Reactive hypogycemia and losing consciousness

I completely agree with you. With a very low BS - I have to raise it up quickly first, even if only to 50's or 60's, then I can gollfo up with food that has proteins and fat.

Mine was in the 40s and I carry a glucagon shot now just in case... 28 sounds terrifying. I'm sorry Stacy :(

I am like you, I don't feel anything until it's WAY TOO LOW and it's scary.

Is your injector of glucose, actually glucose or is it glucagon? I'm asking out of curiosity. I've been a diabetic for 25 1/2 years (insulin dependent for the first 24 of those) and I always carried glucagon but I've never had anyone give me glucose to inject.

My concern with glucagon is that its mechanism is to stimulate the liver to dump stored glycogen and when you eat an extremely low-carb diet you don't generally have much glycogen store and therefore it can be ineffective at treating a low in an emergency.

I had a friend die from exactly that scenario. She was a Type I on an insulin pump who was following a 10g of carbs or less per day diet. She got the flu and her blood sugars were running high and she treated with a large amount of insulin. When her illness broke and her insulin resistance lowered she was taking too much insulin and went very low. Her family treated her with glucagon but it was ineffective.

I'd find it interesting if you actually found someone to give you D50 or similar.

You're right, it's actually Glucagon. Sorry that I wasn't clearer.

I've only had to use the injection once, thankfully. No one can say how low I'd gotten, but by the time I was tested, I was in the low 20's. This event was not while I was on insulin. I didn't even think it was possible without insulin, so I didn't take my hypos as a serious risk at the time.

What you say makes complete sense -- and as you know, I maintain a very low carb intake (although closer to 25 to 30) -- so I am interested in what you suggest is a better solution for an emergency situation.

I also lost a friend to diabetic shock/coma from hypoglycemia -- she was on an insulin pump and recovering from a viral infection as well. I am sorry for your loss. :-( It's one of the reasons that I take RH very seriously.

Honestly, the really scary answer is that there isn't a better way. I was diagnosed as Type I for 20+ years (we obviously now know I'm not Type I). In that community, the gold standard was a continuous glucose monitor which had alarms that would alert you to lows and allow you a cushion to correct them. In addition, insulin pump technology has come a long way in offering 'predictive low' software that can help to temper basal insulin rates based on forecasting and trends.

However, living in in the U.S. means that CGMS technology is extremely cost prohibitive for those without insurance or those not living with a condition that would 'warrant' coverage. I actually have considered purchasing a Freestyle Libre as a sort of in-between option. Link for the unfamiliar. In my case, I'd like to monitor highs, as I luckily do not have issues with lows while off insulin.

I would imagine that access to something like dextrose would be useful, but from what I've read it's only marginally effective when injected subcutaneously and if you were to receive it in a medical setting they would deliver it intravenously. In addition to that, you have the complicating factor that people with RH have cyclic issues if they treat lows with sugar, so treating with glucose would require to that someone then be able to ingest protein/fat to offset the carbs.

So, yeah, no great answer and it's scary.

I know I'm late to the party, but I am cyclic and if I don't follow up with a protein hit, I'm on the roller coaster. Like I said above, my endo would prefer me to head to the ER (or at the very least urgent care) if I get into the 20s because he said I really can't treat myself effectively when it's that low.

Diabetes and its treatment, RH, low-carbohydrate diets and their impacts on the body, etc is extremely interesting to me. On that same vane, I have a friend who's daughter has Glycogen Storage Disease (my friend is Type I, and we're not sure how the two diseases are related).

It pretty much mimics exactly what happens to those of you with RH. Because her body doesn't store glycogen properly (in minimal amounts) when she eats something high carb/loads of sugar she has a spike in glucose and her pancreas kicks in with insulin production which can't be tempered by sugar dumping from her liver. Hence, she ends up dangerously low. They've had to call an ambulance 3 times now because they couldn't rouse her. She also has the issue when she goes long periods without eating. She's 6 years old currently, so it's very hard to explain to her the ramifications of skipping dinner because she's simply not hungry.

I can't imagine dealing with what all of you go through RH at that age!

Glycogen Storage Disease

I have glucagon. I've never heard of anyone being prescribed D50 or similar. Actually my endo said the only thing he could give me was the glucagon, but if I got to the point where I needed it, I should make my way to an ER for assistance.

For what it's worth, f i were in your place I would be keeping a detailed food log. If you have future episides, you can keep a journal of exactly what you ate, and how long it had been. Keep in mind it's not just the most recent meal that's important. If you had gone a long while since eating the next to last meal, it will effect how you react to your current food, for instance. A journal can help clarify things for you and your doctors.