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Medical Forum / Diseases and Disorders / Diabetes / August 2007

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What does low blood glucose mean, in the absence of meds - running out of fat?

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Good Night Moon - 10 Aug 2007 20:54 GMT
Hi all,

 I have my ups and downs of bg (mostly ups), but my fasting usually
is a nice 85. Recently I've had fastings around 70. Does this mean
you're running out of body fat, is the body struggling to
produce glucose? I don't lack energy, I feel fine (some trouble
with circulation), just hungry sometimes. Does it mean anything,
in particular? My BMI is probably 20 or thereabouts. As I say
in the subject, I'm not taking any medication.

Thanks!
Susan - 10 Aug 2007 21:01 GMT
> Hi all,
>
[quoted text clipped - 5 lines]
> in particular? My BMI is probably 20 or thereabouts. As I say
> in the subject, I'm not taking any medication.

Low fasting glucose may mean you're running low on cortisol in the early
morning hours, and/or low growth hormone.

Susan
Good Night Moon - 10 Aug 2007 23:12 GMT
>>   I have my ups and downs of bg (mostly ups), but my fasting usually
>> is a nice 85. Recently I've had fastings around 70. Does this mean
[quoted text clipped - 6 lines]
> Low fasting glucose may mean you're running low on cortisol in the early
> morning hours, and/or low growth hormone.

Thanks; I'll google further.
Nicky - 10 Aug 2007 21:41 GMT
>Hi all,
>
[quoted text clipped - 5 lines]
>in particular? My BMI is probably 20 or thereabouts. As I say
>in the subject, I'm not taking any medication.

T1, or T2?

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6%  BMI 25
Good Night Moon - 10 Aug 2007 22:45 GMT
>>  I have my ups and downs of bg (mostly ups), but my fasting usually
>>is a nice 85. Recently I've had fastings around 70. Does this mean
[quoted text clipped - 5 lines]
>
> T1, or T2?

T2
Nicky - 11 Aug 2007 09:39 GMT
>>>  I have my ups and downs of bg (mostly ups), but my fasting usually
>>>is a nice 85. Recently I've had fastings around 70. Does this mean
[quoted text clipped - 7 lines]
>
>T2

K - then I'll add my 2c : )  Fasting numbers are a product of what you
were at bedtime, how quickly your body uses that supply up, and how
much glucose your liver produces during the night. 70 doesn't sound
worrying - it's 3.8 in my numbers, where 4 is the accepted bottom of
normal - but I think I would be concerned if it drifted any lower. Of
the factors I listed, liver production is by far the strongest - have
you had liver function tests recently?

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6%  BMI 25
Julie Bove - 10 Aug 2007 22:32 GMT
> Hi all,
>
[quoted text clipped - 5 lines]
> in particular? My BMI is probably 20 or thereabouts. As I say
> in the subject, I'm not taking any medication.

I wish it meant I was running out of body fat!  What it means is you need to
eat some carbs.  You can have a hypo without taking meds.
bj - 11 Aug 2007 01:52 GMT
> Hi all,
>
[quoted text clipped - 5 lines]
> in particular? My BMI is probably 20 or thereabouts. As I say
> in the subject, I'm not taking any medication.

I have no problems with (fairly often) fasting bg in the 70's.
And if I don't eat right away I don't go notably up or down or faint
or anything. I can do some chores or whatever without any problem. I'm on
Januvia, but it doesn't make me go low. My BMI is also around 20. The lab
report lists 65 as being the low end of normal bg.
bj
Susan - 11 Aug 2007 02:00 GMT
>>Hi all,
>>
[quoted text clipped - 12 lines]
> report lists 65 as being the low end of normal bg.
> bj

bj, I don't think it lists 65 at the normal end of fasting, but of
casual, right?  I think 70 is more like it, and that's the rock bottom low.

Susan
Michelle C. - 11 Aug 2007 18:56 GMT
> x-no-archive: yes
>
[quoted text clipped - 21 lines]
>
> - Show quoted text -

The bottom number of normal FBG surprisingly is lab dependent.  I
worked in a lab that initially listed the bottom normal range for FBG
as 60.  However, when the laboratory bought a new chemistry analyzer
the normal range changed and the bottom number for normal FBG became
70.

Best regards,
Michelle C., T2
diet & exercise
Michelle C. - 11 Aug 2007 18:52 GMT
> Hi all,
>
[quoted text clipped - 7 lines]
>
> Thanks!

Before I developed glucose issues,....ahem....my FBG was always
between 60-65, and I felt fine.  I wouldn't be concerned with a 70 as
long as you feel okay.

Best regards,
Michelle C. T2
diet & exercise
Wingmask - 11 Aug 2007 23:45 GMT
> Hi all,
>
[quoted text clipped - 7 lines]
>
> Thanks!

My docs office told me 70 was great.
Will, T2 - 11 Aug 2007 23:54 GMT
> My docs office told me 70 was great

When I am at 70-75, which is rare, I am happy as a clam...

Will, T2
Frank t2 - 12 Aug 2007 00:05 GMT
D'you have to be a lawyer to know the emotional state of clams ?

I thought THAT would be a better response than telling
a few lawyer jokes ... am  I right ?

"Will, T2" <wmmckee@cox.net> a écrit ...

>> My docs office told me 70 was great
>
> When I am at 70-75, which is rare, I am happy as a clam...
>
> Will, T2
Will, T2 - 12 Aug 2007 00:33 GMT
> D'you have to be a lawyer to know the emotional state of clams ?
>
> I thought THAT would be a better response than telling
> a few lawyer jokes ... am  I right ?

Heh!... Well there are a few funny lawyer jokes out there, and I have
learned to develop a thick skin over the years.... Most of the time, it is
all in a spirit of good fun... :-) The person who cannot laugh at himself
and his profession, upon occasion, is usually an insufferable tight-a.s....
;-)

Now, upon the issue of the emotional state of clams, I seem to recall
something by Lewis Carroll that spoke to the matter... of cabbages and
kings. ;-) Ok, ok, maybe clams are not quite the same as oysters...but
close. They are both mollusks and bivalves. Oysters attach themselves to
surfaces, whereas clams burrow into sandy bottoms...

"A loaf of bread," the Walrus said,
"Is what we chiefly need:
Pepper and vinegar besides
Are very good indeed--
Now if you're ready, Oysters dear,
We can begin to feed."
"But not on us!" the Oysters cried,
Turning a little blue.
"After such kindness, that would be
A dismal thing to do!"
"The night is fine," the Walrus said.
"Do you admire the view?

Will, T2
Will, T2 - 12 Aug 2007 00:37 GMT
> D'you have to be a lawyer to know the emotional state of clams ?

Then again, clams are assumed to be happy, because they are always
smiling....

And people are happy when eating clams......

All in all, creatures strongly associated with happiness, it would seem....
Even if Lewis Carroll's oysters were a little gullible, they made their
companions happy!

Will, T2
Andrew B. Chung, MD/PhD - 12 Aug 2007 12:37 GMT
> Hi all,
>
[quoted text clipped - 5 lines]
> in particular? My BMI is probably 20 or thereabouts. As I say
> in the subject, I'm not taking any medication.

The liver is unable to make much glucose from fat.

It can make some from amino acids from the breakdown of muscle.

If you have been following a low-carb diet, you may be running out of
muscle.

This would explain the lack of hunger.

We do become less hungry when we are breaking down muscle because of
running out of stored glycogen (aka body starch).

Be hungry... be healthy... be blessed:

http://TheWellnessFoundation.com/PressRelease

Prayerfully in Jesus' awesome love,

Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist
Susan - 12 Aug 2007 17:32 GMT
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rob - 12 Aug 2007 18:50 GMT
Hi All,
           I am director of Diabetes Education in my local hospital.
You raise a very important question.Getting low blood sugars when we
are noton Diabetic meds can be caused by a number of mechanisms.
The number one sourse of quick balancing of blood glucose is through
our Livers.The glucose is stored as
Glycogen...Low carb diets will tend to reduce the amount of available
glucose from Glycogen and as the body has a difficult time converting
fat and protein into glucose there would be a tendency to low blood
sugar.
The second mechanism is through the STRESS response.The condition
hypoglycaemia is frequently associated with the Adrenergic fight
flight responce.This elevates the levels of epinephrine,
norepinephrine and dopamine which stimulate the uptake of glucose by
our cells ...leading to low glucose.
Finally ...There is a condition called glucagonoma...where the hormone
glucagon is secreted excessively by the Pancreas leading to low sugar
levels.
Dr Robert O'Dwyer MB FRCP(C)
Specialist in Internal Medicine/ICU
www.doctorodwyer.com

On Aug 12, 4:37 am, "Andrew B. Chung, MD/PhD"
<heartdo...@emorycardiology.com> wrote:

> > Hi all,
>
[quoted text clipped - 28 lines]
> Andrew B. Chung, MD/PhD
> Cardiologist
Andrew B. Chung, MD/PhD - 12 Aug 2007 19:09 GMT
> Andrew, in the Holy Spirit, boldly wrote:
> >
[quoted text clipped - 34 lines]
> fat and protein into glucose there would be a tendency to low blood
> sugar.

Indeed, very little glucose can come from fat (specifically from only
the released glycerol).  Moreover, only a subset of amino acids from
proteins can be used to produce glucose.

> The second mechanism is through the STRESS response.The condition
> hypoglycaemia is frequently associated with the Adrenergic fight
> flight responce.This elevates the levels of epinephrine,
> norepinephrine and dopamine which stimulate the uptake of glucose by
> our cells ...leading to low glucose.

This would ordinarily be more than offset by the production of glucose
by glycogenolysis when there are adequate glycogen stores so that
there is typically hyperglycemia during the adrenergic "fight or
flight" response in someone with insulin resistance (IR/MetS).

> Finally ...There is a condition called glucagonoma...where the hormone
> glucagon is secreted excessively by the Pancreas leading to low sugar
> levels.

Very rare in a type-2 diabetic.

> Dr Robert O'Dwyer MB FRCP(C)
> Specialist in Internal Medicine/ICU
> www.doctorodwyer.com

Many thanks, much praise, and all the glory to GOD for your
participation in this discussion.

May HE bless you in HIS mighty way making you healthier (hungrier)
than ever:

http://HeartMDPhD.com/PressRelease

Prayerfully in Jesus' awesome love,

Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist
Susan - 12 Aug 2007 20:04 GMT
> Hi All,
>             I am director of Diabetes Education in my local hospital.
[quoted text clipped - 6 lines]
> fat and protein into glucose there would be a tendency to low blood
> sugar.

Except that it's very rare for a type 2 on low carb to have hypoglycemic
episodes.  It's much more common in those who swing from high to low
eating high carbs or those who take beta stimulators or insulins that
need to be "fed."

> The second mechanism is through the STRESS response.The condition
> hypoglycaemia is frequently associated with the Adrenergic fight
> flight responce.This elevates the levels of epinephrine,
> norepinephrine and dopamine which stimulate the uptake of glucose by
> our cells ...leading to low glucose.

You've failed to mention the compensatory secretion of cortisol, to
supply the extra glucose as part of the stress response.  Are you saying
there's sometimes a dysregulation that causes uptake without cortisol
stress response?

> Finally ...There is a condition called glucagonoma...where the hormone
> glucagon is secreted excessively by the Pancreas leading to low sugar
> levels.

This is a tumor, a cancerous one, yes?

Susan
Andrew B. Chung, MD/PhD - 12 Aug 2007 20:50 GMT
> > Andrew, in the Holy Spirit, boldly wrote:
>
[quoted text clipped - 13 lines]
> Except that it's very rare for a type 2 on low carb to have hypoglycemic
> episodes.

We are not discussing reactive hypoglycemic episodes but rather a
person reporting overall trends of FBG decreasing with low-carb
dieting.

Be hungry... be healthy... be blessed:

http://TheWellnessFoundation.com/PressRelease
Prayerfully in Jesus' awesome love,

Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist
Andrew B. Chung, MD/PhD - 12 Aug 2007 17:31 GMT
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Andrew B. Chung, MD/PhD - 12 Aug 2007 20:39 GMT
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David - 12 Aug 2007 23:45 GMT
> Hi all,
>
[quoted text clipped - 8 lines]
> Thanks!
>  
why are you worried about a fasting of 70?  You just said you feel ok,
so what is the source of your worry?  You ought to be thankful you
aren't getting a fast of ONE 70.  :)
 
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