# Reactive hypoglycemia diagnosis



## Jennifer21 (Feb 18, 2021)

Hi everyone 

I have recently been diagnosed with reactive hypoglycemia and early type 2 diabetes. The dietician has advised me to change my diet completely which was a shock to the system. Since eliminating sugar and lowering my carb intake I have been suffering with headaches and nausea. Is this normal? What else should I expect to feel? 
Thanks for reading


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## Jennifer21 (Feb 19, 2021)

No not yet as I am on the borderline so they have advised changing my diet to see if that works before having to be on medication. Yes I have a bloods machine and will start testing. I just hope the headaches will ease off


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## Inka (Feb 19, 2021)

The headaches might be to do with dehydration @Jennifer21 High blood sugar can make you feel rough. High blood sugar can cause nausea too.

Did you have an HbA1C blood test to diagnose you? What was your result (ie the number)? You say “early” Type 2. I was just wondering what that meant - Type 2 or pre-diabetes?


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## Jennifer21 (Feb 19, 2021)

I had blood tests and I had to go into hospital for a 5 hour test where they took bloods every half an hour to see what happened after a meal. In terms of early it was explained to me as i am borderline type 2 and with diet change i should stop having these highs and lows. I've got consultant on March so will have a better idea then.


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## Inka (Feb 19, 2021)

Ah, ok. That 5 hour test sounds like the test for Reactive Hypoglycaemia. I know there can be a link with Type 2. I hope your diet changes work well. It’s great you have the support of a dietician


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## Jennifer21 (Feb 19, 2021)

Yes I agree I feel grateful for the dietican otherwise I wouldn't have a clue where to start with a diet. Have you had diabetes long?


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## Inka (Feb 19, 2021)

Jennifer21 said:


> Yes I agree I feel grateful for the dietican otherwise I wouldn't have a clue where to start with a diet. Have you had diabetes long?



I’ve had diabetes almost 30 years. But there are some people here who’ve had it much longer. I have Type 1 diabetes. I don’t need to watch my diet so much, but obviously I try to eat healthily like anyone should.

It’s a difficult thing to get your head round to start with but hopefully once you start feeling a little better you’ll feel more ok with everything because you’ll see some benefits.


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## AndBreathe (Feb 19, 2021)

Jennifer21 said:


> Hi everyone
> 
> I have recently been diagnosed with reactive hypoglycemia and early type 2 diabetes. The dietician has advised me to change my diet completely which was a shock to the system. Since eliminating sugar and lowering my carb intake I have been suffering with headaches and nausea. Is this normal? What else should I expect to feel?
> Thanks for reading



Jennifer, I don't have RH myself, but I have a very good friend who has lived with it for many years.

As I understand it, the principles of treatment are to soften the curves of you blood glucose.  With RH, like everyone else when we eat, your blood sugar will rise a bit.  If your metabolism is struggling a bit, generally (and a borderline to T2 could suggest that), then the rises can be quite fast and steep, then your body kicks in to deal with that rise, but does it too well, and your lowering blood sugar overshoots through the "good" ranges, into hypoland, and probably lots of symptoms.

Sadly, this activity is encouraged by the carbs we eat.  (We can see rises in blood sugars from protein and a very small extent from fats, but much less so than with carbs.)  So, eating a decent portion of carbs, your body is then eventually producing more insulin that it needs at that time to push your blood sugars right down.

So, many find that by moderating their carb intake, they can soften the peak, which in turn tends to soften the drops, making things much less uncomfortable.  How much you, personally, could need to moderate is very personal, and really this is where your personal fingerprick testing is critical.

I would encourage you to test a lot in the initial stages of any dietary changes, so that you can see what's going on, and learning how _*your*_ body works.  Everyone is very different.

What sort of changes have you made so far to your eating and drinking regimes?  From there folks might be able to help you move in the right direction.

Adopting that approach has helped many people, but unfortunately, it is likely to need to be quite a sustained change, so don't set yourself goals of objective you know you won't be able to live with over the longer term.

Good luck with it all.


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## Jennifer21 (Feb 19, 2021)

Inka said:


> I’ve had diabetes almost 30 years. But there are some people here who’ve had it much longer. I have Type 1 diabetes. I don’t need to watch my diet so much, but obviously I try to eat healthily like anyone should.
> 
> It’s a difficult thing to get your head round to start with but hopefully once you start feeling a little better you’ll feel more ok with everything because you’ll see some benefits.


Aww thats a long time. Yes it is difficult but this forum has lots of good conversations and advice which makes it easier. I cant wait to feel the benefits. Thank you for taking your time to reply to me I appreciate it


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## Jennifer21 (Feb 19, 2021)

AndBreathe said:


> Jennifer, I don't have RH myself, but I have a very good friend who has lived with it for many years.
> 
> As I understand it, the principles of treatment are to soften the curves of you blood glucose.  With RH, like everyone else when we eat, your blood sugar will rise a bit.  If your metabolism is struggling a bit, generally (and a borderline to T2 could suggest that), then the rises can be quite fast and steep, then your body kicks in to deal with that rise, but does it too well, and your lowering blood sugar overshoots through the "good" ranges, into hypoland, and probably lots of symptoms.
> 
> ...





AndBreathe said:


> Jennifer, I don't have RH myself, but I have a very good friend who has lived with it for many years.
> 
> As I understand it, the principles of treatment are to soften the curves of you blood glucose.  With RH, like everyone else when we eat, your blood sugar will rise a bit.  If your metabolism is struggling a bit, generally (and a borderline to T2 could suggest that), then the rises can be quite fast and steep, then your body kicks in to deal with that rise, but does it too well, and your lowering blood sugar overshoots through the "good" ranges, into hypoland, and probably lots of symptoms.
> 
> ...


Hi thank you for your reply I really appreciate it. Yes the lows are horrible make me feel awful until they pass. 
In terms of diet change I have had to change caffine to decaff coffee with no sugar. I had to stop drinking diet coke and change to water with a slice of orange. I used to live on carbs so now I'm down to the bare minimum. I think this is why my body is in shock as to what is happening. Once I can loose the weight I'm sure the RH will go and then I can introduce more carbs back into my diet in a healthy way. 
When is it best to test the bloods initially? Before and after meals? Also how long before and after meals should I test? What would you recommend?


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## trophywench (Feb 19, 2021)

1.  Are you getting testing strips for your meter on precription - or do you want signposting to a meter etc with more affordable strips cos you have to pay for them.

2.  Here's a good testing regime you could follow to get the most out of doing it

Type 2 Diabetes - A Personal Journey: Test, Review, Adjust (loraldiabetes.blogspot.com)


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## Jennifer21 (Feb 19, 2021)

Yes there on prescription and I have to pay for the prescription. 
Thank you ill definitely have a read over it and see what's best to do.


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## AndBreathe (Feb 19, 2021)

Jennifer21 said:


> Hi thank you for your reply I really appreciate it. Yes the lows are horrible make me feel awful until they pass.
> In terms of diet change I have had to change caffine to decaff coffee with no sugar. I had to stop drinking diet coke and change to water with a slice of orange. I used to live on carbs so now I'm down to the bare minimum. I think this is why my body is in shock as to what is happening. Once I can loose the weight I'm sure the RH will go and then I can introduce more carbs back into my diet in a healthy way.
> When is it best to test the bloods initially? Before and after meals? Also how long before and after meals should I test? What would you recommend?



It can take your body a little while to adjust to changes in your diet, and headaches aren't uncommon during that period.  Hopefully it won't persist too long for you, but please ensure you're also drinking enough.  When changing diets, dehydration is quite common too.

In terms of when to test, just before you eat, then I'd suggest hourly until you feel fine, but a minimum of at 1 and 2 hours.  Additionally, any time you feel you might be having a hypo.

The usual regime would be just before you eat then two hours later, but I think with your particular insulin dysregulation, it's good to know what's going on a while after you have eaten - hoping to understand how high you go, then what the resulting plummet down is.

Alongside that, personally, I'd want to record everything I ate or drank.  Of course all that sounds a complete faff, but it is a way to begin to understand how _*your*_ body works.

Do you know what your blood track looked like during your glucose challenge, or were you just given the diagnosis?


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## Drummer (Feb 19, 2021)

You could  be short of salt - there is so much added to processed carbohydrates (I used to work for Allied Lyons) so when you stop eating them a lack of salt is a distinct possibility.
You might try a multivitamin and mineral tablet, just a few times a week, simply because so many foods are low in minerals due to the way they are grown. Starting low carb usually results in a loss of electrolytes.
Changing to low carb can be a big shock to the system, so a little mollycoddling - having a sit down and a warm drink to rest and relax for a few minutes can take the strain off - assuming such behaviour is possible.


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## Amity Island (Feb 19, 2021)

Jennifer21 said:


> Hi everyone
> 
> I have recently been diagnosed with reactive hypoglycemia and early type 2 diabetes. The dietician has advised me to change my diet completely which was a shock to the system. Since eliminating sugar and lowering my carb intake I have been suffering with headaches and nausea. Is this normal? What else should I expect to feel?
> Thanks for reading


Hi Jennifer,

I did a no sugar diet challenge a couple of years ago (lasted a year), had a headache for weeks. Sugar is very addictive and not so easy to just go cold turkey.


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## Jennifer21 (Feb 20, 2021)

AndBreathe said:


> It can take your body a little while to adjust to changes in your diet, and headaches aren't uncommon during that period.  Hopefully it won't persist too long for you, but please ensure you're also drinking enough.  When changing diets, dehydration is quite common too.
> 
> In terms of when to test, just before you eat, then I'd suggest hourly until you feel fine, but a minimum of at 1 and 2 hours.  Additionally, any time you feel you might be having a hypo.
> 
> ...


Thank you. Yes I think I will definitely test regularly as I need to see which foods are sending me into lows and when. I am currently recording everything I'm eating on an app that I used previously as it keeps a record of calories and breakdowns of carbs sugars fibres. I am also keeping a record on an app of the sugars too so hopefully I will find it easier when speaking to the consultant. Thank you


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## Jennifer21 (Feb 20, 2021)

Drummer said:


> You could  be short of salt - there is so much added to processed carbohydrates (I used to work for Allied Lyons) so when you stop eating them a lack of salt is a distinct possibility.
> You might try a multivitamin and mineral tablet, just a few times a week, simply because so many foods are low in minerals due to the way they are grown. Starting low carb usually results in a loss of electrolytes.
> Changing to low carb can be a big shock to the system, so a little mollycoddling - having a sit down and a warm drink to rest and relax for a few minutes can take the strain off - assuming such behaviour is possible.


Yes it has been a shock to the system defiantly and its true what you say about lack of salt and minerals. I will try taking a multi vitamin and see if that helps. I know this feeling is short term until my body is used to it but it feels longterm at the moment. Thank you


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## Jennifer21 (Feb 20, 2021)

Amity Island said:


> Hi Jennifer,
> 
> I did a no sugar diet challenge a couple of years ago (lasted a year), had a headache for weeks. Sugar is very addictive and not so easy to just go cold turkey.


Yes I did one before and I couldn't stick to it. I lasted about 3 days as the headaches and feelings were horrible. This time I know if i don't change my diet i will end up with bad health I think that helps stick to it. Thank you


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## Drummer (Feb 20, 2021)

I eat a wide variety of salad and veges, all low in carbs but all different colours and flavours - it probably helps in many different ways to have such a variety of different foods.


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## Jennifer21 (Feb 21, 2021)

Drummer said:


> I eat a wide variety of salad and veges, all low in carbs but all different colours and flavours - it probably helps in many different ways to have such a variety of different foods.


Hi. I bought a large selection of veg and salad today so hopefully that will help. 

Does anyone know what the recommended daily carb intake should be? As I want to make sure I'm not overeating on carbs

Thank you


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## Drummer (Feb 21, 2021)

There isn't one, I'm afraid. That is why testing plays such a large part in getting control - by testing after meals you can discover what you can or can't eat.
I started at 50 gm a day and reduced down to 40 with no effect at all - Hba1c rock solid at 42.
Some people can eat twice the amount or more and get good results.


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## Inka (Feb 21, 2021)

Jennifer21 said:


> Hi. I bought a large selection of veg and salad today so hopefully that will help.
> 
> Does anyone know what the recommended daily carb intake should be? As I want to make sure I'm not overeating on carbs
> 
> Thank you



Your dietician should have given you an idea @Jennifer21 Did they perhaps say something implied rather than explicitly clear? What kind of things did they suggest you eat? That might give a clue to what amount of carbs they’re thinking about.

It also depends on your starting diet, I’d think.


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## Jennifer21 (Feb 21, 2021)

Thank you. As its all so new with this watching what I eat I find myself so shocked by the carb intake of things I wouldnt even see as bad. If you know what I mean


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## Jennifer21 (Feb 21, 2021)

Inka said:


> Your dietician should have given you an idea @Jennifer21 Did they perhaps say something implied rather than explicitly clear? What kind of things did they suggest you eat? That might give a clue to what amount of carbs they’re thinking about.
> 
> It also depends on your starting diet, I’d think.


Hi Inka. She never mentioned amounts she said to try and switch white products to wholemeal products and try and eat less carbs and more protein and veg. Before this I didnt watch carbs and looking back I ate loads of them. I just wondered if there was a rough estimate to follow. I will also ask the consultant when I have my appointment.


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## Inka (Feb 21, 2021)

Jennifer21 said:


> Hi Inka. She never mentioned amounts she said to try and switch white products to wholemeal products and try and eat less carbs and more protein and veg. Before this I didnt watch carbs and looking back I ate loads of them. I just wondered if there was a rough estimate to follow. I will also ask the consultant when I have my appointment.



There’s no estimate really because it depends on the individual and their previous diet - and also what she’s trying to achieve for you as an individual.

If you have a rough idea how many carbs you ate previously, you could make a cut and see how that goes, then cut down another proportion if needed.


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## Jennifer21 (Feb 21, 2021)

Thank you. I have cut down alot so hopefully this will help me now. I also need to loose 3.5 stone so again I'm hoping by cutting the carbs this will help. I'm having no sugar. Only brown bread and pasta instead of white products like pasta bread rice. No junk food and plenty of veg and I only drink water with a lemon slice. Fingers crossed the weight will start dropping


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## Leadinglights (Feb 21, 2021)

Sometimes cutting out caffeine can initially cause headaches as you have changed to decaf coffee and cut out diet coke that could be a factor.


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## Drummer (Feb 22, 2021)

Jennifer21 said:


> Thank you. I have cut down alot so hopefully this will help me now. I also need to loose 3.5 stone so again I'm hoping by cutting the carbs this will help. I'm having no sugar. Only brown bread and pasta instead of white products like pasta bread rice. No junk food and plenty of veg and I only drink water with a lemon slice. Fingers crossed the weight will start dropping


I'm afraid that brown carbs need to be weighed and counted, as they are little better (if any improvement at all) on white carbs.


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## Inka (Feb 22, 2021)

@Jennifer21 has already said she’s cutting down on carbs. Many diabetes reversal diets include whole grain carbs.


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## AndBreathe (Feb 22, 2021)

@Jennifer21 - I would strongly urge you to be guided by your numbers.  Those are _*your*_ numbers, not anyone else's.

Take your time and invest in lots of data gathering of what you put into your system - not just the carbs, but everything, then matched with your blood sugar readings, and mood/hypos or other signs or symptoms.

For me, initially it seemed a bit of a faff, and boring, but fairly quickly that allowed me, to see trends or foods that whether I liked them or not, were not my friends.  

Trust me, it's much easier to turn your back/build resolve based on data, rather than what an HCP or someone on the internet tells you to do.

You may also learn there are some surprise things that, unexpectedly, don't bother you at all, but most people find they have at least one blood sugar rocket fuel.

I'd urge you to trust in a robust approach of data gathering, then trust your own data.  You will know that is robust, true and clear.


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## Deleted member 25429 (Feb 22, 2021)

Jennifer21 said:


> Thank you. As its all so new with this watching what I eat I find myself so shocked by the carb intake of things I wouldnt even see as bad. If you know what I mean


Within a month you’ll know exactly what’s in all the main foods you eat . For example I only buy one specific loaf of bread because I know the carbs in each slice (I’m type 1 so need to calculate carbs to inject correctly) it does become less confusing with time


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## Jennifer21 (Feb 22, 2021)

Freddie1966 said:


> Within a month you’ll know exactly what’s in all the main foods you eat . For example I only buy one specific loaf of bread because I know the carbs in each slice (I’m type 1 so need to calculate carbs to inject correctly) it does become less confusing with time


Yes I'm hoping so. Im just so shocked at the amount of carbs in foods. I've never paid attention before and now im not surprised I have borderline type 2 diabetes and reactive hypoglycemia.


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## Drummer (Feb 22, 2021)

Jennifer21 said:


> Yes I'm hoping so. Im just so shocked at the amount of carbs in foods. I've never paid attention before and now im not surprised I have borderline type 2 diabetes and reactive hypoglycemia.


I concentrate on carbs from fresh foods such as salad stuff and colourful veges which do not exceed 10 percent carbs - they should prove to be full of micronutrients, vitamins and minerals, particularly if you can grow some of them yourself.
The inability to deal with carbs is not something you have brought on yourself - the modern diet is only really suitable for those who can cope with it, and the advice to eat healthy carbs which has been pushed almost as long as the 'low fat' mantra just ensures that we are set on the wrong path very early on in life. After decades of trying to cope we end up ill through no fault of our own.


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## Leadinglights (Feb 22, 2021)

Drummer said:


> I concentrate on carbs from fresh foods such as salad stuff and colourful veges which do not exceed 10 percent carbs - they should prove to be full of micronutrients, vitamins and minerals, particularly if you can grow some of them yourself.
> The inability to deal with carbs is not something you have brought on yourself - the modern diet is only really suitable for those who can cope with it, and the advice to eat healthy carbs which has been pushed almost as long as the 'low fat' mantra just ensures that we are set on the wrong path very early on in life. After decades of trying to cope we end up ill through no fault of our own.


Yes growing your own is brilliant, nothing more rewarding than to go a pick a whole bunch of fresh veg, even now I have carrots, leeks and salad leaves. My work colleagues used to tease me about my 'weed' salad. Summer yields French beans, peas and mangetout, tomatoes, cucumber, courgettes, aubergines, beetroot, cabbage, pakchoi and a selection of fruit. Sadly I had to give away most of the bumper crop of potatoes. I even tried growing celeriac, not a great success but edible. We were dreading that the lockdown would prevent us going to our allotment but it was allowed and it kept us sane and busy.


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## Inka (Feb 22, 2021)

Healthy carbs have many benefits. They include fruit and veg, but also whole grains, tubers, etc. They do *not* cause ill health.


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## Jennifer21 (Feb 22, 2021)

Drummer said:


> I concentrate on carbs from fresh foods such as salad stuff and colourful veges which do not exceed 10 percent carbs - they should prove to be full of micronutrients, vitamins and minerals, particularly if you can grow some of them yourself.
> The inability to deal with carbs is not something you have brought on yourself - the modern diet is only really suitable for those who can cope with it, and the advice to eat healthy carbs which has been pushed almost as long as the 'low fat' mantra just ensures that we are set on the wrong path very early on in life. After decades of trying to cope we end up ill through no fault of our own.


Yeah thats a good idea. I have bread or pasta on alternate days but some foods I find have carbs in anyway. Thanks for your advice I really appreciate it.


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## Drummer (Feb 22, 2021)

No problem.
I found quite early on that it would be a good idea to avoid grain of any kind, and peas and beans were problematic - my meter showed just how bad - but the good news came quite quickly and I have been classed as in remission for some time now.


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## Deleted member 25429 (Feb 22, 2021)

Jennifer21 said:


> Yes I'm hoping so. Im just so shocked at the amount of carbs in foods. I've never paid attention before and now im not surprised I have borderline type 2 diabetes and reactive hypoglycemia.


Yes it is surprising. I make all meals from scratch so I know what I’m eating . Good luck with your journey x


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## Ditto (Feb 23, 2021)

Hello and welcome to the forum @Jennifer21 if I didn't say hello before. 

Do you have to drink decaf? I've known people who wouldn't touch it with a bargepole. I limit myself to one coffee a day though so I have an ordinary Nescafe. I really look forward to it.  I believe you can get real coffee in bags now so I will give that a whirl when I can.

@Freddie1966 what bread do you eat? I'm avid to know.


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## Deleted member 25429 (Feb 23, 2021)

Ditto said:


> Hello and welcome to the forum @Jennifer21 if I didn't say hello before.
> 
> Do you have to drink decaf? I've known people who wouldn't touch it with a bargepole. I limit myself to one coffee a day though so I have an ordinary Nescafe. I really look forward to it.  I believe you can get real coffee in bags now so I will give that a whirl when I can.
> 
> @Freddie1966 what bread do you eat? I'm avid to know.


I’m type 1 ... but I eat a very high seeded bread with full fat cheese and only get a very slow rise in levels , as long as I inject half an hour before eating


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