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Hypoglycemia and Ketosis

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  • Hypoglycemia and Ketosis

    I'm type-2 diabetic and have been on low-carb/ketogenic diet for 1 yr now. I also started using the Freestyle Libre continuous glucose monitor a couple months ago. Even after years of glucose testing, and a year on keto, the continuous monitoring has taught me things about my metabolism I would never have suspected. One such insight is that as long as my diet is under control, the biggest influence on my blood sugar is stress. Just waking up in the morning raises my sugar 30 points or more, and it remains elevated while fasting and will often go down only after a meal (or snack). The other thing I discovered is that my sugar is lowest when I'm sleeping. Often dipping briefly below 60 or even 50 during deep sleep. But i feel fine. I have no symptoms of hypoglycemia, and it recovers naturally without intervention, so i was unconcerned.

    But when my Doctor saw this he was very alarmed. After briefly reviewing the dangers of hypoglycemia, I can see why. However, these studies seem to assume that your cells require glucose as their only source of energy. This is clearly false. So are there any studies on the effects and risks of non-iatrogenic or spontaneous, asymptomatic hypoglycemia in ketosis?

  • #2
    Also type 2. I’ve been using the Freestyle for 8 months, and I have the low overnight pattern too. Mine drops to 40 sometimes. Two of my friends have the same result. I don’t believe it’s a problem. The sooner you eat something low glycemic the quicker that morning spike will drop. Your doctor probably hasn’t had a patient with a CGM before. And doesn’t know what normal patterns are.


    • #3
      It's true that the doctor is not experienced w/ this device. Something else I've noticed is sensors can either be high or low by 10-15 pts. So one sensor might read 50 when another would read 70, while a finger stick would be somewhere in the middle.


      • #4
        I’ve found too. So I use the 1st score after hour 24 against my finger stick score to adjust.


        • #5
          UPDATE: I just got my latest A1C result, and it's about 29 mg/dL HIGHER than the libreview reported average for the previous 90 day period! So (a) wtf?, and (b) probably the reason I'm asymptomatic is that the hypoglycemic events reported by the CGM are false readings. If it says I'm <70, it's probably just <100. I'm not going to leap out of bed at 4am to test it.