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Quality Health Care and You - Diabetes

Symptoms of Low BS When Not Actually Low

07/14/2009

Question:

I have not been diagnosed with diabetes, but I have had some other health issues lately. Over the last few weeks, I have had bouts of what feels like low blood sugar - weakness, fatigue, shakiness inside, hand tremors, difficulty concentrating. It feels like a much stronger version of what it feels like when you skip a meal or two. The symptoms are relieved by eating, sometimes as soon as 5-10 minutes later, and sometimes they take as long as an hour to fully subside.

I was given a glucometer to check my blood sugar, and it has never been lower then 98. Most of the time, it is about 107-115 before meals. I have never checked it immediately after eating a meal; however, one random test I did yesterday showed a surprising blood sugar of 175. I have also gotten a reading of 140 and 149 on random readings. Although, I do not remember how close it was to my last meal when I took those three tests.

This morning, after fasting all night, my BS was 115. Two hours later, still fasting, it was up to 130. I am confused. How could this happen?

How can someone have low BS symptoms relieved by eating but not actually have a low BS of 70 or under? I am not even close to that number when I get symptoms. Also, is it normal to have a higher test result after eating (like the 175, 140, and 149)? If so, for how long should the BS stay up in a non-diabetic?

-Thank you

Answer:

As for your first question, there are no specific symptoms of low blood sugar. Some of the symptoms caused by low blood sugar (as described by you) are the symptoms of autonomic (sympathetic) nerve activation associated with this condition. Thus you may have problem with autonomic function and not blood glucose and have the same symptoms. Based on the glucose values documented by you, your symptoms are clearly not related to any abnormalities in glucose metabolism assuming that your gastrointestinal system is intact (you did not have any upper gastrointestinal surgery). Similar symptoms have been reported with low blood pressure after meals, which can occur in older individuals and almost never in younger people.

In response to you second question, diabetes status can be determined by oral glucose tolerance test. However, based on the numbers you reported here, you have an impaired fasting glucose and may have an impaired glucose tolerance, which should be sorted out by your primary physician.

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Response by:

Marzieh  Salehi, MD Marzieh Salehi, MD
Assistant Professor of Endocrinology
College of Medicine
University of Cincinnati