Low Blood Sugar- Hypoglycemia

[MacKinnon]

My midwives offer the use of a glucometer to check blood sugars during your normal daily routine rather than doing the glucose tolerance test, if you prefer. I certainly did prefer, and being low-risk they actually offered to let me skip it. However, I've been having clear blood sugar swings, particularly in the morning, so I wanted to check and see where I was. I had the glucometer and checked the last two mornings. I forgot yesterday and ate, but checked my levels an hour later and was at 106, precisely an hour after that, I was at 107. Well under the postprandial levels, but not following the normal trend of going up after an hour, then decreasing. So, I checked this morning and my fasting blood sugar was 25!!! Yes, upon awakening my blood sugar was 25. I did feel like crap, my heart was racing, I was shakey and lethargic. I had a glass of orange juice and a bowl of multi-grain cherrios and took it again an hour later, I was up to 96. An hour after that, 103. It was nearly four hours after I got up before I felt good, and would have driven. I was too shaky, etc. to drive. This is NOT the first time this has happened, hence why I wanted to check, but I wasn't expecting 25! I've read online that glucometers are often 15 to 20% lower than venus serum checks, so this is probably artificiality low, but still, it's alarming!

So, I'm in at the midwives tonight at 6pm and I'm wondering what to ask? They are a free-standing birth center practice of two CNM's and a DEM. Very hands off and non-medical. However, I'm obviously concerned, and expect they will be to. I'm just wondering what to expect, what to be aware of, what to ask. I'm having trouble finding good info about hypoglycemia, or low blood sugar during pregnancy, everything is about gestational diabetes and managing high blood sugar. I'm a researcher/planner person, so I'm driving myself a little nuts with the googling. Anyone BTDT? Thanks!

[Monarchgrrl]

I don't have much help, except BTDT. I've been consistently hypo since I was in grade school. I've fainted so many times I stopped counting (basically anytime I skip a meal). I've talked to my midwife about it and she is hypo also so she really gets it and she just told me things that I already knew. She wasn't alarmed at all. It's better than having super high, uncontrolled blood sugar because it's pretty easily treatable with food:

Eat often, in smaller amounts and stay away from high sugar and empty calorie foods. Keep the protein high and it helps to keep your sugar level steady instead of jumping up (even if it's just barely jumping, it's still not steady) and then crashing down. In the past when I've eaten strictly no carbs I've definitely felt the difference, but I refuse to be totally carb and fruit-less so I still get big swings on the low end every morning. If you can, stay away from OJ as a first morning thing. I know it's easy and fast to get the sugar up (I do it way too often!) but if you eat a hard boiled egg or some nuts in the middle of the night and then some cheese or another egg or nuts first thing instead of juice it will help. And try to do this before even sitting up in bed. For me, if I'm really low in the morning then even just standing up will tip it and I'll pass out, or just barely make it to the fridge for juice before passing out. Of course if you're really crashing (like almost passing out in the shower like I do when I forget to do this) then OJ will be a quick fix, but then very soon after have some good protein. Also, a good trick is to only eat carbs or fruit or anything with natural sugar WITH protein. If I eat grapes or an apple I only eat it at the same time as some cheese, egg, or with peanut butter. IIRC it makes it so your body absorbs and digests the protein first and makes it hard to absorb the sugar from the fruit, thus keeping your sugar levels more steady.

[MacKinnon]

Thank you for your advice! It's helpful! I have been dizzy in the mornings, very light-headed and struggling to feel normal before noon. Your tips are very helpful!

So, I had my appointment and my midwife wasn't too worried. She gave me the option of continuing to monitor my levels for a few weeks while I figure out whats helping/hurting/etc. I choose to monitor, I'm a numbers sort of person, and I think it will help me straighten out what I need to eat and when. Eating more frequently and snacking right before bed will help a lot, I think.

I forgot to talk with her about my thyroid problems though, I have a history of post-partum thyroiditis and I'm wondering if my thyroid levels shouldn't be re-checked, as thyroid levels can be a cause of hypoglycemia without diabetes. She did not recommend any further testing, as I will be continuing to monitor at home, so I'll see if I have persistent lows without any highs. I'm finding myself anxious about not having more testing to confirm that I don't have gestational diabetes, but I suppose the home monitoring will clarify that. I have a co-worker who had gestational diabetes but for 28 to 36 weeks only had low-blood sugar problems. It wasn't until after 36 weeks she started to have high-blood sugar issues, and then they were HIGH, she ended up getting induced at 38 weeks because they couldn't be kept under control.

Oh boy, it's going to be interesting! This is a lot of new things to consider, research, think about, etc. I would appreciate any other input anyone has! Thanks again Beth!