Blood sugar spikes, reactive hypoglycemia, and how to avoid them: an interview with Penny Figtree MD

[@philipthompson117]

Thanks for posting this video (and your other ones). I have been eating porridge for breakfast for the last 15 years. 13 years ago I was diagnosed with diabetes. I have been using a cgm now for 3 months. I stopped the porridge yesterday. Today was the first day with no insulin and no spikes.

[@pennyfigtree5930]

I had a patient on 20 units of long acting insulin in the morning. He would have a hypo most afternoons! I stopped his porridge and his insulin and the next day he was terrific. His Hbaic is 5.2% off all insulin. So it sounds like you are similar!

[@danguee1]

I'm very interested: my girlfriend eats lots of 'Bircher' muesli. A very simple version of it: porridge oats soaked in cold milk with maybe just 7 or 8 raisins. I've always assumed that not cooking it might result in slow release of carbs and lowish blood sugar spikes. Might this not be the case? [Ah: 7:43 - Bircher's also potentially a problem...]

[@h.4727]

Oatmeal, which most people consider "healthy", has a macronutrient profile that's over 90% carbohydrates. Porridge is even higher.

[@philipthompson117]

Thank you Penny. I have stayed off the porridge but I had to go back to the insulin. I tried stopping it again a month ago but blood glucose became unstable within a week. I have a cgm. Thankfully my readings are still improving with a Hba1c estimated at 7.1. I was about 5kg overweight and that is now dropping. Energy levels are improving and brain fog has lifted.

[@sunbeam9222]

I have oatmeal with 300 g of skyr yoghurt which is very low in sugar and very high in protein, + half a green apple or a full one mixed in there, delicious and keeps me full and satisfied for hours, no spike. I'd never eat that alone or just milk tho. Also need to mention, I'm in France, might be different oats.

[@vulcanorigan]

Well said ! I had the experience too. I work night shift, I used to have a cup of coffee with a piece of bread or a piece of baked sweet potatoes at 1 am, I felt hungry and shaking by 5 am . Now I have been on low carb diet for more than one year, my fatty liver reversed,my joints pain is gone, my cholesterol panel is in optimum range, most of all I feel energetic and happy!

[@janiemiller825]

Is very low carb like keto diet of only 20-50 carbs daily ok when you’re hypoglycemic? Or dangerous? Too low carb? 🤔

[@simergill7510]

Can you send your diet ?

[@willamgordon3081]

I am reactive hypoglycemic also. I have the same reaction to oats as Doctor Figtree. As I have aged, my A1C has moved into the pre-diabetic range. I purchased a CGM about 2 weeks ago so that I could get a closer look at my blood sugar. The CGM data revealed to me that my blood sugar levels were all over the place. My lows were around 55mg/dl and my highs were at 180mg/dl. As I started watching my carb intake, I was able to remove the highs and the lows from my blood sugar range. Now I am between 88 and 135. Within a week I notice a drop in my weight, and I was feeling better overall. For me, the CGM is a window into how food effects my blood sugar so I can make the corrections now before it is too late. Thanks for the video; conformation for me!

[@nourishedbyscience]

Very good. Thank you for sharing. Cheers Mario

[@Sparkling-Cyanide]

This was SO informative! She experiences what I’ve been dealing with for most of my life. A huge spike in blood sugar and then a big drop when I eat certain things - mostly grains, even whole intact grains. When I was diagnosed with reactive hypoglycemia some years ago I was told that it was a rare condition. I’ve discovered since then that a lot of people have it but most people don’t recognize it fir what it is. I tried an experiment based on info I got from your previous videos in that I ate a healthy serving of protein prior to eating oatmeal. It worked! My blood sugar only rose 30 points rather than 100! But I think that the best thing for me to do is to just stop eating those things that causes the high/low roller coaster. Those spikes really can’t be good.

[@nourishedbyscience]

Yes, I agree that these issues do seem more common than we used to think. Now, with many people who don't have diabetes wearing CGMs, we are getting much more data, anecdotally and also from scientific publications, suggesting that spiking followed by hypoglycemia is not all that rare even among people with normal fasting glucose and normal HbA1c. Thank you for sharing. Cheers Mario

[@cannotbeshaken7889]

@@nourishedbyscience Do you think berberine would help with hypoglycemia? Or would it make it worse?

[@nourishedbyscience]

@@cannotbeshaken7889 Berberine may reduce the hyperglycemia that can be the trigger for the hypoglycemia. I don’t think it’ll make hypos worse, but don’t quote me on that as I am not aware of any study looking at that specifically. May be prudent to experiment with this carefully while monitoring blood sugar levels tightly.

[@cannotbeshaken7889]

@@nourishedbyscience Ok, thank you, I appreciate your reply.

[@thasleemfrank3690]

Hello dear, what is a CGM ? . please answer me thank you. ​@@nourishedbyscience

[@silkenissen7409]

I have been suffering from severe migraine for many years and only recently it got dramatically better after I started to be more aware of my blood glucose changes and a radical change in my diet accordingly. Thank you so much for this high quality information, it helps me a lot to understand more and to follow my path to get rid of the debilitating migraine attacks!!

[@littlevoice_11]

Metabolic Health Summit just did a video on this. Really interesting

[@silkenissen7409]

@@littlevoice_11 Thanks for the info!

[@nissaquill7229]

Same!

[@daryltjl]

Thank you for this! I've been having the same problem for years. I've been having horrible anxiety attacks and sometimes depression out of no where and recently found out it was my reactive hypoglycemia that caused it. I've found that I also get the same reaction to sugar free foods.

[@RickinICT]

I wonder if the reaction to sugar-free foods is because when you taste the 'sweetness' of the food r beverage, your body dumps a first-phase insulin response in anticipation of the increase in blood sugar. Of course, since the 'sweetness' it detects isn't really sugar, there's no glucose spike. Instead, all that insulin just drives your regular glucose into your cells and out of your blood, causing hypoglycemia. I always had a similar reaction to drinking an artificially sweetened beverage on an empty stomach. I get a little dizzy and 'punchy' (almost like I've got a slight alcohol buzz). I never really thought about the blood sugar angle before. I quit drinking soda altogether many years ago now, so I hadn't thought of this reaction in years.

[@vidakyeremateng5165]

Oh my gosh! Finally I got to know I am not alone or crazy or exaggerating about how I feel. I had been experiencing exactly what the doctor is talking about and I have been explaining to doctors with the horrible feeling, the anxiousness frustrating etc. you name it! Have been hospitalized couple of times with symptoms that I thought only God will understands me. Because you talk to doctors and people and they tell you you are anxious for nothing. And the sad thing you want to hear is to find a way to manage your stress level. Like you are causing your own problem. I have been experiencing this almost a year now with admissions yet no solution or find the cause of my symptoms. At times my sugar levels will be 60s feeling like passing out. But I am not diabetic so no one is taking me serious. Hypoglycemia is indeed deadly than the hyperglycemia.

[@nidhi7402]

Something like this I was also experiencing from past one year and Finally I got someone to realise this because it's hypoglycemia 🔆

[@thasleemfrank3690]

me too same here. even before I was diagnosed as a diabetic I had this low blood sugar problem my body starts shaking like crazy. now I know I am not alone or not crazy. now I am a diabetic

[@bepurushoth]

I was diagnosed with reactive hypoglycaemia in December 2022 and was under the assumption that once the blood sugar goes low they are not coming back to normal range until i eat something. This was not completely true, my blood sugar did come back to normal range after the episode even without eating. With the help of CGM I discovered this and now I am aware how high carb and refined sugar behave on me. My anxiousness to eat every few hours is now reduced and this is because of CGM. I always want to try the CGM but this video pushed me further to buy one. Thanks for the video and the interview.

[@susankaroly-smith2073]

Yes, I had the same experience! Once I was on a walk and the CGM gave me a warning as my glucose was falling too low too quickly (due to the excercise, I expect) - I felt a bit shaky, but I recovered quickly without eating anything. When I got home, I could see that my levels never actually reached the hypoglycemic range - stopped falling at exactly 3.9 mmol/L (70 mg/dl) and recovered without any intervention. Now I don't freak out if I feel an episode developing because I know it can reverse itself - still it's better to avoid them if possible as they can be scary!

[@MissMoonshineDance]

There are many factors at play. Anything that triggers epinephrine or cortisol release like fear or pain can also affect blood sugar- irrespective of food

[@claudiaoliveira-usa]

@@MissMoonshineDancewow, I didn’t know that!

[@williamh5103]

Your one of the best low carb/keto doctors together with Mario such an analytical mind, what a combination. Excellent as always!

[@lauragaimon7742]

Great video!! it helps to realize I am not crazy. This is how my doctor treated me when I went to the Dr with my glucose monitor, asking if I was feeling bad after a "healthy" breakfast (bread with jam) I was spiking and falling down (from 210 to 50) . And he told me it is normal to spike and you are healthy because your body recovers by itself. What an advice coming from a Dr.!!! I ignored it and started to do my own research, and after doing low carb and eating more consciously about what I eat, the order and the combination, I feel much better. THANKS!!

[@nourishedbyscience]

Thanks for sharing. Yes, bread with jam is an extremely glycemic meal, and really not to be recommended, not even for people with normal glucose tolerance. Based on my research, an increase in blood sugar to 180 mg/dL or higher is not physiologically normal, and reactive hypoglycemia is also not normal. Good for you for educating yourself. Just make sure to be clear that being on a lower carb diet may impair your first-phase insulin response, so while eating generally low-carb, we need to stay particularly clear of highly-glycemic naked carb meals. Cheers Mario

[@claudiaoliveira-usa]

@@nourishedbysciencedoes that mean that even if you don’t eat sugary or starch foods for a long time and one day you eat some will you have hypoglycemia again?

[@gladdie01]

Am newly diagnosed with type 2 and have bn experiencing episodes of hypoglycemia until I learned the order of eating my food. So right now..its bn a couple of days and I haven't experienced hypoglycemia at. I am so grateful. I have gone more than 8/10hrs without snacking..its unbelievable. 🇿🇼🇺🇲

[@cbgbstew4072]

I recently got a pre-diabetes diagnosis and have been wearing a CGM for 9 days at this point. It’s absolutely fascinating. I had the same glucose spike experience with a seemingly-healthy, very low sugar and high fiber cereal, with 2% fat milk. It was surprising. Fantastic video and channel in general!

[@nancyj621]

Any liquid milk seems to spike my blood glucose.

[@h.4727]

Milk is a carbohydrate, that happens to also have protein. Lactose... "ose" is a sugar. Any type of cereal is a carbohydrate. So you were just eating solid carbs soaked in liquid carbs.

[@cbgbstew4072]

@@h.4727Did you miss the part about fat being included (in the milk)? Plus milk has protein. It was not only carbohydrates.

[@shrameks]

I found your talk to be excellent. As someone who wears a continuous glucose monitor, I've always been puzzled by why some days I can eat a small amount of carbohydrates without any issues, while other times even a small amount can cause a high spike in my blood sugar. Your presentation was very informative and helped me understand that the balance of hormones in my body plays a significant role in how different foods affect my blood sugar levels. Thank you for shedding light on this topic. I am a 78-year-old male thanks again

[@ritamorelli3869]

Naked carbs I have experienced spikes with oats as well

[@lauraleilyn]

Finally received this diagnosis after years of symptoms. The hypoglycemic effect really knocks me out, and usually comes on very suddenly. I become so hazy and very cold, and fall asleep drooling for about an hour. Not cool when driving.... I've been on a very low carb diet for a couple of years now and it has helped tremendously. but I must say that it does occasionally still happen even with a protein rich meal. It seems like after an extra hard workout or maybe if my sleep is off, idk. Also, I learned that any amount of alcohol has the same effect. Cutting it out entirely has been beneficial in every way :)

[@BeKind419]

I deal with reactive hypoglycemia post meals. Also exercise induced hypoglycemia. Even a walk I’ll crash into the 50’s. I also have it while sleeping. I have to treat and eat during the night several times. It is so hard on my body. Still trying to figure out what diet to follow. I always have a protein shake before a complex carb meal, which includes fats and fiber to help stabilize, which helps with the spikes. But I always have the crashes. All day long. Randomly. Very frustrating. Thinking of trying a very low carb diet, carnivore or keto.

[@danielgirl283]

Hello, I have Hashimoto’s no meds treating naturally with diet lifestyle. I am reactive as well. Started tracking glucose lo carb no refined carbs. Feeling great! Yesterday after lunch and soon after became extremely fatigued Later realized it wasn’t what I ate but how much. That does matter, for me anyway

[@Rockies896]

Thanks for another great video. After watching your videos, finally felt like I was listening to someone very reasonable. It feels like when it comes to diet, masses are always chasing different extreme diets, like Keto or complex carbs or whatever. In my view the best diet is called moderation, eat in moderation with a mix of different healthy foods, you have nothing to worry about. After watching your videos I was very much inspired to buy the CGM, so over the black Friday sale (over $200 for 2.... very expensive without prescription) got the Libre 3 for both me and wife. Both me and my wife's A1C hovers borderline pre-diabetic around 5.7 or so. We did not change a thing on our diet, we just wanted to see what our bodies does after every meal we eat. The results were truly eye opener for us. We rotate breakfast among different things we consider 'healthy', the one that barely budged the needle on sugar was eating two poached eggs, followed by an apple. I have been eating that most mornings for many years now. Even homemade fruit smoothie with just water and ice as a base was not that great, but what that means is, smoothies are usually bad, but not fruits eaten by themselves. Eating white rice with animal protein increased the sugar the least (around 140), but rice with vegetables and lentil soup caused spike as high as 160. I experimented with the idea you presented in a different video about freezing the carb after cooking. So started cooking rice good for few days and left them in the refrigerator. Interestingly, there was no change for us in the CGM reading between freshly cooked vs refrigerated. I guess different people react differently to same food. As a part of our experiment, we did confirm that even a gentle walk after every meal greatly reduces the chance of a huge sugar spike. The sweat spot seems to be walking 30 minutes after a meal. Last but not least, being a moderate scotch drinker, I was very excited to find out what CGM will show after I start drinking. Surprisingly, no matter how much carb I ate along with my scotch, my blood sugar dropped to 85 and it stayed there for 2 to 3 hours. Finally after 4 hours or so, the blood sugar started to spike as if I had just eaten an hour ago. Same behavior with beer even though beer has a lot of carb. Did a quick google, and read that after sensing alcohol, liver deprioritizes sugar processing and starts processing alcohol, so sugar level drops because processing sugar takes backstage for a bit. Is that a correct assessment? Again pretty amazing to see it firsthand!!!

[@nourishedbyscience]

Thanks for sharing. Loved reading that. The impact of alcoholic beverages on blood sugar is complex, and varies greatly depending on the type of beverage consumed, the timing relative to food intake, the composition of that food, and there are also big differences between people in this regard. I'll make a separate video about alcohol and blood sugar regulation soon, as it's been requested by several people. Best wishes to you and your wife. Cheers Mario

[@onthepipe]

This is the best video I've seen on this issue, thank you doctor and thank you for having Dr Penny on to share her experiences. Like Dr Penny, I've always had a tendency to go hypoglycaemic after a carb-based breakfast, and discovered that a hearty eggs and bacon breakfast fixed that problem (I have now stopped having them on toast). Two years ago I underwent an Ivor Lewis Esophagectomy due to oesophageal/stomach cancer. Since my stomach is now a fraction of its original size, I now suffer constant bouts of dumping syndrome, both early and late. The 'late' episodes almost always bring on episodes of hypoglycaemia, sometimes seriously low (2.4mmol/L). I have used Libre2 CGM's to learn of my blood sugar variations but due to the high cost I'm not using them presently. It's now obvious to me after watching your video that excess carbs are the cause, and although I had cut down knowing they were bad, I now will be making more educated decisions to reduce carbs further.

[@misterbaleize]

What a delightful presentation and, having just completed the first 14 days of my first ever CGM - simply out of interest as I am not diabetic - I can confirm that my situation and, especially in so far as oats is concerned, precisely reflects the experience of the good doctor. Thank you for such an informative discussion!!

[@shurrrig]

the way i clicked IMMEDIATELY at the title because that experience of TOO much insulin and resulting hypoglycemia has almost caused me a car accident once and is the reason i eat no/low carb now and feeling much much better since my body is starting to become what i think is fat adapted.... i can't believe i'm learning about this randomly on youtube and all my life i've been dealing with it wrong, by eating MORE sugar when i felt i had low blood sugar. thank you.

[@irenemuench7159]

I believe I have suffered from reactive hypoglycemia since childhood sometimes resulting in fainting. When I was a young, normal weight ICU nurse my annual screening labs resulted in a “critical low” glucose report! I always had 4-5 meals daily. For the last year I have been eating clean keto to low carb. I continue to require two very low carb breakfast meals to help avoid symptoms. I plan on getting a cgm

[@lseh4720]

When I was in college, my blood sugar dropped so low that my roommates had to manually feed me. I don’t recall why but it was certainly related to food. Now, 40 years later, when I eat a bowl of vermicelli, my blood sugar shoots through the roof if I eat a large bowl, vs. small. Thanks for this video.

[@krystlepoulin6382]

My personal experience confirms Dr. Figtree's hypothesis. My husband was a type 2 diabetic and I suffered from reactive hypoglycemia. We started a low carb diet, which cured his diabetes, but the diet also cured my reactive hypoglycemia. It's interesting that adding fat can prevent the massive spike and subsequent drop. I miss oatmeal, so maybe I'll try it as a side dish to a high fat meal on occasion and see what happens.

[@nourishedbyscience]

Thank you for sharing. Cheers Mario

[@trend0000]

Thank you, thank you! I learned from this channel about diabetes more than all other channels on KZbin together! All these particular data and information you couldn’t find on other channels are simply amazing! I come across this channel by accident and remain addicted to it! Everybody talked about these issues in general terms without real substance as you do! 👏👍

[@nourishedbyscience]

Thank you for your kind comment.

[@marybusch6182]

I found that coffee vs tea also impacted the reactive hypoglycemia... but our hypoglycemia was around 3 hours after a meal.. I also noted that my lunch and dinner appetites were stronger if I skipped protein at breakfast. I really appreciated her comments about the chocolate cake... and also the comments about the children and overeating and the impact on their stress hormones....

[@CommonSintz]

yes go decaf

[@juliapace2845]

Very informative. Next, I'll be searching for your missive on muscle mass and insulin resistance - since I'm elderly, my muscles aren't what they used to be, and it seems to be a full-time job to keep up with it. Bless you, you're one of a kind. Something terribly amiss with medical education in this country. My docs are always clueless about nutrition. And they aren't too fond of me knowing something they don't - I have to stuff a sock in my mouth so I won't speak too much at the doctor's office.

[@mamafoodlivelaughlove9746]

Thanks to Dr. Mario and Dr. Penny for your sharing and trying hard to educate people ❤

[@donnagrant950]

I have four years had issues with reactive hypoglycemia and have managed it on my own with a low-carb diet. One thing that makes it concerning is that depending on what activity you are doing when you have that low blood sugar,such as driving or doing something where cognitive accuracy matters greatly, the impact can be very important. I get something like brain fog and feel weak an unable to concentrate when this happens. Not good.

[@nourishedbyscience]

Glad you figured out what was going on and were able to address it. Cheers Mario

[@littlevoice_11]

It's also worth noting that ones blood sugar response to particular foods can also be determined by the gut microbiome and also intolerances/impaired intestinal permeability

[@nourishedbyscience]

Yes, for sure, and at least one study also suggests that the gut microbiota explains differences between people in how their blood sugar responds to any given food. I'll talk about that at some point. Cheers Mario

[@magdalenaczudzak4319]

I started to read about these things only two months ago so I know very little. There are several questions that maybe already have an answer, and some of the commenting people would help me find them: 1. What about fructose - can we measure its level in blood? does it concern? 2. Perhaps the important thing is SPEED of sugar level change rather than the amplitude? 3. For how long have we collected measurements with CGM device on larger public scale? 4. Are muscles able to take glucose from blood without use of insuline? Thank you for your conversation! ❤

[@Julia_USMidwest]

I had scary hypoglycemic drop-offs right after high-carb meals or snacks. I pretty quickly found that eliminating sugar and juices helped. Finally I learned that low-carb was even better. Really appreciate the observations here.

[@janiemiller825]

Is very low carb keto ok when hypothermic? Like only 20-50 carbs daily?? 🤔

[@TrulsPen]

Also thank you Mario for your non black and white thinking like hers. When she said fiber is rubbish I’m glad you said not necessarily as it depends on the person, we are all different. For her it does not help. For you it helps a bit. For me it almost completely blunts massive increase

[@nourishedbyscience]

Yes, research clearly suggests that for the average person, adding fiber to a meal lowers the blood sugar response. Cheers Mario

[@tinybarabo]

I was just thinking the same. Also I am always a bit worried if anyone is telling me to cut down drastically certain food groups. Probably it didn’t help, that I really love my oats with plenty of Greek yogurt, with nuts and a bit of fruit.

[@colinpope2832]

This occurred to me 25 - 30 years ago. I ended up in A+E twice. I worked out some of the problem but never had an explanation . Thanks very much. 30 years later I have been diagnosed with Type 2 diabetes, so perhaps I got closer to the problem than I realised !

[@brendasmith8296]

I tried to get my Dr. To approve a CGM , my dietitian diagnosed my condition if reactive Hypoglycemia after several blurred vision while trying to exercise etc or eating a cracker. Im also have a gluten allergy. Im finally getting better to controling it. However, thank you for rhis channel and its good to know that im not alone on this journey.

[@gretelspitzer9565]

I have some similar experiences to what is described here. I started wearing a CGM periodically because I was feeling groggy, flushed, diaphoretic and unwell in the afternoons 1-2hrs after eating (particularly higher carb or more processed foods). I didn’t find a clear answer with random/symptom triggered blood glucose testing. I thought I might have postprandial hypotension, but didn’t see associated low blood pressures when I checked. I later performed a home OGTT and noted very high sugars at about 45 min postprandial (204mg/dl ) but didn’t meet criteria for actual DM or pre-DM since the sugars came down into the normal range soon after. In the course of my normal (not low carb diet), my sugars are usually in the ‘normal’ range, but when I eat more simple carbohydrates (particularly without fat and protein alongside) I get sugar spikes to about 145-150mg/dl followed by a pattern of lower level spikes for the next few hours…these hours are associated with feeling headachy and mentally sluggish. eating an apple for an afternoon snack will give me symptoms, but an apple with peanut butter may not. A serving of fresh grapes will trigger symptoms, but grapes with cheese usually will not. My worst symptoms are temporally associated with the time right before and right after the large initial spike….my question is what does this signify? I know I have some insulin resistance because I have polycystic ovarian syndrome have been on metformin for over a decade as treatment for that. I try to generally eat healthy and I have a normal BMI currently. My hemoglobin A1c is normal. I have interpreted my CGM results/ symptom pattern to signify that I have much more insulin resistance than my lab results indicate and maybe even have occult diabetes that is masked/compensated by the metformin and health conscious diet.

[@kristinebarbaree2697]

I have been suffering from this my whole life I described it to my thyroid diet (endocrinologist ) and he told me 20 yrs ago . He said we don’t need to test you , that’s what you have . I will have a full blown melt down one hour after I eat a donut . I feel like I am going to pass out , start shaking , become confused , and sometimes start crying and sweating for no known reason . My sister , dad, and niece have had similar symptoms their whole lives. I am now 58 yrs old and just had my first A1C test , coincidently my accident , because the lab ran it when the test wasn’t ordered (they were just ordered to run TSH thyroid test . The results came back and the nurse said casually that “you know your A1C is 5.8 so you are prediabetic. “. Gee , my endocrinologist isn’t concerned and didn’t notice . An endocrinologist is a diabetes doctor !!! BTW, I am not overweight and work out regularly

[@nourishedbyscience]

Kristine, thank you for sharing. May I suggest that you take a look at the other related videos in this series (links are in the comment box below the video)? The information may be helpful to you, as a first step (more to come on glucose tolerance). Cheers Mario

[@kimberlythomas2296]

My problem is very similar and my A1c was the same, but if I try to take on the donut in the morning I’m finished it feels like someone drugged me. I can take on more carbs in the evening, but even then I now take in 1/2 servings depending on what it is! Feeling like you’ve been hit with a ton of bricks is a terrible feeling!

[@RhondaO]

Meat and Dairy cause insulin spikes which worsen Reactive hypoglycemia. High protein does this as well as Carbohydrates creating spiked Glucose. It's been debilitating for Me. Hospitalized a few times in the last month. Also ALWAYS do a confirmatory Finger Stick as CGM are Highly inaccurate. I've had differences of 40 points.

[@galaxywanderer5945]

Hallelujah!!!!! Finally I have someone who share the same graph as I am! Thank Dr Mario for such a brilliant example! This is what I have been saying all along! doctors SHOULD bring real life person instead of relying on studies!

[@nourishedbyscience]

My opinion is that we should look at research studies AND real life examples. Lots to learn from either ... Cheers Mario

[@zainab2845]

😢😢😢 4 years of been told u have anxiety and depression when i was actually experiencing real hypo that destroyed my life in all ways. Just now someone lisned and did a mixed meal test. Can wait to hear findings and how i can go back to life

[@nourishedbyscience]

To figure out if your struggles are related to hypoglycemia, I think wearing a CGM for 2-4 weeks can be very helpful. One mixed meal test can be hit or miss. If you just eat your regular meals and can see the ups and downs in your blood glucose, that can provide much more insight. Best wishes, Mario

[@zainab2845]

Thanks🙏. Luckily i did catch a low of 3.4 in the mixed meal test and and elevated c peptide levels, despite normal fasting insulin. I am definitely considering a cgm because i do spike and dip from what i can see on a home machine

[@evgenysergeev8186]

I am healthy. And I eat only slow carbs (lentils, mung beans) and I do running. Usually, I don't need any nutrition for a half marathon (21K) and I can run evenly fast all the distance. Two days ago I decided to take energy gels (liquid sugar) every 5K while running a full marathon (42K). I started losing performance from 16K at a slower pace than in a half marathon. Eventually, I was totally crushed, struggling till the finish line. Blurry vision, plugged years, vomiting, cramps. I want to have a CGM to measure my glucose to see when to take carbs. And gels will not be an option.

[@gaWalt]

Hello Mario, I just recently found your channel and have watched a couple of your videos. Thank you for your videos and expertise. I had an annual physical this past March and was diagnosed with Prediabetes. My hbA1C was 5.7 and my fasting was 99mg. Previous to this discovery, I had been working on losing weight, by reducing my caloric intake, to reduce my blood pressure and dependence on BP meds. My physical , in March, was at the time that I had dropped from 213 lbs down to 180 lbs for a total weight loss of 33 lbs. I was taken off of my BP med at that time. I purchased a glucose monitor and started checking my glucose levels 4X /day. Once for fasting and then after 3 meals/day. Before I lost weight, I thought I was eating healthy meals. For breakfast I would eat Minute Oatmeal/daily loaded with fresh fruit. One cup of blueberries, 2 slices of Cantaloupe, a handful of Walnuts, 2 slices of Pineapple, 3 to 4 Strawberries and 1 banana! I must've have been consuming 140 + grams of carbs! Also, all that fruit turned into sugar quickly. I constantly ate bananas and other fresh fruit at each meal. I'd wager to say that that's what triggered my hbA1C to rise and or triggered insulin resistance. I'm 76 years old. My father and an older brother were diagnosed with Diabetes/Prediabetes respectively. My father didn't develop Diabetes until he was in his late 80s. Currently, I'm not eating any sweets, bananas(less fruit) nor any white breads, also I only eat about 6 berries like raspberries, black berries or blue berries and a half of 1 strawberry. My fasting glucose now ranges from 86mg - 92mg. One hour after eating, my glucose registers usually less than 140 and sometimes 145 but most of the time it's in the 120s. After 2 hours my glucose registers around 102 except when I'm at 145mg it sometimes doesn't drop much or drops down to 125mg. Is the most accurate reading 2 hours after you eat or 1 hour? Also, I have continued to lose weight and have stabled out at 172 lbs. I'm trying to gain some weight back to 180 lbs but am have a difficult time gaining while not consuming too many carbs. I've added almond butter, cheeses, butter on toast. Typically breakfast is 2 eggs with 2 Ezekiel pieces of bread, a handful of Walnuts and sometimes a small container of Chobani zero sugar Yogurt. I alternate breakfast with steel cut Oats, with Walnuts, some almond butter , Yogurt or 1 egg. No matter how much fat I add I'm still not gaining. Should I go see an Endocrinologist to rule out Pancreatic Cancer? How can I gain back some weight? Sorry for the lengthy comment. My wife and I also walk almost daily so I end up burning up some of my caloric intake walking. Thank you , in advance, for your response. Gary

[@nourishedbyscience]

Hi Gary, Thank you for sharing. To your questions: - I cannot answer your question whether 1 or 2 hours after a meal is more accurate. Both together matter, and also the level around 30 min after the meal. If you are up for it, you could measure 30 min, 60 min, and 120 min for a few meals only, to see your typical pattern to your typical meals and then measure only at those time point(s) that are most informative to you. - You mention that you think that your high consumption of fresh fruit and berries may be a cause of your elevated HbA1c and potentially insulin resistance. You know your body best, but from a scientific point of view, there are no data to suggest that eating fresh, whole fruit or berries has negative long-term effects on blood sugar regulation. And even the acute glucose response tends to be modest with fruit and particularly berries. - You also seem to be wondering why you continue to lose weight. That's something I cannot comment on, because that would cross the line to providing personal medical advice. I therefore suggest you discuss this with a physician or dietitian. Best wishes to you, Mario

[@gaWalt]

@@nourishedbyscience Thanks Mario for your info. Gary

[@thaihangnguyen2677]

Hi Dr. Kratz and Gary. I have the exact same conditions as Gary mentioned in his comment. I am only 58 however, and very lean. I exercise for more than 1 hour every day and eat almost a non-carb diet every meal (with the only carbs in beans and nuts). With an HBA1C of 6.0, a fasting glucose level of 96-106, I am concerned that there is something else that is not picked up in my blood glucose tests. I do not have a CGM but intend to get one so that I get better data throughout the day. Not only I am concerned with my pre-diabetic condition, I am also concerned about cancer risks. I have lost about 5kg (11 lbs) over the last five years and now weight a meager 110 lbs. I wonder if this weight loss (and inability to regain any weight) is due to the lean diet (with plenty of protein and fat but no carbs) or due to the regular exercise (more than 1 hour per day with both cardio and weight training) or due to something else. Any comments would be greatly appreciated.

[@ganh222]

​@@thaihangnguyen2677 Why dont you test fasting insulin? Pl read about it

[@charlenewilliams219]

@@thaihangnguyen2677I am not an expert just a senior lady. Could it be that You may not be eating enough &/or exercising too much. Try taking a couple of days off of exercise. If you exercise to the point where you’re raising your cortisol levels, you’re also raising your insulin levels not always the healthiest thing.

[@melaniem8040]

I get the spike and downfall below 70 as well with sprouted oats and steel cut oats in a short time. I appreciate you bringing light to this.

[@nourishedbyscience]

Thanks for sharing. I am actually learning from all of your feedback as well; this does seem to be a pretty common issue. Cheers Mario

[@Kit-tee]

I see an endocrinologist because I have thyroid issues. Lost 40lbs on a Whole Foods low carb diet (under 20 grams of carbs) and my thyroid issues are cured but ever since I started introducing complex carbs back into my diet I have been feeling like crap. Now I know it’s reactive hypoglycemia. Been doing my own experiments at home because my doctor refuses to give me a prescription for a CGM. I’ve noticed that if I eat naked carbs I will have a spike and then my blood sugar drops within 20-30 mins and start sweating, shaking and light headed. If I eat protein and fat first then the carb 5-10 mins later my blood sugar spikes a little then stabilizes. I’ve had reactive hypoglycemia for 14 plus years and have seen many doctors in regards to this and never knew what was going on until now. I still have about 30 more lbs to lose but I’m pretty sure I’ll have to eat low carb for the rest of my life. 😊

[@83shaunam]

I've seen some tech bros that started wearing CGMs when they don't need one, because they think the key to longevity is to have as little spiking as possible. It seemed dumb to me, but my mom had some extras so I tried it. And I'm SO GLAD I did! My a1c has been hovering right under the pre diabetic cut off for years and with both of my parents having type 2, I figured I'd just get it eventually and there wasn't much to do except try my best to eat healthy and exercise. Despite doing my best though, I'm still carrying 40 or 50 extra lbs. But within just a few days of wearing the CGM I figured out the pattern that was keeping my bg up, and I was able to change things up and now I'm excited for my next doctor visit. My sugar cravings and urge to overeat disappeared. I'm losing weight. I lost 6 or 7 lbs in one month WITHOUT TRYING. I see a lot of people jumping to ozempic, but I think they should try a CGM first. There might be something that's easily fixable. In my case, it was my gastroparesis. When food sits in my stomach, my bg stays elevated. Not crazy high. But if it's at 120 all nigtt long, every night, it causes a problem. So I started intermittent fasting. I've done it before, but looking back, I was still having tea with honey during my supposed fasting times and I wasn't doing it every day. I was having "cheat days". But this time I was strict. My numbers started improving right away. About 10 days into it, I noticed I wasn't craving sugar anymore. Less than a month in, my urge to overeat disappeared. And the thing is, everyone with gastroparesis is told to eat small meals throughout the day. But in MY case, it was screwing me over. I deal with nausea, bloating, etc but I don't puke. So shortening my eating window hasn't caused a problem. If I was the type of gastroparesis patient that struggled to gain or maintain weight, it might be an issue, but I'm clearly getting enough calories. Other than that, I learned I can't eat naked carbs. I knew you were supposed to pair carbs with fat, fiber, and protein to prevent unnecessary spiking, but it wasn't really REAL to me until I had the numbers right in front of me all the time. So now I eat at least a good bit of protein with each meal and snack. I struggle more with fat and fiber because of the gastroparesis but protein seems sufficient to prevent spiking. My bf actually does have type 2. You wouldn't know it by looking at him. He's very muscular and fit. He refuses to do fingersticks and just finds out every doctor visit if he's on the right track. His last visit 2 days ago he did not get good news, so he let me put a CGM on him finally. I'm excited to see what he finds out. I don't think I need my CGM long term. Now that I'm doing better, this will probably be my last one. It comes off today. If anything changes, or I start struggling again, I'll put one back on. But as a "healthy" non diabetic person, this was an invaluable and illuminating experience. I'm really hoping I can head off the diabetes. Maybe I'm not destined to get it just because my parents have it. I have information that they didn't have. They both wear a CGM now, but imagine if they'd been able to wear one BEFORE they became diabetic. Honestly, I think everyone should try it for a month. I'm sending a few to my friend in the UK that can't afford them out of pocket. His wife is struggling with gastroparesis and reactive hypoglycemia. I hope she finds out as much as I did so she can start feeling better.

[@susanmahr6068]

I have the same diagnosis as Dr. Figtree. I took the 6 hrs glucose tolerance test and at the 3rd hour my BS spiked up to 200 and dropped to 32. It was horrible. Took me years to be able to regulate my BS. I cannot eat too much in one sitting. So I nibble all day. Salads do help me a lot. And yes, constantly hungry in the 3-4 hours.

[@Sparkling-Cyanide]

I had the same results as you on my 6-hour glucose test. A high of 210 and a low of 35. It was terrifying. I felt like my whole body was imploding. Anything with grains or sugar (or a combination of both) really hit me hard. I try eating them once in awhile, but nothing has changed. I just need to stop trying and eliminate them for good.

[@susanmahr6068]

@@Sparkling-Cyanide Thanks for sharing. I was diagnosed back in 1979. So I've been putting up with this darn sugar since then. The doctor scared me. He said better follow the diet because I could fall into coma. And also said that very likely I will be a diabetic in my old age. I'll be 70 and did not happen yet. :-)

[@Sparkling-Cyanide]

@@susanmahr6068 LOL! I was told the same thing - that I could die in my sleep and I’d be diabetic before I was 40. I’m 74 and I’m not diabetic. Still alive too, obviously!! Still, those lows are really scary. I always carry raisins with me in case it happens when I’m out and about.

[@nourishedbyscience]

Thank you both for sharing this. You have unusual issues of very late spikes and very late hypoglycemic episodes. Has anyone ever looked into what is causing this?

[@Sparkling-Cyanide]

@@nourishedbyscience Yes, my primary doctor referred me to two endocrinologists and neither could figure out what was causing the RH. It’s very strange. All the doctors were certain the condition would lead to diabetes but it hasn’t. All grains and grain products cause my RH along with concentrated sugars. Dried fruit by itself, like the raisins I carry for extreme lows, will affect me the same as grains. Raisins work great to raise a bad drop but I need to get to a good protein source within an hour to prevent a rebound. Yet I can put two cubes of table sugar in my morning coffee and my blood sugar remains stable. I guess everyone has different triggers and maybe that’s why a physiological cause is so hard to find.

[@JaniceT-Poet]

I have what I believe to be Familial Reactive Hypoglycemia. I felt very healthy on Keto, but a vegan relative encouraged me to stop my Keto regime ... and a year or so layer I suffered 3 heart attacks. This informative video is very helpful for me. Thank you!

[@martinstech5514]

Although not as convenient, you can also use a standard blood glucose monitor (ie the kind that requires you to prick your finger to get a drop of blood), to see if you suffer blood sugar spikes. If you test (say) 30 minutes after you eat, you can see if your glucose spikes. The advantage of a standard glucose monitor is that it is cheaper than a CGM.

[@nourishedbyscience]

Yes, agree. Probably best though to test several times within the first hour, such as at 15, 30, 45, and 60 min (at least a couple times), so as not to miss any spike. Cheers Mario

[@MikeFroom]

CGM sometimes give you wrong readings. I have tested FreeStyle Libre 3

[@martinstech5514]

@@nourishedbyscience agreed, in principle you need to do this, but pricking your finger for blood is mildly unpleasant, and I wouldn't want to do it 4 times after I eat. A compromise is to eat something that you know spikes your blood, and then test at 15, 30, 45 and 60 minutes to establish the approximate time of the spike, and then use that time for subsequent tests.

[@jksinorbit]

It is amazing to me that cgms aren’t extremely common!?

[@susanfennimore3152]

The CGM can be extremely expensive in USA ,I sacrifice because it’s so worth

[@chrisvandenbergh2028]

I get glucose spike and severe hunger after having oatmeal. My blood glucose used to drop so low I got the shakes and dizzy spells. I have found a lot of medical practitioners who advise me to drink a glass of orange juice or eat a slice of bread to bring my blood glucose up to a normal level. I consider such advice as wrong. Yesterday I got up with a fasting glucose of 3.5 mmol/l, had a cup of coffee, took the dogs for a 60 minute walk after which I visited 4 stores for grocery shopping, all of it I classify as very mild exercise after which my glucose tested at 4.3 mmol/l. My observation is that in the event of very low blood glucose a short brief exercise will allow my body to react to the possibility of hard work and automatically correct my glucose level. In the past I have even peddled my exercise bike very hard for two minutes with the same result so definitely no orange juice or bread for me.

[@doccritica9456]

I watched the same glucose spikes with my CGM after porridge without sugar and with only a bit of milk. My fasting glucose is in the upper normal range. Today I got the results from the laboratory: They found GADA and ZnT8 antibodies, C-peptide (still?) being normal. Unnecessary to say that the OGTT failed to detect anything abnormal.

[@jackgoldman1]

Thanks. Looking forward to the alcohol and fatty liver show. I have since given up alcohol and will lose some weight to keep the liver healthy. Great show.

[@ronjanyberg8028]

Hey! Really appreciate all your videos. Would be great to hear you talk about differences between monophasic and biphasic glucose curves after meals. Thanks!

[@martinstech5514]

You mention that blood sugar spikes and reactive hypoglycemia in non-diabetics is an "under the radar" and potentially very common phenomenon. May I suggest another phenomenon that might be under the radar: raised early morning blood sugar levels. I'm non diabetic, and non pre-diabetic and recently purchased a glucose monitor. I did this because of the conflicting recommendations about "healthy" foods (for example oatmeal is often recommended as a healthy breakfast), and another youtube channel suggested the only way to know for sure about what foods spike your glucose is to actually measure it. Anyway, I've started measuring my waking blood glucose and find that it is sometimes unexpectedly high: commonly around 6.0 mmol/L (108 mg/dL), but sometimes as high as 7.0 mmol/L (126 mg/dL). I know that diabetics can experience an early morning glucose high, but perhaps this phenomenon is more common than realised in non-diabetics?

[@nourishedbyscience]

Yes, the dawn phenomenon. It's a little less 'under the radar', I feel, because fasting glucose is one of the diagnostic criteria for pre-diabetes and diabetes, whereas blood glucose 30 min or 60 min after the meal are not considered at all. One thing you may want to consider is that there are circumstances where the dawn phenomenon is more pronounced. A common one these days is people on very-low-carb or keto diets. If there is no good explanation for this and fasting glucose concentrations >6 mmol/L are commonly seen, it may be advisable to speak about this with a healthcare provider. All the best, Mario

[@lindapelle8738]

I figured out the same thing many years ago in my 20s back when no one was talking about low carb diets. I realized if I ate cereal, or toast I would feel like crap. But I was a stubborn vegan at the time. Eventually I replaced it with eggs and avocados and felt so much better. No need for testing or devices, Your body will tell you exactly what you need.Of course if you can’t afford the new gadgets it’s good to have them just to prove it to yourself. Or if you’re on the fence and wondering.

[@ellf535]

Could you discuss what causes very low glucose levels during sleep periods? I’m a generally healthy woman but after wearing a cgm a few weeks ago, I notice that during sleep, generally around 5-7 hours after my last meal of the night, my glucose levels drop to alarmingly low levels which sets the monitor’s alarm off and wakes me up. I don’t feel any jitteriness or discomfort during the episode, except being awakened by the monitor’s alarm, and I wouldn’t have known about the huge hypoglycemic levels if not for the monitor.

[@richardjackson5380]

Your readings may well be errors if you haven't checked them against finger prick testing. It's a common occurrence with compression lows if you are pressing against the sensor, that it will create a low reading in error.

[@sallyastles9148]

Thank you both for the excellent video. I certainly recognised myself jn Penny s experiences. The CGM was an eye opener and explained so much about why i can feel so tired and low. Those low sugar episodes are horrid and i find now i can tell my sugar is high by the jittery dast heart beat feeling. Porridge was a shock when i saw the blood sugar spike as i love porridge! After lots of experiments, i found a spoonful of chopped nuts in a grain and seed porridge brought the spike down to normal and is delicious. Thank you so much for these great videos.

[@CommonSintz]

cinnamon helps too

[@realinohio]

I got a CGM two weeks ago and it was an eye opener. Nice video Thank you

[@nourishedbyscience]

Got a few more you may find helpful: How to interpret your CGM data: kzbin.info/www/bejne/eoexdWxmq7Zjrqssi=qBrJRrlTcIQGvhrv How to use a CGM for maximum benefit: kzbin.info/www/bejne/fJTIZoevqtFppMksi=mZH_QKy85DAn1ZxZ How to avoid blood sugar spikes: kzbin.info/www/bejne/r5iTimabg7h0hMksi=0nOBrKK6mqGePHRm Cheers Mario

[@monikakress3867]

thanks for these videos. I am recommending this channel to all of my friends and family.

[@nourishedbyscience]

Thank you! Appreciate that! Cheers Mario

[@kerrybyers257]

Yep! I was doing “healthy” smoothies as part of a vanity weight loss calorie-counting excursion. Lost 50#!!!! Figured I’d ace my next checkup. Boy was I knocked off my pedestal! Next Dr visit….I rocked a 5.9 HA1C! UP from 5.3! My healthy smoothies got me a script for Metformin. Fast forward ,10 yrs and lots of dietary modifications, I’m weight stable but overweight(BMI 28) with an A1C of 4.7! Carb & whole food mindful omnivore diet. Still searching for a holy grail though and dreaming of a size 10 body. One can dream.

[@tomcaron9113]

Thanks Dr. Kratz. Glad I discovered your channel. 20 years a type 2 and finally got a CGM. Wow. Every pre and full diabetic needs one of these. Usually in range now and experience the spikes with high carb meals. Currently maintain an average 75 carbs or less per day. Didn’t know that a low carb person may be hyper sensitive to carb spikes. The Glipizide 10mg seems to bring me down way too much at night. Will discuss coming off this not so great drug now with my low carb diet. Thank you!

[@jagi7838]

I have been experiencing what I believe to be reactive hypoglycemia for a few years now. My doctor had me do 2 hour glucose challenge and the test was normal. At 3 hours I tested my blood sugar at home and it was 54 and I thought I was going to pass out. My doctor shrugged his shoulders. I'm about to buy myself a CGM and investigate and hopefully fix this. I haven't been able to sleep in years because I believe that my blood sugar drops at several times at night. Coincidentally, this started happening in perimenopause, which makes me think that decrease in hormones (particularly estradiol) has something to do with it. Thank you for this video, makes me feel a bit less crazy!

[@MoonLightOnWater1]

My CGM has changed my life as well. After gaining 30lbs during covid, I searched for a plan that would help me lose weight and after wearing a CGM, I see that I have hypoglycemia….which explains why I so quickly gained weight during covid (i abandoned my low carb lifestyle). I eliminated all high carb foods and I now have lost almost 35lbs since last October (2022). I now feel so empowered to avoid foods that spike my blood sugar and I’m so much more happy.

[@nourishedbyscience]

Thank you for sharing! All the best, Mario

[@jensschreiner5351]

This is very interesting. I've been into bodybuilding all my life and so these patterns of insulin responses are key to understanding how to trigger yourself to maximize gains. Not only in specific times (ex. Post workout) but in general also during diets. I really enjoy this kind of content and if wish there was more research and detail on the actual intake patterns of food The salmon and chocolate cake example is a really interesting example and exploring all other potential combinations would really prove valuable. This could help us as a population diminish the effects of certain foods that are just too comfortable to avoid all together. The combination and that matched with the total calorie intake over a period of time would really make a big difference.

[@runfridr]

Think you! Thin is so interesting! People always reccomend me to eat oatmeal but i drops so fast from it in the morning so I avoid it. However i don get this problem in the evening, like ut works when i have a good base of food from out the day.

[@h-man2561]

I think this was one of the best videos to date! 🥇 A few observations. The poor who could use a CGM just can't afford it. Many of them do takeout with delivery charges 33:23 when they should make their own meals so more education is needed. A few years back I became tired after having my weekly pizza 🍕 in my late 50's, beginning of last year January 2023 I started making my own 🍕. Using a no sugar, some fiber, wheat crust & control the quality of toppings with protein & some greens. I also just started grating my hard cheese. I'm not getting sleepy after my pizza anymore. I also removed over 17 days of calories. The one disagreement I have with Dr Lutz is that I believe in count cal's & knowing your macros is very beneficial. Today when I have pizza 🍕 my total carb's for the day are now in the low 30's. My total sugar intake is 45g with an equal amount of fiber 45g making my net sugar zero. This has been a three year journey all changes done based on my own observations & before watching these type of educational video's. Last years blood work were mostly optimal too! Looking to tweak that a bit more this year. I hope some of this might help others make changes for their health. You can do it! 🍀

[@robertthompson3814]

Great video. Mild exercise also can moderate blood sugars spikes pretty quickly.

[@sankarN84]

What a wonderful talk, with loads of practical information ! thanks a lot to you both🙏

[@claudiocapelli7507]

That's was very informative, thanks so much Since blood sugar spikes occur after meals, prior to buy a CGM, I thought to do it the cheapest way, by using a simple glucometer with which I took for few days FG and BGs after one hour and two hours post each of the main 3 meals. Enough to get an idea of glucose behavior, actually shocked by the 190 reading one hour after dinner on which I had crab hamburger, green salad (oil & vinegar), 75gr of homemade bread and 1 free alcohol beer (330ml), instead of 130 (heavy breakfast with cereals, oats, milk, fruits, nuts), 150 (100gr pasta lunch, glass of wine, strawberries and 15gr of dark chocolate). FG averaging around 90, no hypo glucose effects, I realized, watching the table kindly provided by you, that beer has a very high glycemic index, but never thought it could be so devastating?

[@BAdams138]

Very interesting points that the two of you brought out today! Thanks.

[@Gabriel-fi3kn]

Awesome information, thank you for this video. Totally in sync with Jessie Inchauspe's "Glucose Revolution" which I think is a very well written book. I highly recommend it, if you liked this video.

[@nicejoy9998]

Thanks for the video. When I eat carb rich foods like 2 slice of bread my sugar goes up from 100 to 200 in 30 minutes and come down to 100 in an hour. But the story is different if I exercise after this meal. If I exercise my sugar goes down to high 50s and recover after 5 minutes and go back to 100 s which is my baseline. Luckily I was not symptomatic . CGM helped me to identify this problem. If I exercise on empty stomach then my sugar doesn’t drop and stay very steady. Very interesting findings about myself. I am going to to cut down my carbs and add more fat and protein to reduce the spike and resulting excess insulin production.

[@pamstaub5403]

Fascinating. I have had reactive hypoglycemia for decades. I Found long ago moderating naked carbs is effective. I am now pre-diabetic and get spikes depending upon my food intake, high GI or large meals. But my concern more than the spikes is the increase in my running glucose average of 110 to 120. I literally run most of the day at the level. I eat low carb, low GI, lift weights, walk after eating but I can’t get the average down. My body will moderate down from a spike quite quickly just like this healthy doctor. But how can we moderate down the running average. I’m not certain spikes are all that surprising. It seems to me at a cellular level my body no longer uptakes the carbs. I appreciate your content!!

[@marynguyen6417]

I am so glad finally this is brought to people 's attention. I experienced extreme hunger, nausea and tiredness every single time abour half an hour after I had my "healthy" oatmeal porridge with cinamon and fruits, and I didn't know why. I no longer experience anything like this anymore since I transited to a low carbs Ketovore diet. To me, carbs aren't my friends.

[@200Nora]

If they are consumed in excess, they are nobody's friends.

[@marynguyen6417]

@@200Nora I don't think it's the matter of quantity, as a n average size of a breakfast bowl of oat porridge isn't excessive!

[@200Nora]

@@marynguyen6417 I am talking about carbs no matter where they come from. Oats is just an example in itself without add ons it can raise a BG considerably. If you add fruits, honey, etc. It will double or triple the amount of carbs. Most people thing that oats have lots of fiber to compensate, but that is not true (read the label) most of the time you will see a meager 2 or 3 grams of fiber.

[@nourishedbyscience]

Nora, I know that the narrative in the low-carb community tends to be that carbs are bad, and I respect anyone's opinion here. However, I will say that fully glucose tolerant people can eat all the carbs they want and still keep their blood sugar in the 70-140 mg/dL normal range. And I don't see any evidence that fluctuations in that normal range are harmful in the long run. Also, some of the healthiest and most long-lived populations in the world eat largely plant based high-carb diets; sure, that's observational evidence, but we don't have any such compelling long-term outcome data on any low-carb diet. And I am saying that as someone who absolutely is a fan of low-carb or keto dietary approaches. I just feel that if the data suggest that there are many paths to health, then that's a good thing. Low-carb is not a great fit for everyone, just like low-fat is not a great fit for everyone. Warmly, Mario

[@200Nora]

@@nourishedbyscience I respect your opinion. However, here is the question; if there is a select group of humans that can eat whatever amount and kind of carbs they want, why then, in the US, there is an 80% of insulin resistant people and 1 out of three people have pre diabetes and they might not even know it? This is what the scientific and statistic world is saying. I think these are very high and scary numbers. If many of us can still eat carbs to our heart contents. Somebody is got to be wrong with this studies and scientific views. As a nurse, who has seen lots of people and most of them diabetics, I tend to believe in the numbers given. I hope you and yours stay healthy, sayonara my friend.

[@Mojo_DK]

I would really like to see an interview with Dr. Guess

[@trueblonde89]

I’m healthy, I teach group fitness, but I suffer from this as well. I suddenly developed Hashimotos. Some of the protocols helped me with my symptoms as I switched to AIP/ paleo diet. When I started adding in Gluten free items, I started to feel Horrible. I wore a cgm and found that my blood sugar would go up a little, then crash. I managed to regulate during the day, but night then was hard, especially on very active days 😢

[@houras8332]

I’m on low carb diet for 4 years and happy about it but I can’t figure out why I have hot flash few hours after eating 😢it’s disturbing, I don’t feel shaky or dizzy just hot flash and I’m 60 year old . I have noticed when my stomach is empty this hot flash doesn’t happen

[@successandlifestyle]

I ate green smoothies for breakfast most of my life. All good. I stopped eating this way about 5 years ago... now, if I have a smoothie, I need a nap within an hour. Also, I will get a hypoglycemia reaction if I fast for 36 hrs. I'm in my 50s now, but when in my early 30s, I had a surgery where they said I couldn't eat from the night before. I got a hypoglycemia reaction by 10 am, and they had to give intervenes to make it to surgery time. My reaction is watering mouth, pukey feeling, and slight dizziness.

[@mimineambrois8625]

At age 34 I was diagnosed with gestational diabetes and was told I was hypoglycemic at times I remember the shakiness if I ate bare carbs but was offered no coaching/advice. Now at age 72 found out I am pre-diabetic and I am wearing a cgm. If I eat any carbs like yams, beans etc I spike way up and then get reactive hypoglycemia -so it continues. I am slim, have always exercised and eaten healthy foods. Now the only things I can eat without big spikes are protein (mostly salmon) and veges. Wish I had had the cgm and knowledge I now have all those years ago and likely would have a lower HB A1C now.

[@nourishedbyscience]

It's wonderful to hear that you are figuring this out. However, please consider that blood sugar spikes followed by reactive hypoglycemia could be made more likely if your general diet is low-carb and you then consume a high-carb meal only occasionally. In other words, if you want to figure out your body's ability to handle different high-carb foods, it would be best to do this after having eaten a normal- to high-carb diet for at least a couple of weeks. That is because a low-carb diet lowers the first-phase insulin response, which makes spikes more likely. You can learn more about this here: kzbin.info/www/bejne/gofaZ2OIfs2VsMksi=glVxuxPwOr6TkpSg Best, Mario

[@texasindy2193]

Well, there are people who are pre-diabetic, very slim and don't want to get too skinny. So what do they eat to maintain a healthy weight? Please need your help.

[@GinaBehrensprung]

That was so helpful. I have been experiencing hypoglycemia after eating fiber one cereal. I thought I was being healthy. No more naked carbs!

[@johannaandrews]

Thank you . Lots of helpful information and look forward to your upcoming videos , cheers

[@ryans1623]

One major thing i will add to this is, it could be the mix of high fibre or high protein with sugar that will cause high spikes then hypo, it happens to me because these digest more slowly and the insulin over responds. I have liquid sugar it doesnt go near as high and goes back to base line. I think the slower digestion is causing the spikes and low blood sugar after.

[@SherryGentry-r6e]

I don’t have issues w/eating oatmeal (I’m T-1) as long as I follow it w/exercise, but yes I do have spikes of 210 mg/dL if not, but normally my meal bolus brings BG down to normal range with in an hr!😊

[@SAMBLACKHAM]

Again your videos spark much interest and some frustration on my part. I exhibit both blood sugar spikes and reactive hypoglycemia. After years of being told there was not a diabetic drug that fit my situation (CPSS) I came across the subject of Alpha-glucosidase inhibitors, i.e, Acarbose. I tried it for a few months but the GI problems were too much. Acarbose raises both primary and secondary BA's. I already have too many of these. Acarbose also changes the composition of the microbiome and in my case causes dysbiosis. It did however lower my BS spikes by about 20% and alleviated my reactive hypoglycemia to a certain degree. Acarbose works in the enterocytes where it inhibits the enzyme which converts disaccharides to Monosaccharides (glucose). I then started to look for a natural element that would do the same. I wear a CGM and I noticed that my sugars didn't spike and I didn't have postprandial somnolence on "Taco Tuesdays". I looked into this and there it was. Capsaicin is a natural Alpha-glucosidase inhibitor (among other things of value to the hyperglycemia issue). It ranges between 20-80% (depending on plant variety )as efficient as acarbose but so far it doesn't have the BA and dysbiosis issues. One thing to note is that AGI's by their nature only work on glucose derived from the gut (diet) and not glucose the liver uses from storage and Gluconeogenesis which in my case is a sizable amount because of my BA/FXR situation. www.orientjchem.org/pdf/vol34no5/OJC_Vol34_No5_p_2211-2228.pdf www.jocpr.com/articles/comparative-study-of-jalapeno-extract-with-acarbose-on-alpha-glucosidase-inhibition-8911.html www.mdpi.com/2218-1989/11/10/649 I have more studies on AGI's and BA's if you are interested Thanks for all you do! Steve

[@creativeby_nature]

So grateful for this info! Thank you!

[@ITSREALLYNOTYOURFAULT]

Wow, great to see videos like this! I got so bad i would find myself back in bed, fully clothed. If i ever forced myself to stay awake i would feel like i was having a complete breakdown. I also had what my doctor described as rapid gastric expulsion, which is what led to the diagnosis of low blood sugar episodes.

Chaîne très intéressante, bien informée. Merci beaucoup pour votre travail.

[@emmas816]

5:20 it's not just because naked carbs, it's specifically related to oats, you can use wheat flour to bake cookies and you don't get that effect you see when bake same cookies but with oat flour. I noticed that when I was in highs school and was puzzled that there is something about oats in particular makes blood sugar drop so low that my hands start shaking from weakness. I knew it was overproduction of insulin, no other food had such effect on me, only oats.

[@dthornew]

Thanks for sharing. What particularly piqued my interest was the section on protein smoothies. My wife had been using one loaded with sugars - it is now in the trash.

[@BrianAllenbyAUS]

Thanks Mario for sharing this video. It gives us yet another insight into blood sugar. My takeaway is: 1. It is interesting that a "healthy" person's blood sugar would spike to diabetic levels which gives me a little bit of peace of mind that blood sugar spikes could be normal for some people. However, 2. It also raises a question as to how would Dr Figtree (or anyone for that matter) pass the OGTT test which I would think is more "vicious" than the oatmeal? Is that because of the low-carb diet that she is adopting? I understand from your previous video and from the health guideline here in Australia that one must consume 150gr of carbs a day preceding the OGTT. Could this lead to misdiagnosis? 3. For a physician who treats diabetic patients saying fibre is rubbish makes me a little bit uncomfortable but hey she could be referring to the context of her topic which was the meal in the cafe. Thanks again. Would love to hear more about glucose tolerance and ways to reverse it. I hope you have plans for that topic.

[@nourishedbyscience]

Hi Brian, I don't think blood sugar spikes are normal or should just be ignored. Watch some of my previous videos where I address this. 2. In an OGTT, the patient drinks 75g of glucose in water, and blood sugar is measured at 0 min and at exactly 120 min, not in between. Look at her pattern; she will almost certainly be back to below 140 mg/dL at the 120 min time point, which would then mean that she has normal glucose tolerance by that definition. 3. Her viewpoint is that of a low-carb doctor who sees a lot of benefit in her patients when they cut out all carbs, and her own experience where - admittedly - the fiber in her oatmeal and her musli didn't help much, right? I understand where she is coming from, but also felt compelled to express my opinion that fiber does help lower blood sugar responses for many people. There is plenty of research on that, so this is really not up for debate. Cheers Mario

[@marklucas1898]

Phew! I recently started using a CGM, and I was having spikes within 1/2 an hour after meals after carbs... as this was even after adequate fat and protein! These "spikes" were mostly below 10 mmol/L (well I thought they were spikes) but several times around 11 MMOL/L after eating white rice and white bread at restaurants! These are things that I do not use but when you are out and have to eat in a restaurant... you make the best of things! I am in Thailand and I was not sure if they were loading up their sauces with sugar and that was quite alarming for me. I am a vegan (not one of the obnoxious ones who wants everyone to eat grass... Eat whatever the hell you want... but mine choice is based on religion mostly) and so this makes it extra difficult... what the hell else is there to eat but mostly starches!

[@nourishedbyscience]

Once glucose tolerance is reduced, a starch-heavy diet can be tricky. In those cases, using the strategies to minimize the blood sugar spikes is a good first step, but it would be good to implement other changes to improve glucose tolerance. I have a series of videos planned about that, so hopefully, these will be helpful. Cheers Mario

[@susibul5320]

After eating steel cut organic oats, soaked and boiled in water, nothing, Nothing added my glucose was back to 5.7 after one hour. Great talk thanks.

[@nourishedbyscience]

Yes, the responses to oatmeal differ greatly from person to person, even among healthy people.

[@judythomas1050]

This was so interesting…. I had to learn all the same things myself… with no help… unable to get an insulin resistance test from my doctor Trying to manage Diabeties myself… found out about porridge years ago .., stopped eating it … protein only breakfast

[@arnkbb4656]

Thank you for sharing these mazing information

[@ronaldruiz3333]

Doc Mario Thank you for the info. Hope to hear more videos in this matter about insulin Spikes and how to prevent w/o wearing CGM monitor. God bless including Doc Penny Figtree.

[@russellmania4542]

My endocrinologist wont prescribe a cgm because he said they arent accurate and off by 40% I was diagnosed reactive Hypoglycemia 24 years ago and have been told i have too much insulin in my blood and always have low bloodsugar. I was completely normal until age 27 and im now 52. Im not diabetic and have followed high protein low carb, no sugar diet and i still suffer. I have requested to be tested for non cancerous insulinoma causing the extra insulin and low blood sugar. Ive caught my bloodsugar as low as 43. WHAT DO I HAVE TO DO TO GET A ENDOCRINOLOGIST HELP ME? IM SO DESPERATE. IM SO SICK AND CAN NO LONGER DRIVE OR WORK? HELP!!!

[@alexiamountain]

Hi! Can't you change your endocrinologist or talk with your insurance company?

[@nourishedbyscience]

I am sorry to hear this. I agree with the other commenter: I would find a different endocrinologist. Ideally, take a record of your blood sugar levels to convince them that more testing to figure our the cause of your hypos is needed. Also, if you are in the US, it seems that CGMs are soon going to be available without prescription. For the time being, you could also try to purchase one through Levels or Veri; I think they both have doctors that can write the prescription for you. Best wishes, Mario

[@dedegriffith2782]

I have the same thing and believe I have always had it. But, at one point being 358 pounds, I had RouxNY gastric bypass 20 years ago, it probably exaggerated the postprandial reactive process. The CGM recently helped me identify the problem.

[@arebolar]

I have exactly the same problem, the blood glucose spike and then hypoglycemia, after eating some fruit on an empty stomach, particularly ripe bananas. However, if I exercise vigorously after eating my bananas, I avoid the problem. So my solution was never to eat bananas unless I’m going to exercise vigorously afterwards

[@mathunnyjose4467]

Recent studies suggest the muscle behind our legs just below knees are storing the sugar. So trigger the muscle by raising the legs have positive effect to reduce sugar. Alternatively same effect if riding treadmill for 30 minutes after the meals is helpful to myself when meditation doesn’t work , rather than hard exercise. Try it out and find out how effective. Still it depends on what causes own sugar spikes is . No one is alone in this-many friends in it.

[@eagleeye9549]

I used to have those symptoms when I eat carbs. So, I fixed it by not eating them. These days, I feel great! If I do eat carbs, I eat green veggies once in a while. Mainly I eat meat these days and no longer have those spikes and drops. Cheers.

[@chqshaitan1]

Excellent video, and its really good to see real world cgm results, especially with the timings of the blood sugar spikes

[@serendipity101084]

Thank you Dr Mario! I was diagnosed with pre diabetes with A1C of 5.8%. Your videos have been so educational on how to use CGM and how to modify diets to keep levels stable. With good eating (no naked carbs, more fiber and protein), my pp glucose levels are always below 120. I am not on keto diet but do complex carbs - lots of lentils, salads etc. However, I still see fasting morning glucose levels at 105-110. What do you recommend to get the fasting glucose within the clinical guidelines below 100? I have not got any clear explanations besides the dawn phenomenon. Feels like the all night glucose levels are making my averages tilt towards pre diabetic even when I am able to metabolize food well.

[@nourishedbyscience]

The main reasons for elevated morning glucose could be the dawn phenomenon, so it may make sense to look at the levels just prior to that morning rise that occurs upon awakening. If that is consistently also higher than 100 mg/dL, then I would look into whether I may have an elevated fat content in the liver, which is very common these days. These two videos here may be helpful for that: kzbin.info/www/bejne/mYGYaKKDbdF1l7csi=UZMuN_cFKt9qQYwj kzbin.info/www/bejne/fJiWn2Csnpenabssi=aQozPNd-JpdyHh7j The other possibility could be that your evening meals are too rich, i.e. too high in calories, fat, and carbs (even whole food sources of carbs). Particularly the combination of high in fat and high in carbs can keep the blood sugar elevated for a very long time, even over night. I have very good glucose tolerance, but even I occasionally have levels around 100 mg/dL when I eat a late dinner that is high in calories, fat, and carbs. In essence, what sustained high glucose levels tell you is that there may be too much energy in your system. Maybe experiment with having dinners that are a bit higher in protein and lower in fat and/or carbs. Or adopt a fasting regimen of some kind, such as time-restricted eating. I have more videos coming our about that, but this here is the first video about it: kzbin.info/www/bejne/qIWwc3WoipKeprssi=0AYoKKYY780H-8mE Lastly, I have set up a community where I help people have the right information and support to address problems just as these to prevent them from progressing to a chronic disease. You can learn more about it here: community.nourishedbyscience.com/ Hope this helps. Cheers Mario

[@gabrielcaleb9277]

❤ Thank you ! VERY VERY informative . Among thé best I vé ever Heard. Greetings from France 🍀

[@rosemarybdea]

Excellent information as always. Thanks to you both.

[@dominicm6144]

Do you have a video on how to make the most of a CGM? Maybe some guidelines from an experienced perspective? Thanks for the video

[@nourishedbyscience]

Yes, indeed, two: How to Interpret Your CGM Data: kzbin.info/www/bejne/eoexdWxmq7Zjrqssi=gdK6IJ5p4pKDQQWc How to Use a Continuous Glucose Monitor for Maximum Benefit: kzbin.info/www/bejne/fJTIZoevqtFppMksi=kpH3GD4r5ea8o90I Cheers Mario