I was busy working, and hadn’t eaten in a few hours, but I started to feel hot, sweaty and shaky. These symptoms are very similar to dumping syndrome that occurs within a few minutes after eating, also associated with RNY – but I hadn’t eaten anything recently. I thought to check my blood sugars – good thing I did: they were low!
That’s when I did some research and first learned about reactive hypoglycemia. The “treatment” is to eat something every 2-3 hours, to help keep my sugars stable, and to prevent anymore lows. It doesn’t always work.
How Low Counts as Hypoglycemia?
It depends on the doctor and their criteria. Typically blood sugar readings of less than 70 are considered hypoglycemic, but some criteria suggests that blood sugars less than 60 are hypoglycemic. I have always started to feel hypoglycemic symptoms when my sugars are below 70, but lately – my sugars get far lower, before I even realize there is a problem. My warning symptoms are changing – and that’s scary. These are the symptoms that I use to recognize there’s an issue, so I can take action.
The other day, I didn’t get sweaty. I didn’t get shaky… I was fine one minute, and the next, I was very confused, disoriented and everything sounded muffled. I managed to check my sugar and it was 44. No matter what scale you want to use – that’s low. My son managed to get me some juice, and I was fine within 30 minutes. The lowest my sugars have gone, that I got a reading on, was 21. I passed out after that. That was the day that we had to come up with a plan to better monitor and manage my low blood sugar episodes.
Why Does a Hypoglycemia Episode Occur?
Hypoglycemic episodes occur when there is a mismatch of insulin & glucose levels in the body: insulin levels too high and glucose levels too low. Low blood sugar is fairly common in diabetics (type 1 or type 2) and usually occurs in those who are insulin dependent. Adding insulin into your body, without balancing out the carbs you intake and/or energy you expend, can trigger a hypoglycemic episode.
Which brings me to the topic of this post… the other type of hypoglycemia, which I have: Reactive Hypoglycemia, also known as postprandial hypoglycemia. Reactive hypoglycemia is found is people who do not have diabetes…like me.
My low blood sugar episodes are caused by different endocrine and metabolic health conditions I have (suffer from, would be more accurate):
- Metabolic* from the late phase of dumping syndrome¹ as a result of the RNY Gastric Bypass surgery I had in July 2004. My body is producing an excess of insulin in response to the food eaten + with shortened digestive tract = low blood sugar attack. Even though I no longer have diabetes since my surgery, I most likely do have Metabolic Syndrome³ (aka: Insulin Resistance).
- Endocrine* issues arising from two health conditions: insufficient cortisol production (adrenal insufficiency². aka: adrenal fatigue), and also from hypothyroidism³ (low thyroid production).
*Read the links in the footnotes, to get more details on Metabolic and Endocrine conditions, and how they fully play into the hypoglycemia puzzle.
Why low blood sugar is an issue
Your body is genetically programmed to recognize low blood sugar as a threat to survival. Severe or prolonged hypoglycemia can cause seizures, coma, and death. When your blood sugar levels drop below normal, your adrenal glands respond by secreting a hormone called cortisol. Cortisol then tells the liver to produce more glucose, bringing blood sugar levels back to normal.
…except my body is no longer producing sufficient amounts of cortisol! So everything is low: my sugar, my thyroid AND my cortisol. It’s a triple hit of badness that makes me feel dreadful. Remember the song when you were a kid, “The knee bone’s connected to the thigh bone…etc.”, that’s what’s going on with reactive hypoglycemia. All of our bodily systems are meant to work together. If one (or more) are not functioning properly, it causes a cascading effect of issues.
- Heart palpitations
- Pale skin
- Tingling sensation around the mouth
- Crying out during sleep
As hypoglycemia worsens, signs and symptoms may include:
- Confusion, abnormal behavior or both, such as the inability to complete routine tasks
- Visual disturbances, such as blurred vision
- Loss of consciousness
What’s In My Emergency Glucose Kit
If you have high blood sugar, or low, you need an emergency glucose kit ready. Your insurance company may provide you with diabetic supplies, but you can purchase these items yourself, without prescription.
My kit includes:
- Glucose Meter: you put the test strip in the meter, put a drop of blood on it and it tells you what your blood sugar level is
- Lancets (also, need the ones that work with your meter): this is the tiny needle that pricks your finger to get the blood
- Glucose Test Strips (you need ones that work with your meter): this is what the blood drop goes on
- Lancet Needle Clipping & Storage (be safe, and properly dispose of your lancet needles)
- Alcohol wipes (to clean your finger before, and after, pricking)
- Glucose Tablets
- A snack bar (protein bar, granola bar)
- A bag to put it all in, so I can take it with me. You can put it all in your purse, or grab a handy bag like this one.
- Glucagon Pen (this would be prescribed by your doctor. You can’t buy these without a prescription)
Medical ID Information
Last, but definitely not least – you need some sort of medical identifying…something. Bracelet, necklace, card… something to indicate your medical conditions, in case of emergency, and you are unable to convey those to medical personnel. I have tried an engraved medical bracelet. Which works well, if you only have one or two health conditions to list; when you’re like me – and I have 15+, well… let’s just say they don’t make engraved medical ID body armor! 😀
So I recently got the MyID system. This system gives access to medical personnel to all of my info stored online. All of it. I control the info that’s in the system they access. I have the pod, which is the electronic hub, and then I have two bracelet bands I can use with it. You could also put the pod into a necklace or car keychain. They offer all those items. I also bought the stickers and the medical ID card, which I keep in my purse.
Then, they also have a QR code that I put as my iPhone’s lockscreen, and home screen. It can be scanned with a QR scanner app, and the info accessed that way. Not all medical personnel will have a QR scanner, which is why I have the bracelet and the medical ID card on me at all times.
Whew!! Lots of info – but very important.
Remember: I am not a doctor. I don’t play one on TV. So the info above is merely from my own research, some of that linked below; and also from my own personal experience. Please speak to your doctor, if you suspect you have low blood sugar, high blood sugar or any other medical issue.
Do you have hypoglycemia, or know of someone who does? How do you manage this condition – comment below.
¹ Post Gastric Bypass Hypoglycemia: A Serious Complication of Bariatric Surgery
² Adrenal Fatigue and Hypoglycemia Symptoms
³ Thyroid, Sugar and Metabolic Syndrome
4 Hypoglycemia Symptoms
5Accu-Check Glucose Monitors & Supplies