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From Eugene, Oregon, USA:

I am female, 26 years old, 5 feet, 5 inches and was always 115 to 120 pounds. This past year, I have put on over 25 pounds despite my pretty good eating habits and exercise (four or more hours daily). I have always been very athletic and stay busy running after two young kids. I have had low blood sugar for years, since I was a teen. It got increasingly worse once I had both my daughters, in 2000 and 2002. When I was pregnant, my OGTT reading was 135 mg/dl [7.5 mmol/L] during my first pregnancy and 137 mg/dl [7.6 mmol/L] during my second pregnancy. When I would get low blood sugar, my mom would just have me eat cheese or drink orange juice and that always seemed to help. I'd get really faint, dizzy, shaky, weak, fatigued, numbness in my tongue, headaches, etc.; it was just awful.

Last year, I was at my diabetic grandmother's house and I had a "low blood sugar" spell and asked for some orange juice. She decided she wanted to test me first and it was a good thing she did. I was in the high 200s mg/dl [over 15.6 mmol/L]. I do not remember the exact number, but I felt awful. She sent me home with a meter and strips and I have been monitoring my blood sugar since then (10 months ago). I have had lots of readings in the 200s mg/dl [over 11.1 mmol/L] and quite a few in the 300 mg/dl [16.7 mmol/L] range. I still continue to get daily low readings, 40s mg/dl [2.2 to 2.7 mmol/L] and 50s mg/dl [2.8 to 3.2 mmol/L]. I have even been as low as 30 mg/dl [1.7 mmol/L].

I went to the health clinic last year when I did not have insurance and had a blood sugar reading in clinic of around 180 mg/dl [10.0 mmol/L], three hours postprandial, so they took blood for an A1c test, which came back at 4.7. I was kind of shocked that it was so low. I felt silly pushing the issue and just continued to keep testing myself. I now have three meters which are all newer. I mainly use the Accu-Check Aviva, which is one point off from the laboratory readings, so it's very accurate, I believe.

I decided to go back to the doctor's since I have been feeling worse, especially when I go high in the mid 200s mg/dl [around 13.9 mmol/L] and when I am low. I always have pretty high postprandial spikes. Sometimes, they come down quickly; other times, they stay elevated, but between 180 mg/dl [10.0 mmol/L] to 250 mg/dl [13.9 mmol/L] is pretty average after just about every meal. I told the doctor that my last A1c was great, that my fastings are almost always in the 80s mg/dl [4.4 to 4.9 mmol/L] at home, but, the way I understood was that if I were having a lot of lows, that could be a reason for my low A1c. He agreed, told me that I am "unofficially" diabetic and gave me a prescription for test strips. I told him I didn't want an unofficial diagnosis, that I wanted to be sure, and requested the OGTT, which he did not want to do. He felt confident that the blood work he was ordering would show something.

Well, today, I got the results that my fasting blood sugar was 91 mg/dl [5.1 mmol/L], my A1c was 4.6, and a letter from my doctor that I am indeed not diabetic. I am beginning to get more frustrated. I am not getting answers other than my A1c is great, which it is. Why am I having highs and lows, feeling awful and just always tired? Going from 75 mg/dl [4.2 mmol/L] pre meal to 250 mg/dl [13.9 mmol/L] and then back down makes me exhausted and an overall just an icky feeling. I am experiencing a lot of low blood sugars, a lot of high postprandial spikes. I know my meters are working.

The only other health issue I have is endomitrioma and have had cysts on my ovaries, but was told that was not related at all. Diabetes runs in my family, both types 1 and 2. Years ago, my cousin was diagnosed with type 1 as a child, and most of my grandparents (maternal and paternal) are diabetic. My father has issues with his blood sugar as well but has not been to a doctor.

I would love to hear your input and advice. I feel like I am getting the run around from doctors. Are my levels normal and just something I need to learn to deal with or should I keep pressing the issue?


With your history, I would have a 75 gram oral glucose tolerance test (OGTT) performed. This is the best test for evaluating post-meal glucose. With the information you bring to the situation, you could very well have post-meal high glucose levels that make you feel bad and have the ability to rebound back to a normal fasting glucose without a high hemoglobin A1c. Therapy directed at decreasing your marked post-meal glucose excursion could make you feel better.


Original posting 10 Sep 2008
Posted to Diagnosis and Symptoms


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Last Updated: Tuesday April 06, 2010 15:10:16
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