Low blood sugar - is this normal?

[flippyfloppy]

Hi there, just a bit of background - I am currently 26 week pregnant. Still suffering from nausea and morning sickness which only seems to subside if I eat constantly. I am totally worn out all the time, and my pulse seems to be racing and I have palpitations (tested iron levels over Xmas and were fine) . I was at the midwife yesterday, mentioned all of this (again) and didn't seem concerned, however my bp was also raised to 140/90 and there was a trace of glucose in urine so I need to go back monday to check again. Anyhow.... my dad is an insulin dependant diabetic and I was there this morning when I felt dizzy, sick etc.. and he suggested a blood sugar test which I took and the result was 2.4, which he thought was very low. I rang the hospital and spoke to a midwife who did not seem overly concerned, said this often happens in the early part of the day and just said to make sure I am eating regularly. I have (stupidly!) been googling low blood sugar and frightened myself with stories of coma's and seizures! Anyhow I wondered if anyone else has had this and if it is something I need to worry about and could it be linked to my other symptoms?? TIA

Bump.

Not normal and the midwife should not be fobbing you off on this. Anything below 3.5 is considered a 'hypo' for a diabetic. I don't know what it could be but you need to see a doctor.

Thanks for bumping and thanks for reply, I am at midwife tomorrow so will speak to her about it. Anyone out there have experience of this in pregnancy?

Hi

I'm type 1 diabetic so kind of well versed in all things blood sugar. People without diabetes tend to run lower blood sugars than normal when pregnant; for example when non pregnant your blood sugar would probably be somewhere between 4 and 5 when you woke up, whereas when pregnant more likely between 3.5 and 4.0. So whilst it is normal to run lower, 2.4 is very low indeed. From the point of view of someone with diabetes, I would be feeling pretty bad if my blood sugar was that low (it rarely goes below 3 and I keep tight control of my diabetes), I would feel shaky, irritable and would be very hungry and would definitely consume a small amount of 'fast acting carbohydrate' such as fruit juice or boiled sweets before carrying on with my day. don't panic about it but do be careful and knowing that you are suffering with low blood sugar its probably a good idea to have some juice or a snack before driving.

One of the early signs of type 2 diabetes (and perhaps gestational and even a slow onset type 1) is 'reactive hypoglycaemia' - this is where your insulin response is basically a bit out of whack and at times you release too much insulin in response to the carbs you have consumed. It may just be a one off incident that you have suffered but you certainly shouldn't be being fobbed off; if you were diabetic you would take a blood sugar of 2.4 seriously enough to treat it with fast acting glucose (in the form of glucose tablets, juice, boiled sweets etc).

With a history of diabetes in the family you should definitely be pushing this to get sorted, book an appointment with GP also tell her the measured blood sugar and family history....

In the meantime whilst you are waiting to get this sorted do what you can to keep your blood sugar as even as possible by eating things that contain complex carbohydrates (like wholegrains, pulses, pasta) and also fats which slow the release of carbs into your bloodstream; if you can stomach it starting the day with something like cheese on wholewheat toast will keep your blood sugar fairly even, or a bowl of porridge made with big oats. bananas are also good.

sorry for long winded post i hope everything gets sorted out soon for you x

Hi Ilovekitty..., thank you so much for taking the time to reply, very interesting what you say. If I am not satisfied by the midwife tomorrow I will definitley book in with GP. I'm going to take more notice of what and when I am eating in the meantime, thank you for the tips. x

Hi, I've got Gestational Diabetes. It was only diagnosed because my granddad was type 1 so they did a glucose tolerance test on the basis of my family history. I'd not had glucose in my urine or anything.

When you see your midwife tell her that your dad is an insulin dependent diabetic and that you'd like a GTT as soon as possible as you are recognising some symptoms.

I wouldn't tell her you used his kit to test (although I think you were right to do so) because some medics get a bit funny about prescription only stuff being shared. Also sometimes they like to diagnose on their own without being "advised" by their patient. Just my experience, anyway.

If you would like some advice from people with GD then there's a thread on it here

While 2.4 is considered a hypo if you are diabetic, people with normal glucose metabolism, particularly women, can get their blood sugar down to this level without there being anything wrong.

This is NOT a sign of gestational diabetes, it is just normal.

This can happen in pregnancy and doesn't mean anything concerning most of the time. Eat regularly and things should be fine.

I think your midwife sounds very sensible here. Just let her know if eating regularly doesn't settle things.

(A diabetes specialist doctor)

mrs gangly - i find your advice very surprising for a diabetes specialist; this lady has experienced lower than normal blood sugars (yes its normal for a pregnant woman to run lower, but not that low, i know people who are barely coherent at that level!), a family history of type 1, and has had glucose in her urine? what about that combination of factors make you think she shouldn't at least have preliminary investigations such as a GTT and/or HbA1C run?

whether you're a diabetes specialist doctor or not i really disagree with you that running a blood sugar of 2.4 is not cause for some concern. i typically run in the 3.5 to 6.5 range (ie close to 'normal' with a correspondingly 'normal' HbA1C so it's not like i run high and experience low symptoms at a normal blood glucose level) and anything less than 3 i would really feel it and definitely not be safe to drive. in fact i have a 3 year medically restricted driving licence for the very reason that all persons with insulin dependent diabetes are considered at high risk of hypoglycaemia on the roads (which is frankly bullshit if you are in control of your condition but unfortunately the DVLA doesn't really get this). if a person with type 1 diabetes were in a car accident and their blood sugar measured 2.4 the hypoglycaemia would almost certainly be blamed for the accident and the person with type 1 would almost certainly lose their driving licence.

I absolutely agree with ilovekitty.

Normal blood sugar for women can go as low as 2.0 on lab testing. It is also worth remembering that home blood glucose monitoring tends to read a bit low, precisely to ensure that diabetic folk treat their hypos, so lab glucoses will be up to 0.5mmol/L higher. We can't rely on capillary blood sugars for diagnosis therefore.

Diabetic folk run sugars a bit higher, as you rightly say, so will experience symptomatic hypoglycaemia much earlier.

The midwife is rechecking the glucose in the urine. Pregnant women can have glucose in the urine without having diabetes because the renal threshold for glucose is lower - more glucose is passed out of the body.

A family history of Type 1 diabetes does not make you more likely to get gestational diabetes, above and beyond having a higher risk of just happening to develop T1DM concurrently with pregnancy. The causes of T1DM and gestational diabetes are different and not related.

If there continues to be glucose in the urine, a GTT sounds very sensible. Indeed, despite what NICE says, many diabetes specialists, including me, think that ALL women should get GTTs during pregnancy, not just 'at risk' ones.

As much as I am amused at people with no knowledge disagreeing with me, I posted to reassure the OP that her midwife sounds like she is taking things seriously.

(FWIW, I agree with you about the DVLA. The rules are arcane and unfair.)

"As much as I am amused at people with no knowledge disagreeing with me, I posted to reassure the OP that her midwife sounds like she is taking things seriously."

What are you talking about? I have had type one diabetes most of my life and as such - living and breathing the condition 24/7 AND having gone through medically intensive pregnancies - I would say that makes me pretty knowledgable on the subject. In fact so-called specialists misdiagnosed me to begin with. It's a pretty misunderstood condition at the best of times.

If you read carefully the OP says her dad is insulin dependent NOT type one diabetic. Quite, quite different. As a specialist I'm sure you will be aware that type two diabetics often end up on insulin - and that type two diabetes often runs in families. It makes me feel quite bitter when specialists claim that those with diabetes know little about the condition.

A blood sugar that low is not 'normal' as you put it and it does require investgation: not a fobbing off which is clearly what this woman has got. To make it worse she is pregnant - and passing out through low blood sugar, I'm sure you'll agree, is not something to be taken lightly.

One more thing - blood glucose montiors not being accurate!? I have to say, I've never heard that one before.

Thanks everyone, some very interesting comments last night! I'll report back tonight after my appointment.

gangly your attitude is incredibly arrogant and dismissive - do you assume that all your patients have an incredibly low IQ and are incapable of reading and understanding scientific literature also? you are not the first and won't be the last medical professional to have this assumption that diabetes and mental retardation and irrevocably linked conditions, but it doesn't ever fail to shock me.

where does your commment about people with no knowledge come from exactly? you know nothing about any of our backgrounds whatsoever, besides which you are showing no respect for people with diabetes who are well educated and well controlled in their condition (and I have to say, being a well educated person with a science degree and educated to post graduate level that holds down a challenging professional job, keeping my blood sugars in a tight range whilst maintain a normal lifestyle and eating habits is by far the most challenging part of my life).

As I mentioned in my post I keep my blood sugars in a very tightly controlled range and my HbA1Cs over the last few years have averaged 5.5%; yet you are insistent on this point about running higher and experiencing hypo symptoms at higher levels - it is true that some people do, but when your blood sugars are maintained at the same levels as a non-diabetic person it simply isnt the case; I maintain that if i start to experience hypo symptoms at a BG of less than 3.5 that 'normal' persons would have a similar experience seeing as my HbA1C is within the normal range and achieved without wil swings (just checked my meter at this point; 7 day average 6.2, number of tests 69, number of readings above 10 - 2, number of readings below 4 - 4 (none below 2).

If you re-read my post you will notice that i did not make any assertion that because the op has T1 in her family that she has gestational diabetes (again where do you get off thinking that other people are totally uneducated and don't know this), my personal thought was that it was possible that she was in the early stages of T1; your comment is rather sweeping about there not being a link between gestational diabetes and type 1 though; no known link perhaps, but to me it seems unusual that otherwise slim and fit people in my close family have developed gestational diabetes and that I have type 1.

re meters, there is a natural margin of error but the assertion that they are set 0.5mmol lower is one i have not heard before and when i use the usual algorithm to compare meter average and the HbA1C achieved via a blood test it doesn't suggest this error.

I just dipped into this thread. Mrs Gangly is not to be trusted! Someone online claiming to be a doctor: credentials unknown. Stupid stupid arrogance definitely portrays that of an ignorant and arrogant medic, or someone being a fictitious one. Do not hang around with low blood sugar. Especially that low! Make an emergency appointment with your doctor: to get it checked properly. Bogus doctors are ten a penny- as are those with overgrown heads who think they are above everyone else.

And I am very amused that she thinks we'll trust her credentials when she clearly sounds like someone with their head so up their own arse that they can't hear any one else! Doctor: my arse!