After 10 years of PN small fibre, I have found that sometimes it has a mind of its own. I have had exacerbation after viruses and after antibiotic use mainly.
I am on the thin side and active so blood sugar was never a problem for me.

That changed a couple months ago as I found I could no longer eat carbs and sugar. It was exacerbating my PN in a bad way.

Why? Who knows?? But sugar seems to be a big aggravator of PN for a lot of people not just diabetics. Processed sugar is toxic.