Postprandial Blood Sugar Fluctuations and Fatigue Symptoms

Previously measured elevated postprandial blood glucose levels using a glucometer?

Hello, doctor.
I would like to ask you a few questions.
Last August, during a hot weather, I had a sweet smoothie, and shortly after, I experienced dizziness and fatigue, feeling sleepy.
This fatigue persisted for several days, especially after breakfast and lunch, but I did not have this issue after dinner; instead, I found it harder to sleep at night.
I monitored my blood sugar levels with a glucose meter before meals and 2 hours after meals for 9 consecutive days.
On one of those days, I recorded a post-meal blood sugar level of 176 mg/dL after dinner.
However, in the following 7 days, all readings were within the normal range.
The post-meal sleepiness symptoms also improved after a week.

In June of this year, similar symptoms reappeared.
In May and June, I experienced episodes of trembling, coldness, and weakness before dinner, but my blood sugar readings at that time were around 79 to 85 mg/dL.
On June 7, after having pork cutlet for dinner with friends, I measured an abnormal blood sugar level of 158 mg/dL two hours post-meal.
The following day, on June 8, I measured my blood sugar before and after dinner, which were 87 and 120 mg/dL, respectively.
On June 9, my fasting blood sugar was 99 mg/dL.
Additionally, in the mornings during breakfast, I would immediately feel dizzy and sleepy, and this occurred either during the meal or right after finishing.
Sometimes, when I drink a sugary beverage in the morning, I experience a sensation of swelling around my eyes.

I would like to ask the doctor if these symptoms could be caused by insulin resistance or if they are related to long-term work stress and poor sleep at night.

Mr. Lin, 30~39 year old female. Ask Date: 2023/06/09

Dr. Lin Jianliang reply Internal Medicine

Hello, there are many conditions that could cause the situation you described.
Regarding blood sugar levels, since they can sometimes be elevated, it is advisable to consult a physician for an evaluation and to have a blood test to check your hemoglobin A1c levels.

Reply Date: 2023/06/09

More Info

Understanding postprandial blood sugar fluctuations and associated fatigue symptoms can be quite complex, as they involve various physiological mechanisms and individual health factors. Based on your description, it seems you are experiencing significant fluctuations in your blood sugar levels after meals, particularly breakfast and lunch, which correlate with feelings of dizziness and fatigue.

When you consume a meal high in carbohydrates, such as a sweet smoothie or fried foods, your blood sugar levels rise. In a healthy individual, the pancreas releases insulin to help cells absorb glucose, lowering blood sugar levels. However, if there is insulin resistance—where the body's cells do not respond effectively to insulin—this process can be impaired. This can lead to higher postprandial blood sugar levels, as seen in your case when you measured 176 mg/dL after dinner on one occasion and 158 mg/dL after a meal of fried pork cutlet.

The symptoms of fatigue and dizziness you experience after meals could be attributed to several factors:
1. Postprandial Hypoglycemia: After a meal, especially one high in sugar or refined carbohydrates, your blood sugar may spike and then drop sharply, leading to hypoglycemia (low blood sugar). Symptoms of hypoglycemia can include dizziness, fatigue, and weakness. This could explain why you feel tired and dizzy shortly after eating.

2. Insulin Resistance: If your body is resistant to insulin, it may not effectively lower your blood sugar levels after meals, leading to prolonged periods of elevated blood sugar. This can cause fatigue as your body struggles to manage energy levels.

3. Stress and Sleep Quality: Chronic stress and poor sleep can exacerbate insulin resistance and affect how your body metabolizes glucose. Stress hormones like cortisol can increase blood sugar levels and contribute to feelings of fatigue. If you are not sleeping well, it can further impair your body's ability to regulate blood sugar.

4. Dietary Choices: The types of foods you consume can significantly impact your blood sugar levels. Meals high in sugar and refined carbohydrates can lead to rapid spikes and subsequent drops in blood sugar, causing fatigue. It may be beneficial to focus on balanced meals that include protein, healthy fats, and fiber, which can help stabilize blood sugar levels.

Given your symptoms and the fluctuations in your blood sugar readings, it would be prudent to consult with a healthcare professional. They may recommend further testing, such as an oral glucose tolerance test or HbA1c levels, to assess your overall glucose metabolism and determine if you are at risk for diabetes or prediabetes.

In the meantime, consider implementing some lifestyle changes that may help manage your blood sugar levels:
- Balanced Meals: Aim for meals that include a balance of carbohydrates, proteins, and healthy fats to help stabilize blood sugar levels.

- Regular Monitoring: Continue to monitor your blood sugar levels, especially after meals, to identify patterns and triggers.

- Stress Management: Engage in stress-reducing activities such as exercise, meditation, or yoga to help improve your overall well-being and potentially enhance your body's insulin sensitivity.

- Sleep Hygiene: Prioritize good sleep practices to improve your sleep quality, which can positively impact your metabolic health.

In summary, your symptoms may be related to a combination of factors, including insulin resistance, dietary choices, stress, and sleep quality. A comprehensive approach that includes medical evaluation, dietary adjustments, and lifestyle changes may help alleviate your symptoms and improve your overall health.

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