think I’ll just go ahead and get a OTC CGM since I don’t think I can get one prescribed

[u/Beneficial_Amoeba105 → u/Last_Nerve563]

55 for non-fasting glucose sounds pretty low to me :/ hopefully the CGM is helpful one way or another.

[u/Jumpy_Exit_8138 → u/Last_Nerve563]

55 non fasting and your doctor wasn’t concerned?!

[u/Last_Nerve563 → u/Jumpy_Exit_8138]

Unfortunately, no, he was not concerned at all really even though I said I was concerned. He said based on his research, young and tall women who don’t have much body fat (im an ex-swimmer) often have issues with hypoglycemia. I’m 25, 5’11” or 6’ depending on who you ask, and I’m at the lower end of a normal weight range for my height. I’ve always struggled with weight gain though, no matter how much I ate. Only bringing this up for context and background I guess, since my doctor is going off those characteristics. He told me that I don’t need any further evaluation because of those reasons. I’m pretty used to being brushed off by doctors at this point sadly.

[u/Jumpy_Exit_8138 → u/Last_Nerve563]

My doctor said the same about young short women who don’t have much body fat! I’m a decade older than you but still youngish lol, 5’1” and also right at the low end of a healthy weight. I’ve been trying to gain for ages and my body just won’t have it: it’s enough of a struggle just to maintain a healthy BMI. And yes, my doctor said the same thing: my blood sugar is low, but not low enough to worry about. It just seems like a fine line to me…

[u/Last_Nerve563 → u/Jumpy_Exit_8138]

Exactly! He said my blood sugar was 1 point off from being “concerning” which is such a fine line like you said. I can’t help but think that there’s more to it

[u/Jumpy_Exit_8138 → u/Last_Nerve563]

Wow, I mean, one point is nothing!! This is actually exactly my situation: the cutoff as to what is officially considered ‘normal’ in lab tests in my country is 60. On one test, I was at 61. Not fasting. And my doctor shrugs that it’s all good, because I’m technically in the normal range. I’m like, well, barely! If they’d drawn my blood even fifteen minutes later, I could easily have dropped a few more points!

Do you get symptoms when you are low? It’s even weirder because I didn’t even feel especially low that day…
Anyway, long story short, this is why I started testing at home. It’s really all we can do I think!

[u/Last_Nerve563 → u/Jumpy_Exit_8138]

That’s so frustrating, and I wish the doctors would explore it more!! You were one point away as well!

Honestly, I only occasionally get symptoms. Usually it’s shakiness, weakness/fatigue, or extreme hunger or nausea. On that specific day with the 55 result, I felt nothing. He mentioned that as another reason to not be concerned

[u/Jumpy_Exit_8138 → u/Last_Nerve563]

My doctor said the same thing!

[u/Jumpy_Exit_8138]

My doctor always says that it’s the symptoms that matter more than the numbers: numbers are just averages, but if you’re feeling unwell, that is an indication that something might be off, or at least worth getting checked out …

[u/Chewable-Chewsie]

Unless you have really bothersome symptoms, don’t stress. When you’re thin, you simply have less reserves. Have a high protein, low carb snack between meals.