New to insulin: Anyone have type 2 diabetes and reactive hypoglycemia?

Posted by mmnp @mmnp, Jul 1, 2022

I had type 2 diabetes for years. Recently my A1C and blood sugars spiked. A lot. I am now on insulin and have been told my pancreas has basically gone belly up. We have diabetes and other auto-immune diseases in the family so this was no surprise to me. What is a surprise is that my fasting blood sugar is high and my blood sugar daily spikes when I DON'T eat. I am pretty good about a high protein low carb diet, but too low carb and I feel weak and sick. My dietician said I have reactive hypoglycemia. She is great as is my endocrinologist, but I am struggling with how to figure this out as in I have to keep eating throughout the day even when not hungry or I get a quick spike. My chief complaint is the fatigue....seems like I can't do anything! Anyone else have diabetes and reactive hypoglycemia? Any tips other than trying to keep an attitude of gratitude? Thank you. Martha

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Hi @mmnp, I think you might find these related discussions helpful:
- I'm having problems managing Type 2 Diabetes with medication https://connect.mayoclinic.org/discussion/type-2diabetes/

- My Diabetes 2 Backwards Numbers-Anyone else? https://connect.mayoclinic.org/discussion/my-diabetes-2-backwards-numbers-anyone-else/

I'm also bringing @amoreenap @babette @dorisena @kateia @collierga who may have some experiences to share.

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Type 2 is not an autoimmune disease. Are docs telling you that you have type 1?

If your pancreas is not putting out insulin regularly, you will have high blood sugars even when not eating. This is a major misunderstanding in hospitals about type 1's. I have seen a nurse disconnect a pump because the patient wasn't eating. Net result: a blood sugar around 400!

I don't understand this sentence: "I have to keep eating throughout the day even when not hungry or I get a quick spike. " The word "spike" usually refers to high blood sugar. Usually eating, however regularly, would cause blood sugars to go up. Are you saying that eating a meal all at once causes a spike? You should be able to eat normally and do insulin boluses for meals and snacks.

Reactive hypoglycemia is a different problem entirely. You are discussing "spikes" which would be high blood sugars, and hypoglycemia which would be low blood sugars. Are you having both? (That is pretty common on insulin!)

Is insulin causing your lows or are you having lows a few hours after eating carbs? I do not have diabetes and am not on insulin but if I eat, say, sorbet- something sweet without protein or fat- I have a low blood sugar a few hours later. I have been told that is reactive hypoglycemia.

When I eat, I try to always have protein and/or fat with fast acting carbs.

Sorry for what you are going through.

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Thank you for your reply. Actually, I have been told I have Dawn Phenomenon: I do not eat overnight and my blood sugar actually goes up because I DON'T eat, so weird; by FBS is actually higher than my RBS. And I have been told I have reactive hyperglycemia....go figure? I was a nurse also, but my specialty was palliative care and hospice so not much focus for years on diabetes. I take a long acting insulin only and will probably see my endocrinologist next week as well as my dietician, both of whom are great. I am pretty good with my diet, was being treated for type 2 diabetes for years so had learned better habits. If I have too few carbs, I feel like I am starving but am not hungry....that I can figure out. I am not hungry, but my cells are starving. I have the Libre Free Style 2 system which is great but have yet to set it correctly so I am not getting alarms so often. Have a great weekend, Martha

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@mmnp

Thank you for your reply. Actually, I have been told I have Dawn Phenomenon: I do not eat overnight and my blood sugar actually goes up because I DON'T eat, so weird; by FBS is actually higher than my RBS. And I have been told I have reactive hyperglycemia....go figure? I was a nurse also, but my specialty was palliative care and hospice so not much focus for years on diabetes. I take a long acting insulin only and will probably see my endocrinologist next week as well as my dietician, both of whom are great. I am pretty good with my diet, was being treated for type 2 diabetes for years so had learned better habits. If I have too few carbs, I feel like I am starving but am not hungry....that I can figure out. I am not hungry, but my cells are starving. I have the Libre Free Style 2 system which is great but have yet to set it correctly so I am not getting alarms so often. Have a great weekend, Martha

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@mmnp Hello Martha,

I found your posts to be interesting. I've heard of people concerned about high early morning blood sugar numbers but had not heard of Dawn Phenomenon. I did find some information on this on Mayo Clinic's website. Perhaps you are already familiar with this but here is the link, https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/dawn-effect/faq-20057937#:~:text=Regina%20Castro%2C%20M.D.

Here is another article under the title, Reactive Hypoglycemia, https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/reactive-hypoglycemia/faq-20057778.

You said that you've had diabetes for years. Is this high morning blood sugar new to you or has it always been a problem? You mention that one of your main problems is fatigue. Does eating help that fatigue?

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thank you so much, I will be visiting those sites.

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I was recently diagnosed with diabetes 2 never had it long term it was very sudden along with heart problem my endocrinologist started me with lantis 8 units before bed time and an oral hypoglycaemic in the morning well hypoglycaemia became my middle name but no spike so finally he stopped insulin but has continued with the oral hypoglycaemic brand name Diampa lt generic name is empagliflozin May be you can check with your endocrinologist about it for your spikes may be you aught to cut down your meal size and eat more frequently when does the spike occur ? Is there a specific time? In my case for hypoglycaemia I just eat one candy all the best

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Interesting post. I take Metformin for my type 2. It’s well controlled however I too have higher readings in the morning after fasting. It never made sense to me either. I’m losing weight and watching my diet carefully. Average readings lately are 79 and 89 but always in the 100s in the mornings.

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@calicat

Interesting post. I take Metformin for my type 2. It’s well controlled however I too have higher readings in the morning after fasting. It never made sense to me either. I’m losing weight and watching my diet carefully. Average readings lately are 79 and 89 but always in the 100s in the mornings.

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I too had higher reading during am hours my endocrinologist suggested I take my Metformin at night
And that works for me I would ask my Dr if I could switch also most people go to a regular Dr for diabetes and I would suggest to go to an endocrinologist I have much better results when I switched I also went to plant based foods and that really helped no meat and no dairy
I lost the weight I had been trying to for 30 years good luck

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