One of those snark-inducing "Diagnose Me!" type questions.
March 9, 2007 5:21 AM   Subscribe

My friend, who was recently diagnosed with Diabetes Type I thinks I am hypoglycemic. Is he overly concerned because of his recent diagnosis or should I investigate further?

Events of yesterday:

06:15 Awoke.
08:00 Ate breakfast (2 hard boiled eggs, 1 whole wheat english muffin)
10:30 Drank coffee (black)
12:00 Ate lunch (Carrot, cauliflower and red lentil dhal, brown rice)
03:45 Swam for 30 minutes.
04:15 Sat in sauna for 10-15 minutes.
04:20 Felt very unsettled, hands visibly shaky.
04:30 Drank 15 oz. of 100% OJ
05:00 Ate some organic peanut butter on a slice of rye/pump bread.
06:30 Tested blood sugar = 88

I know nothing about blood sugar (hyper or hypo), but my friend who was in town visiting wanted to test my blood sugar after I told him about my shaky hands. He said the fact that my reading was 88 two hours after having OJ and half a pb sandwich was a concern.

I think he's extra sensitive to these things because he was just diagnosed with diabetes, but want to see if others in the hive who know about such things concur.

I did a little reading in hypo threads and was propelled to ask because most of the recommendations to avoid hypo are exactly what I did yesterday... complex carbs, water, exercise. I find it a bit odd that I experience (at least what my friend thought was) hypoglycemia considering my day was particularly healthy.

Also, passing out is apparently a symptom. I've never passed out, but a day doesn't go by where I don't get tunnel vision/have to steady myself from standing up at some point (especially if I'm squatting or sitting on the floor). I've always figured it was low blood pressure though, or something related to a low pulse (my resting heart rate is in the low/mid 50s).

What should one's blood sugar level look like two hours after a sugar infusion? Does a bottle of OJ count as a "sugar infusion" even? Also, how does one go about testing this sort of thing when they don't have a friend with a fancy machine sleeping on their couch?
posted by 10ch to Health & Fitness (14 answers total)
Type II Diabetic here.

Since you're having other issues, go to the doctor, but it doesn't sound like you're hypo. Normal people tend to have low numbers like that 'cause they're, you know, normal. Type II's shoot for a range of 90-140 two hours after a meal, so your 88 is fine. Dropping below 70 is considered hypo.

but yeah, get that other stuff checked out.
posted by Brandon Blatcher at 5:38 AM on March 9, 2007

Best answer: Is he overly concerned because of his recent diagnosis or should I investigate further?
Probably, yes.
03:45 Swam for 30 minutes.
04:15 Sat in sauna for 10-15 minutes.

The good life!
04:20 Felt very unsettled, hands visibly shaky.
This could be due to what happened five minutes prior.
06:30 Tested blood sugar = 88
A nice, normal reading.

Anyway, you're probably fine. Hypoglycemia is defined as having a low blood glucose level, with the bottom limit around 50. It can also be defined as a level at or below which hypoglycemia symptoms manifest themselves, such as those you mentioned.

Please note that glucometers are not very accurate, and that readings can deviate by as much as 10-40 points from actual plasma readings. Additionally, there are many, many other causes for symptoms that can be attributed to low blood sugar levels.

Diabetics are vigilant for symptoms associated with low glucose levels, as they often take medicine or insulin which can result in hypoglycemia. Oftentimes diabetics with previously uncontrolled blood glucose levels can develop such symptomatology even at "normal" sugar ranges: some patients with an average level in the 200-300s can start to feel shaky when they hit their goal levels.

Non-diabetics, however, shouldn't be on anything that should lead to a drop in blood glucose levels. Some medications unrelated to diabetes can lead to hypoglycemia.

At any rate, there are many causes for hypoglycemia, and there are many causes for symptoms that can be attributed to hypoglycemia which have nothing to do with glucose. As an example of the former: you could have a tumor that secretes insulin, leading to hypoglycemia. Example of the latter: you could be tired, relaxed, very warm from sitting in a sauna and feel lightheaded from sitting up too quickly.

The bottom line is this: if you're concerned, go see a physician. If you have symptoms, go see a physician. If you're worried about having low blood pressure or a slow pulse, go see a physician. Normal people can feel unsettled and have shaky hands at times. Normal people can have a resting pulse in the 50s. Normal people can get tunnel vision and unsteady upon sitting or standing up rapidly from a prone position.

I guess my short, internet answer would have to be: "you're probably fine. BUT YOU NEVER KNOW!"
posted by herrdoktor at 5:46 AM on March 9, 2007 [1 favorite]

This may or may not be germane, but just to answer one of your sub-questions:

Does a bottle of OJ count as a "sugar infusion" even?

Yes. I don't believe I'm hypoglycemic, but I am pretty aware of my blood sugar levels, and a bottle of OJ without accompanying protein is enough to make me feel sugar-crashy. There's plenty of fructose in there.
posted by clavicle at 6:11 AM on March 9, 2007

I'm type 1. Your friend is wrong that being 88 two hours after orange juice is a concern. My guess is that most non-diabetics would be at that level (based on anecdotal evidence from testing Mrs. Chinston after she eats cake, candy, etc.). And for that matter, I would expect to be at 88 (or somewhere in the 80-120 range, anyway) two hours after drinking orange juice, as long as I dosed my insulin correctly. (And yes, a bottle of orange juice would count as a sugar infusion. I use o.j. to treat hypoglycemia because you don't need much and it works so blessedly quickly.)

Try to be understanding of your friend's recent diagnosis, I guess (as it sounds like you are). Developing the disease as an adult can be a shock and require major life changes.
posted by chinston at 6:15 AM on March 9, 2007

Best answer: The shakiness is a result of an adrenal response to hypoglycaemia, from what I recall, so it isn't necessarily hypoglycaemia if you get it. I get the same thing if I'm just sitting waiting for an interview or something, independent of blood sugar.

Funny vision only happens for me when I'm relatively severely hypoglycaemic (did I mention I'm type I?) - I'm not even sure it's the vision that goes funny as much as my brain going woolly (a good indicator for me is a sudden inability to do integral calculus, but that's not one everyone could use perhaps). That wouldn't just vanish again quickly I wouldn't have thought, so that doesn't quite match up for me.

People who live with the risk of hypoglycaemia, or live with people who do tend to be more alert to stuff like this to the point of having false alarms (annoyingly often too), so don't be too quick to tie together events that could be coincidental and have other causes.

To sum up, I wouldn't think there's a lot of evidence to make you think it's definitely the problem, but like herrdoktor says if something's not right see a doctor.
posted by edd at 6:19 AM on March 9, 2007

Induced snark: A carrot is not enough calories to swim for 30 minutes on.
posted by DU at 6:51 AM on March 9, 2007

12:00 Ate lunch (Carrot, cauliflower and red lentil dhal, brown rice)
03:45 Swam for 30 minutes.
04:15 Sat in sauna for 10-15 minutes.
04:20 Felt very unsettled, hands visibly shaky.

More protein perhaps? When I don't keep up on protein and work out, I get the shakes and get muderously hungry.
posted by Brandon Blatcher at 7:13 AM on March 9, 2007

Hi, type 1 here. My girlfriend (without diabetes) occasionally checks her blood sugar under different conditions, just to compare with me. She's tested as low as 60, 65 (and been grouchy as well), and in the middle of carb-absorption/digestion has been as high as 135 on my consumer-grade meter. These are all well within the normal range of variation, and neither level persisted long enough to be of concern... In my own experience, when I have a very tight range of control (standard deviation of ~15 mg/dl), a drop of 15-20 mg/dl is enough to make me feel a little shaky, and I certainly will by 70.

Also, another friend tested low (55-65) during her pregnancy, which corresponded to her occasionally urgent hunger.

Regarding the sauna, I have experienced lightheadedness and hypoglycemic-like behavior after an exceptionally hot shower or a brief nap under too many covers, and a check of my blood sugar was not low enough to correspond with these feelings otherwise... My unscientific recommendation is to take it easy after being in a hot place and have a replenishing carby snack after exercise.
posted by zachxman at 7:23 AM on March 9, 2007

Yoiu're likely not hypglycemic, but if you're concerned, check your blood sugar when you're symptomatic, ie, when you're shaky, not 2 hours later. The shakiness in this case likely came from the sauna.

88 is normal, but says nothing about your reading two hours prior when you were symptomatic.
posted by cahlers at 8:53 AM on March 9, 2007

Do you always spend 15 minutes in the sauna?

If you have naturally low blood pressure, that can lower it (or it does for me) and I can feel a little wonky afterward.
posted by konolia at 9:08 AM on March 9, 2007

Tell him MYOFBS.

Really, it's cute he's concerned and it's nice that he's vigilant about his own care. But really, just because he has a cool looking little kit doesn't make him an authority. Just like my having a sewing machine doesn't mean I should make you a dress for the Oscars.
posted by hermitosis at 9:31 AM on March 9, 2007

Type I diabetic here. I'm working on postprandial (i.e., 2 hours after eating) targets of <1 80 mg/dl. that's set as being around the average reading non-diabetics would have after a large>
I wouldn't panic, but second the recommendation that, if this is a frequent occurrence, you check your blood glucose during (if possible).

Regardless if it's low blood sugar or low blood pressure, if you're having an episode a day, I'd think you should get a workup from a medical professional at the next reasonably convenient occasion.
posted by stevis23 at 9:52 AM on March 9, 2007

I'm struck by how little you ate in the 9-1/2 hours before exercising. Does the food on your list (prior to swimming) amount to even 500 calories? I'd be real shaky, if not passed out on the floor, if I tried that.

If that's your normal routine, you might just need to eat a little more.
posted by sgass at 10:09 AM on March 9, 2007

Hypoglycemia is not a disease.
Is not a pre-cursor of diabetes.
Is not a medical problem.

Eat a bit more protein and fat. Watch your intake of high-glycemic index foods.
posted by docpops at 10:54 AM on March 9, 2007

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