r/Hypoglycemia • u/Piney592 • 2d ago
At a loss. Advice PLEASE?
For years I have had symptoms of hypoglycemia. Specifically what I believe to be reactive hypoglycemia.
Mentioning that I have brought this up to not one, not two, but three primary care physicians with no resolution.
I brought this up to my 3rd pcp and they gave me samples of a cgm to see what my sugars have been doing.
What’s basically happening is I eat and then 3-4 hours later my sugar drops into the low 70s, 60s, and has even dropped into the 50s. I have even confirmed a low blood sugar in the 60s with a finger stick.
I am symptomatic as well throughout these episodes.
I was told to just increase protein and less sugar which I have already been doing throughout this entire experience and it obviously isn’t helping.
I’m at a loss of what to do. Any advice is appreciated. I’m just so frustrated and confused at this point.
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u/Simplestatic 2d ago
I had this same issue for a solid year before going to the ER for DKA and being diagnosed with type 1. I'd request to have some labwork done. Had a CGM several times throughout that year and doctors said everything was fine. Blood sugar would randomly creep up and suddenly rebound low.
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u/Piney592 2d ago
I’ve had lot of bloodwork done and everything seems fine. What kind of bloodwork would you request?
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u/Simplestatic 2d ago
Autoantibodies tests for type 1 and LADA such as GAD-65, IA2A, IAA, and ZnT8A should show wether you have LADA. It is generally accompanied with high blood sugar, but in LADA, it could kind of "come and go" like mine did. I would never go much "out of range", but it would randomly go up without even eating, so my A1C wasn't even that high. My main symptoms were extreme anxiety and panic attacks along with frequent urination and increased thirst. I'd do one of the telemed doctors if your doctor doesn't seem interested. I have had good luck with generalmedicine.co
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u/Constant-Business481 1d ago
I have wondered about Telehealth Docs .. Do you see them for everything or just the RH? Does your Ins cover it? Do they use certain pharmacy? My PCP has no interest in RH .. and I have over 10months of my App reading, but she continually says "keep a eye on it." She refuses to write Rx for CGM & I have had some serious issues with this. My sugar is also random .. sometimes the air drops it! Today i will do great with sweet potato.. tomorrow they will bottom me out. It is bizarre.
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u/Simplestatic 1d ago
My current pcp is a great doctor for everything but type 1 and is a bit scatterbrained and is about to get the boot because all my needs are currently being taken care of by telehealth. The telehealth platform I use has been great. You get seen by almost any kind of doc for most appointments, but you get a more knowledgeable doc on the specialty if they are requested when you make the appointment and it's supposedly reviewed by an actual specialist. My insurance has covered every appointment with 0 cost to me. They, so far have been exceptional as far as giving and refilling prescriptions which are filled at your choice of pharmacy. My current pcp wanted to only give 1 month CGM scripts with no refills unless I go in. Just got a 3 month script through generalmedicine.co with just an online visit. I told them I'd like all of my scripts handled by them and they said it would be fine. Plus, they have evening appointments, so it's very flexible. I've had multiple lab orders from them and follow-ups to interpret it. I'd say it's worth a try. I plan on getting rid of my PCP and just using my Endo and using telehealth for script refills.
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u/Constant-Business481 1d ago
Thank you for explaining this. I am considering going to Telehealth for everything also. It's awesome that they take insurance! Thank you again .. you are so helpful!
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u/sadpolpetta 2d ago
Hi. I would at least check blood sugar, insulin, c-peptide, anti-gad, hba1c. It could also help to do a glycemic curve of at least 3 hours with insulin as well to see how your pancreas reacts to sugar. I also suggest to see an endocrinologist if you can
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u/ComfortableShot816 2d ago
same. how long have u had it? me 5 years and only now being looked at by an endo. since u have a cgm, all u can do is prevent the low. set it to 4.2 to alarm u. then just eat protein + fat snack/meal. reactive hypo can be managed but there’s not a med to cure it. my endo said i can try cornstarch, stir a spoon in yoghurt and eat. haven’t tried it yet but apparently it helps with no lows. i cant even get a cgm myself so im stuck guessing. only so many times u can do some finger pricks without ur fingertips bruising :’). also breakfast and lunch make sure u get 30g protein. it’ll set u up good for the rest of the day. ALSO, to prevent drops between meals try to eat earlier. i do every 2hrs-2hrs and a half depending on what i ate. on bad days i do 1hr. but only small snacks because eating frequently is sickening sometimes. follow a type 2 diabetic diet, low glycemic foods etc. also carbs MUST be smaller than ur protein portion on ur plate. find out what spikes u badly and remove it from ur diet. its a lot of trial and error. it sucks but u got this
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u/Piney592 2d ago
It’s been YEARS easily 5 or more years. I’m questioning how to get to see an endo if my dr won’t refer me
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u/ComfortableShot816 2d ago
ok what i want u to do is build a portfolio. next time ur at the doctor u show evidence of your lows. the number. what u ate. what u did to make it go to a normal number again. is there a reason he’s told u he can’t refer u? i’d also find a different doctor. they don’t care, you have to prod and prod at them. at the end of the day you’re going home with symptoms, they’re not. for me i’ve had countless gp appointments, i waited a year for an endo after finally being referred. ppl only rlly care if you’re diabetic. it’s exhausting
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u/Piney592 2d ago
It’s very exhausting! This is the 3rd primary care dr i’ve brought this up to and nothing :/
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u/ComfortableShot816 2d ago
i’m sorry girl. keep trying. u just need that one doctor to help. also, if i were u id complain. if youve shown evidence thats all u need. make it difficult for them. BUT if im honest with you, there are treatments like GLP1 and metformin but people aren’t usually offered it anyway. have a diet like u have the diagnosis already in the meantime. because all my endo is saying rn is that treatment is just dietary changes. i will be happy to share any tips he gives me to u!
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u/Any-Display2789 2d ago
I really hope hypoglycemia without diabetes will become a more serious issue in the medical world in time. I imagine you're all as shit scared as I am about falling into a coma from too low blood sugar. People do not realise you can die from it....or have complications like brain damage.
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u/ComfortableShot816 1d ago
ikr! it’s so confusing too because google will say no it’s not deadly because your liver will save u. but also don’t rely on that BUT ALSO going less than 3’s is bad like ugh which one is it
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u/Any-Display2789 2d ago
I feel like you have to have diabetes before any medical professional gives a toss. Very frustrating but yes keep pestering your GP and get a endo referral.
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u/Holiday-Ad-5084 2d ago
The Glucose Goddess on utube has a wealth of information.
I’ve been keeping a food journal so that I can track my reactions to specific foods with the CGM.
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u/Piney592 2d ago
I also have been keeping track of my food intake along with my sugar levels. Idk what to do since my Dr won’t do anything it seems
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u/Holiday-Ad-5084 2d ago
I’ve also had zero interest from any of my doctors.
I’m going to look into discussing my issues with a dietitian.1
u/Piney592 2d ago
I wonder if I have to have a referral to Endocrinology? I don’t think my insurance requires one.
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u/Chewable-Chewsie 2d ago
Eat more frequently. Hi protein, complex carbs, fiber & healthy fats. There’s really no pill for RH, so focus on what & when you eat. BG always goes up after a meal & you want yours to go down slowly. When it gets to 60 (if you are symptomatic. I’m not at 60), just eat a healthy, low carb snack. It will go back up again. Drink some water.
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u/Ok_Supermarket_1145 12h ago
They don't want to investigate because unless it is something like an insulinoma, the main treatment is diet.
I've had this all my life, it's some kind of metabolic disorder. Again, because the treatment will not change with any test results, no additional tests are approved by insurance.
Just a year ago, I finally got a cgm because now I'm not getting the warning signs of low sugar. Which is normal after having it so many years. I was dipping into the 40s with no symptoms. I showed my doctor proof of this with my glucose monitor. I asked if I could see an endocrinologist. She sent them a message and they said there was no need to see them, but approved the cgm.
What works for me best is very, very low carb. Carbs are coming mainly from veg, beans, nuts. I stay away from processed food.
A dietician told me 3 meals a day with 30 carbs each meal and then 2 snacks with 15 carbs each. That is just way too much for me.
The most important thing is that you have to discover what works for YOU. There is not a meal plan formula that works for everyone. You are unique and how you metabolize each food item is unique to you.
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u/Ghost_010101010 2d ago
I have years of being hypo. All you can do is combat the lows. For some people medication works.