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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I am a non diabetic patient and had few episodes

Answered by
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Dr. Minal Mohit

Endocrinologist

Practicing since :1998

Answered : 815 Questions

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Posted on Mon, 21 Jan 2019 in Thyroid Problem and Hormonal Problems
Question: I am a non diabetic patient and had few episodes of Hypoglycemia where my sugar level was 51 as BSR. Kindly help.
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Follow up: Dr. Minal Mohit 9 minutes later
I tried taking glucose water and meals and it raised to 106... But few hours later it drops to 50’s. What I experience is palpitations and weakness and bit of shivering. I have faced such episodes before like a year ago but that wud subside on taking meals but today nothing helped.. facing symptoms even after taking meals.
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Follow up: Dr. Minal Mohit 7 minutes later
Just had some tests and usg... reports attached.
I am afraid if it could be something more serious. Please help. Besides i am facing frequent urination. Have history of gerd, gad and high lipids. Taking rousavas, fenfofibrate, escitalopram and amitryptiline.
doctor
Answered by Dr. Minal Mohit 12 hours later
Brief Answer:
IT CAN BE INSULINOMA

Detailed Answer:
DEAR SIR, ALL YOUR REPORTS THAT YOU HAVE SEND ARE NORMAL.
YOU NEED TO UNDERGO "PROLONGED SUPERVISED FASTING"
THAT CAN BE DONE ON ADMISSION ONLY. SO IF YOU CAN COME DOWN TO XXXXXXX YOU CAN SEE ME OR YOU CAN SEE ANY ENDO AT YOUR PLACE. IT IS A 72 HOURS ADMISSION. AND YOU MAY EVEN DO MIG SCAN PANCREAS TO FIND OUT THE PANCREATIC MASS.
REGARDS!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Minal Mohit 15 minutes later
i changed the strips of my glucometer and now recorded bsf as 77. i would be measuring pp in an hour after.i had my usg done its normal. doc here said you may need to go for CT scan for precautionary measure. could you please tell me what else it can be other than insulinoma?? and what ct scan i need to do? i am also allergic to certian medicines and sea food.
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Follow up: Dr. Minal Mohit 1 hour later
Pp today was 114. Could it be some dietry factor or malfunction glucometer... coz yesterday in cold it first showd only 31 n then 51 and then 77.
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Follow up: Dr. Minal Mohit 1 hour later
When my hba1c is normal and not suggestive of Hypoglycemia in past months. Could it be defective glucometer or dietry factor as my symptoms are subsided now.
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Follow up: Dr. Minal Mohit 21 hours later
went to doc today. he said u dun hav symptoms of hypoglycmia and sound more like anxiety as i am already GAD patient. no need to bother and all your base line tests are normal.
doctor
Answered by Dr. Minal Mohit 46 minutes later
Brief Answer:
symptoms are the most important marker.

Detailed Answer:
dear sir, first thing , if you have no symptom , why did you check your sugars?
so definitely, most important thing is symptom. even when fasting, like during ramadan, paryushan, sawaan, karva chauth, people don't land with hypoglycemia and don't repeatedly check sugars. so if no symptom , please forget everything. but if you are symptomatic, and then check sugars and they come low, you need a work up.
CT abdomen with contrast for pancreas or mri with contrast for pancreas, or MIG for pancreas are the investigations of choice.
prolonged supervised fasting for 72 hrs is also diagnostic method.
blood glucometer errors, or capillary constriction due to cold temperature and small size of blood drop giving false low values are insignificant if you are symptomatic. if you are not symptomatic , please don't check sugars.
regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Minal Mohit 8 hours later
the symp i experience are palptations, and bit weakness... thr is no sweating at al... and all the symptoms i experience don%E2%80%99t subside after eating. today i checked my bsr was 120 still i had palptations... thats y my doc said its more like anxiety and once i left the doc room i am fine since now. clonozepam .5 helped me.
doctor
Answered by Dr. Minal Mohit 21 hours later
Brief Answer:
continue anti anxiety treatment in that case.

Detailed Answer:
Dear sir, continue anti anxiety treatment in such a case. and if at all sugar falls again, keep in mind that the plan is
1. prolonged supervised fasting for 72 hrs.
2. MIG scan pancreas.
regards!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Minal Mohit 26 minutes later
One last question mam.. today again uli had episodes of palp and weakness but my sugar level was above 70 all the time. These episodes took place usually 2 hrs after eating where as in fasting i was absolutely fine even though sugar level was 67. Could it be reactive Hypoglycemia?
doctor
Answered by Dr. Minal Mohit 6 minutes later
Brief Answer:
but as per the report there is no hypo! only symptoms?

Detailed Answer:
dear sir, as you said sugars were above 70 post meal, so there is no hypoglycemia actually!
so reactive hypo is not a real pssibility, but keep monitoring post meal , 4 hrs.
regards!
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Minal Mohit 1 minute later
could u plz suggest my any supplementary drug to overcome weakness. provided i am allergic to sea food.
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