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

A conversation with Penny Figtree, MD, about her personal experiences with blood sugar spikes and reactive hypoglycemia.

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- VIDEO DESCRIPTION -
In this video, I am talking to Dr. Penny Figtree, a primary care physician from Port Macquarie on the East Coast of Australia. Dr. Figtree leads a low-carb clinic to treat obesity, type 2 diabetes, fatty liver disease, and other metabolic disorders. She also has a long history of experiencing blood sugar spikes, often followed by reactive hypoglycemia, even though she does not have prediabetes or diabetes. We are discussing who is most at risk of blood sugar spikes and reactive hypoglycemia, the symptoms of reactive hypoglycemia, and how to avoid both the blood sugar spikes and the reactive hypoglycemia.

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- TIMESTAMPS -
0:00 Introduction
0:58 Introduction Dr. Penny Figtree: a physician with unexpected blood sugar spikes and reactive hypoglycemia
6:44 Food that cause a blood sugar spike
10:30 How to prevent reactive hypoglycemia
14:34 How to avoid blood sugar spikes
22:18 Risks of continuous glucose meters
26:00 Eating carbs while on a low-carb diet
26:25 Pre-diabetes diagnosis as a result of blood sugar spikes to a single food eaten regularly
31:05 Summary

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- SIMILAR VIDEOS -
The Regulation of Blood Sugar:
How to Avoid Blood Sugar Spikes (Without Reducing Carb Intake):
Blood Sugar Spikes Q&A:
How to Use a Continuous Glucose Monitor for Maximum Benefit:

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[philipthompson]

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.

[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!

[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.

[silkenissen]

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!!

[vidakyeremateng]

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.

[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.

[willamgordon]

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!

[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 :)

[Rockies]

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!!!

[cbgbstew]

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!

[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.

[lseh]

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.

[lauragaimon]

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!!

[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

[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.

[irenemuench]

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

[marybusch]

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....

[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.

[juliapace]

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.