When to see Endo

Hi all, I posted on the RNY board but really didnt get much help.  Long story short I have been experiencing some numbness in my toes and fingers and decided to get my levels checked.  My D is still low but I am working on pulling that up with D3.  The problem is that my glucose was 45!  Doc was worried and called me in.  ITs a new doc (primary care)and I explained that I knew I was hypoglycemic because I had symptoms of it.  I had never kept track of my levels etc I just knew to pop some glucose tabs when I felt bad.  Well.  The scary thing is that when I saw her I truely felt just fine!  I had no symptoms at all and went about the rest of my day feeling ok.  She gave me a blood glucose meter and told me to test when I felt bad.  I asked her well shouldnt I test more often and she said no only when I felt bad.  Seems to me if I had a level of 45 and felt nothing and thats a dangerous level I need to test more frequently then that.  She seemed really confused. 

Do you all think I need to Confer with an Endo right away or take this as causually as my doc is taking it?  Ive talked with a few people who have diabetes and they told me that I should see someon asap.  I dont know if thats blowing it out of proportion and that these levels are normal for us who have RH after gastric.

Take it seriously. Very seriously. I'm surprised your doc isn't that worried about it.

Levels should be around 100, some folks don't always feel their levels drop though and they end up in comas because they don't catch the drops fast enough to correct them. A lot of times this happens with folks who are diabetic and take insulin - it's like they build up some kind of tolerance to the feelings associated with really low blood sugar and quit recognizing the symptoms until it's too late. If you were at a 45 and felt fine, you REALLY need to be talking to someone. Who knows how low you could go before you noticed it? And you certainly don't want to end up in a coma because you don't realize you are having an episode.

I would see another doc asap; you just never know when something is going to happen.

Take Care.

I get the shakes when I am in the 70's, and if it gets lower than that I really feel bad. That is scary that you can get that low and not have symptoms. Yes, I would see an Endo, if I were you. Normal blood sugar levels are 80-100 for the average adult.
Take care,
Beth

I would get an appt with an endo and check throughout the day for a week or so so you can tell the doc what numbers you have been running.

Taking glucose to correct just perpetuates the cycle.

Try keeping PB crackers handy and maybe 3 of them, with water. Seems to bring it back faster and hold it steadier than hitting your confused pancreas with more sugar.

Look up: nesidioblastosis, just so you're up on it.

What are you doing for your D?

Thanks Everyone. With the D I am taking D3 and its helping some.  My D was 11 last time I got tested and now im at 27. And yes I know thats still bad!

Looks like the consesus here is that my doctor should be taking this more seriously and that I should test more often. I will say that my Dr. seemed VERY confused! Why I don't really know.   I am going to make an appt with the Endo and see what he has to say.  I will look up nesidioblastosis are you saying that basically what  I am dealing with?

Oh not, not diagnosing anything. Just want you to look it up in case that is something he talks about.

It has been mentioned in some ASMBS literature, but the treatment scares me. As long as I can control the RH with not having as many carbs as I want, I'd prefer it. The treatment is still experimental and includes taking a large hunk of pancreas OUT. Those who have done it are not terribly pleased with the results.

See an endo asap.

I have these articles on my blog about reactive hypoglycemia (or "late dumping" as they are calling it in some places) and the RNY:
Endocrine News
Endocrine Today Blog
Evaluation and Management of Adult Hypoglycemic Disorders An Endocrine Society Clinical Practice Guideline
Low blood glucose levels may complicate gastric bypass surgery
Gastric Bypass Linked to Abnormal Glucose Tolerance
Abnormal glucose tolerance testing following gastric bypass demonstrates reactive hypoglycemia
Pathophysiology, diagnosis and management of postoperative dumping syndrome
Reactive Hypoglycemia is a miserable condition. You go high with your blood sugar and then drop really low very fast. It's like riding a roller coaster that you can't stop. And sometimes the roller coaster hits bottom and crashes and kills you.

Don't be the one it kills.

Thank you!  I have put in a call to my surgen to see if he will prescribe more strips since my primary care physcian refused to do so.  She told me to wait a month! 
I will also try to get a recommendation from him on Endo that he refers his patients to..