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Glucose intolerance in lean POTS patients


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Glucose intolerance is also being found in lean POTS patients. They found 50% of lean POTS patients have glucose intolerance in a small study. This is happening to me right now with post prandial glucoses right at 200 on multiple occasions. It should never be above 140. I have zero family history of either type of diabetes.

My quick notes on this video:

-- Basically, if a patient is demonstrating increased sympathetic activity, it can increase blood glucose. This is similar to the increase in sympathetic activity obese patients have.

--Pots patients tend to have normal fasting glucose levels versus obese patients developing type 2 diabetes. However they do have impaired glucose tolerance when challenged with a high glucose meal. It sounds like because of this, the A1C, while useful, may not indicate the degree of glucose intolerance the pots patient is experiencing. A standard glucose tolerance test is the best way to test these patients.

--Time frame of development of glucose intolerance is shorter in a lean patient with pots compared to an obese person who does not have pots.

--About 50% of lean pots patients have impaired glucose tolerance.

Here's the video:

https://vimeo.com/485528506

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Oh my goodness. Thank you for posting this! 

I am having a terrible time with my glucose levels. Last year I bought a glucose meter and my fasting were in the 110's. I could not believe it. My entire life I had always been in the 70-80's fasting. I brought all of this to my doctors including a 200 reading after having potatoes. They both blew it off when I told them I was getting increasingly worried about it. They told me I'm too thin for that problem..../sigh!

I've completely changed my diet the past year, but still having a terrible time. Edit: My fasting is down to 95-100, but I saw a 150 two days ago after eating a small salty snack.

I thought the glucose issues were tied to my beta blocker as they can cause glucose issues too, but if it's just POTS, I would not be surprised at all. 

Edited by Birdlady
added info about fasting levels
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8 hours ago, Birdlady said:

Oh my goodness. Thank you for posting this! 

I am having a terrible time with my glucose levels. Last year I bought a glucose meter and my fasting were in the 110's. I could not believe it. My entire life I had always been in the 70-80's fasting. I brought all of this to my doctors including a 200 reading after having potatoes. They both blew it off when I told them I was getting increasingly worried about it. They told me I'm too thin for that problem..../sigh!

I've completely changed my diet the past year, but still having a terrible time. Edit: My fasting is down to 95-100, but I saw a 150 two days ago after eating a small salty snack.

I thought the glucose issues were tied to my beta blocker as they can cause glucose issues too, but if it's just POTS, I would not be surprised at all. 

I'm not on a beta blocker FWIW. My fasting glucoses are high too, but that's probably because they aren't really fasting. My stomach empties too slowly. Other lab values are also indicate that fasting times for me are not fasting times for normal people. I also see values around 200 after a carb heavy meal. That is just not normal. Renal threshold is different in different people but you would probably start spilling glucose in your urine when it gets over around 140. And that is definitely not normal.

This  research is so new I wouldn't expect it to make its way to clinical medicine any time soon. But I'm thinking this may be a new POTS related type of glucose intolerance that doesn't fit in the current two (type 1 and type 2) known types. Time will tell.

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1 hour ago, toomanyproblems said:

I'm not on a beta blocker FWIW. My fasting glucoses are high too, but that's probably because they aren't really fasting. My stomach empties too slowly. Other lab values are also indicate that fasting times for me are not fasting times for normal people. I also see values around 200 after a carb heavy meal. That is just not normal. Renal threshold is different in different people but you would probably start spilling glucose in your urine when it gets over around 140. And that is definitely not normal.

This  research is so new I wouldn't expect it to make its way to clinical medicine any time soon. But I'm thinking this may be a new POTS related type of glucose intolerance that doesn't fit in the current two (type 1 and type 2) known types. Time will tell.

That is good to know you aren't on a beta blocker. I don't think I have stomach emptying issues, but I could see that being an issue for some. I came off of my beta blocker to see if it helped. I do believe it helped slightly. Interestingly my A1C was good at the last test, but of course that was a year after I made a ton of changes. Insulin levels were not tested. I bought chex mix as a salty treat and now I won't be able to eat it anymore. Back to salads and pickles/olives for salt.

Yeah I have completely cut out carb heavy meals. The spikes were just too high and those meals have always made me feel so sick (IST). I have not tested my urine, so that would be interesting to see.

Obviously something is not right, but most doctors wouldn't consider this a problem. I searched the forum last year for high blood sugar/fasting and nothing really came up, so I am glad you posted this video. As you said it doesn't fit Type 1 or Type 2.  I also found out I have osteoporosis in my 30's, so I'm waiting for research to show POTS causes that too. 

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  • 1 month later...
On 7/16/2021 at 11:26 PM, Birdlady said:

Oh my goodness. Thank you for posting this! 

I am having a terrible time with my glucose levels. Last year I bought a glucose meter and my fasting were in the 110's. I could not believe it. My entire life I had always been in the 70-80's fasting. I brought all of this to my doctors including a 200 reading after having potatoes. They both blew it off when I told them I was getting increasingly worried about it. They told me I'm too thin for that problem..../sigh!

I've completely changed my diet the past year, but still having a terrible time. Edit: My fasting is down to 95-100, but I saw a 150 two days ago after eating a small salty snack.

I thought the glucose issues were tied to my beta blocker as they can cause glucose issues too, but if it's just POTS, I would not be surprised at all. 

Same.  Fasting is usually 108 in morning.  Got it down to 98 doing keto.  I eat only after 6 pm because too nauseaus /upset stomach earlier.  Could not get blood sugar below 87 doing keto n fasting ...fasting was not really intentional.  Was pretty strictly extremely low carb. ...

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On 7/16/2021 at 11:26 PM, Birdlady said:

Oh my goodness. Thank you for posting this! 

I am having a terrible time with my glucose levels. Last year I bought a glucose meter and my fasting were in the 110's. I could not believe it. My entire life I had always been in the 70-80's fasting. I brought all of this to my doctors including a 200 reading after having potatoes. They both blew it off when I told them I was getting increasingly worried about it. They told me I'm too thin for that problem..../sigh!

I've completely changed my diet the past year, but still having a terrible time. Edit: My fasting is down to 95-100, but I saw a 150 two days ago after eating a small salty snack.

I thought the glucose issues were tied to my beta blocker as they can cause glucose issues too, but if it's just POTS, I would not be surprised at all. 

I do have higher morning blood sugar with adrenaline.  2 yrs ago I barely ate anything for weeks and it was usually 108 every morning but even 123 with more adrenaline 

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8 hours ago, E pots said:

I do have higher morning blood sugar with adrenaline.  2 yrs ago I barely ate anything for weeks and it was usually 108 every morning but even 123 with more adrenaline 

The blood sugar increase you see makes sense with high adrenaline since that stimulates your adrenal glands to produce more cortisol (your natural steroid), which in turn can increase your blood sugar. 

Since I have Addison's and all the steroid in my body comes from oral ingestion or injection (when I'm not absorbing properly due to gastroparesis) I can control how much is in my body at any given time. So although the increased adrenaline causes increased cortisol production causes increases blood glucose thing is an explanation, that mechanism isn't what's causing the high blood glucoses in me.

It's interesting when I'm having a problem proposed to be linked to increased cortisol from stimulation of the adrenal glands because I know that's not the cause for me since I control those steroid levels myself.  

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