[net.med] Hypoglycemia

seifert@hammer.UUCP (Snoopy) (12/20/85)

In article <2124@aecom.UUCP> werner@aecom.UUCP (Craig Werner) writes:
>> Craig, I'm surprised that you don't know the difference between a test
>> for diabetes and a test for hypoglycemia. (hint: there is more than
>> one form of hypoglycemia, the test for diabetes only catches one)
>> 
>> Snoopy
>
>	Obviously a test for blood sugar levels would pick up high (diabetes)
>and low levels (hypoglycemia).  Since you are right that I don't know of any
>hypoglycemia that is NOT reflected in low blood sugar levels, you'll have
>to enlighten me and the net (or get a mailpath that works).  In order for
>Fredericks to be right, it would have to be ~1000X more common that the
>detectable type.

I didn't say that hypoglycemia wasn't related to low blood sugar, I said
that the test for diabetics only catches one type of hypoglycemia.

The test for diabetics consists of taking a single sample of blood,
a "fasting" sample.  You can't have eaten anything for 'n' hours
previously.  If the fasting blood sugar is too high, you have diabetics,
(hyperglycemia) if it is too low, you have hypoglycemia.

There is another disorder that is also called hypoglycemia.  Another
name is "reactive" hypoglycemia.  This type is much more common.
The fasting blood sugar is normal, therefore a diabetics test doesn't
catch it.  You have to take the Glucose tolorance test (GTT).
Procedure for GTT: fast overnight as for the diabetics test.
Draw a fasting blood sugar.  Drink a bottle of glop containing
a measured amount of glucose.  Take blood samples every so often
and plot out the results.  In a normal individual, the blood sugar
raises somewhat, then dips down a little and finally levels out.
In a diabetic, the blood sugar starts out high, goes way up, and slowly
comes down.  In a reactive hypoglucemic, the blood sugar starts out normal,
then shoots way up, then comes crashing down, and several hours later
finally levels out.  When the blood sugar is high, you have a lot of
energy and feel great, when it is dropping, you feel tired, have headaches,
and are very iritible(sp?).  A good good test should have samples
at least every half hour, every 15 minutes would be better, and should
last for six hours, not just three.  The morons who did my test
refused to do it properly, so the numbers didn't show a problem,
but the symtoms were definitely there.  (Imagine the nerve of a
mere patient thinking that they might possibly know something!)

There are a number of books on the subject, which explain all this
much better than I have, and give real numbers for the blood sugar
levels, and describe variations.  (I only described one)  According
to the books, it's not just the absolute level of blood sugar,
but how fast it's dropping that counts.  It could be above the fasting
level, but be dropping quickly and you would feel rotten.  And it could
be a little low, but fairly steady, and you could feel ok.

The treatment is to avoid refined sugars, and any food that dump
a lot of sugar into the blood quickly.  Eat food that provides a
slow, constant supply.  Vitamin and mineral suppliments may help,
especially since it is often caused by eating large quantities
of refined sugar that "wear out" the pancreas.  Refined sugar
can cause vitamin and mineral deficiencies, since it no longer
contains what it needs to be metabolized.  (Natural sugar does)

Recomended reading:  "Dr. Atkin's Super Energy Diet", "Dr. Atkin's
Nutrition Revolution" by Dr. Atkins  [who else?  :-) ]
"Hypoglycemia, the Disease your Doctor won't treat", by <somebody>
(Saunders I think) and Ross.  [Ross is a MD, Saunders has hypoglycemia]
These can be found in paperback in bookstores and nutrition stores.
Yes I know the titles don't sound very highbrow, read them anyway!
If I remember right, there are plenty of references for those out there
that want them.

As far as the mailpath, sorry, but "they" changed the mail software
on the "tektronix" machine, resulting in massive problems.
(e.g. mail going to the wrong people, tektronix and ihnp4 not
talking to each other, fun stuff!)

Snoopy
tektronix!tekecs!doghouse.TEK!snoopy

tektronix may or may not be currently speaking with: allegra, decvax,
ihnp4, sequent, ucbvax, uw-beaver, ...

csg@pyramid.UUCP (Carl S. Gutekunst) (12/21/85)

I hate to snipe at a fellow netter, but Snoopy@tekecs's comments on "reactive"
hypoglycemia included some common misinformation.

>The treatment is to avoid refined sugars, and any food that dump
>a lot of sugar into the blood quickly.  Eat food that provides a
>slow, constant supply.

Close, but a bit off the mark. The treatment is to moderate your intake of all
food, focussing on an even intake of all carbohydrates. Frequent snacking is
recommended, and three balanced meals per day is a must. Sugars are a specific
concern since the American diet tends to include them to extremes, and they
are so often hidden in unexpected places (like processed foods).

>Vitamin and mineral suppliments may help,
>especially since it [hypoglycemia] is often caused by eating large quantities
>of refined sugar that "wear out" the pancreas.

This is utterly and totally false. All forms of hypoglycemia are genetic. Diet
may aggravate it, but it doesn't cause it. "Wearing out" the pancreas makes no
sense, since in hypoglycemia the pancrease produces *too much* insulin.

>  Refined sugar
>can cause vitamin and mineral deficiencies, since it no longer
>contains what it needs to be metabolized.  (Natural sugar does)

Oh gawd, I hate to start this one again, but here goes....

This is classic pulp health/diet bilge. Sugar is sugar, be it from factories,
oranges, or honey bees. A 12oz glass of freshly squeezed orange juice contains
3 tablespoons of sugar, exactly the same as a 12oz bottle of Coca-Cola. A true
hypoglycemic with be aggravated equally by either.  Of course the orange juice
is more nutritional, but metabolization of sugar has nothing to do with it.

Hope this doesn't come across as a flame; I appreciated Snoopy's posting since
it *is* extremely difficult to find medicos who understand hypoglycemia. 
-- 
Carl S. Gutekunst   {allegra,cmcl2,decwrl,hplabs,topaz,ut-sally}!pyramid!csg
Pyramid Technology Corp, Mountain View, CA  +1 415 965 7200

Look, Ma, no graphics!

bert@infoswx.UUCP (01/10/86)

The recent articles about hypoglycemia have prompted me to post this
account of my experience, having had this condition for several
years.  There are several books on this subject, many of which I have
read.  There is a diversity of opinion regarding the prevalence and
even the existence of this condition.  I am not interested in trying
to convince anyone of anything, and I will try to be objective.
WARNING: THIS IS LONG AND TEDIOUS. You may want to skip it.

My first symptom of the problem that was overt enough for me to notice
(I had always been very healthy, to the point of never even giving
the idea of being sick a second thought, read: I didn't pay much attention
to subtle signals from my body) occured in 1978.  I would get up in the
morning and do a short exercise routine.  Suddenly, a feeling of panic
would come over me.  This feeling has best been described as the
feeling agorophobic people get, just a general feeling of dread and that
you should get away from wherever you are immediately.   I had never
experienced any mental disturbances (well, maybe anxiety) before and it
was VERY frightening.   This went on for a week or two, and I finally
decided to see my general practitioner.  After explaining this
to my doctor, much to my suprise he asked if I had a family history
of diabetes.  I said no, but he insisted that this sounded like a sugar
problem and said I should have a glucose tolerance test.  I had a passing
idea of what this was and I was suprised but thankful that he had
something to say other than "maybe you need a long rest...".

The test, which ran 3 hours and required of six blood samples,
showed my blood sugar level dipping to 40 (some unit of sugar per
milliliter of blood), about 2 hours after drinking the 100 gram
glucose solution.  This level was, my doctor explained, low enough
to cause many people to lose consciousness, and he seemed suprised at
the results.  He immediately put me on a standard diabetic diet,
high in protein (and consequently fat) and low in carbohydrates and devoid
of sugar.  I was suprised by the diagnosis, but relieved that I wasn't
losing my grip.  The panic attacks began diminishing in a matter of days, but
the diet I was following was also a calorie restricted diet, and I began
to lose weight.  Being naturally thin anyway, this wasn't going to do, so
in a followup visit my doctor prescribed Orinase, a diabetic drug used
in lieu of insulin in mild cases, and gave me the ok to eat more than
the 1300 calories a day on my previous diet.  I took the medication
only a few times, because they seemed to cause a reaction and 
because by now I had read a few books on the subject
and couldn't understand why I would want to take a drug to lower
sugar levels when they were already low.  Also, my doctor seemed to
believe that my low blood sugar was a precursor to diabetes, a conclusion
that I don't understand at all.

Now, I was and am grateful to my doctor for so quickly diagnosing the cause
of my problem.  There were many other symptoms of a problem,  mild headaches
in the morning, almost constant hunger, and strange visual disturbances,
but I didn't really give these much thought.  Although I realized in
retrospect that I had been experiencing these symptoms in varying
degrees for several weeks, I never associated them with the panic attacks.
Fortunately, my doctor did.  But after he prescribed the Orinase, I began to
realize what later became a certainty to me - that I would have to
manage this problem myself.  I really can't blame the medical profession
too much for not knowing much about this malady - people are dying of
serious diseases and I just can't eat sugar, no big deal.  But the next
3-4 years were very difficult, because thats how long it took me to
find, by trial and error, just how to keep my blood sugar under control.
In the meantime I suffered almost constant headaches, weakness, chills,
fatigue and emotional disturbances, mostly a raging temper.
And what I found to work for me isn't much like what the medical profession
OR the 'holistic\alternative' view proposes as proper treatment.

I learned that I react to almost all forms of sugar.  Honey, sucrose, glucose,
brown sugar, you name it.  One partial exception is fructose, which I
seem to be able to handle if I don't overdo it.  I can eat about all
of the fruit I want, and I can eat moderate amounts of the complex-carbohydrate
sweeteners sorbitol and mannitol without reactions.  But that is ALL.
You find out quickly how difficult it is to find processed foods without
sugar.  I prefer whole-wheat bread, but most of it is loaded with sugar.
You find that almost everything has sugar, finding cold cereals and snack
type foods is difficult at best.

I cannot have anything with caffeine or any kind of stimulant without
some degree of reaction.

Now, this feature of my condition pretty much
matches the recommendations of the 'experts', excepting the fruit which
is supposed to be restricted heavily in most prescribed diets.
But the thing I learned out of desperation for some kind of improvement
was that the high protein-low carbohydrate diet doesn't work at all
for me.  My guess is that the high fat component of my high protein diet
was the culprit. (try to design a really high protein diet without
a high fat content and you'll find there are very few foods that
will fit in)  After ditching it for a diet of mostly complex-carbohydrates -
bread, potatoes, rice, etc., my symptoms diminished dramatically.
According to the medical and holistic 'experts', eating a high carbo
diet would be courting disaster.  In my case, they were all wrong.

Another mismatch is alcohol.  I don't know a great deal about the
metabolism of alcohol, but the texts and articles I've read all explained
that hypoglycemics cannot handle alcohol because it turns to sugar
in the blood.   But I can drink moderate amounts of wine (not overtly
sweet stuff) and some liquors (not rum or liqueurs) without a problem.


Along with the blood sugar problem, I seemed to develop allergies
at about the same time.  I have at times considered the possibility
that my sugar problem is an allergic problem - but I am now sure
that it isn't for various reasons.   One thing that I don't know
about this problem, and I suspect that the medical profession doesn't
know either, is what has actually gone wrong with my physical self.
I mean, which organ or gland is responsible -:)  I have asked doctors
and my allergist, and I get vague answers.

Now for the one thing that irritates me.  I have read of many doctors
who say that hypoglycemia is a 'fad' disease, and that it is extremely
rare, or that it doesn't exist.  Well, I would be happy for any of them
to make it go away.  Being unable to eat sugar or consume coffee or tea
(at least there are now the caffeine free sugar free soft drinks which
I like occasionally) is no fun to say the least.  The four years I felt
absolutely terrible cannot be replaced.

I am not suggesting that everyone who has low blood sugar would do
best on my type of diet.  I believe that there may be several different
causes of this problem, and that one person's may be different from another's.
But if everyone with low blood sugar has the same mal/dys/etc-function in their
metabolism I think this diet would be the best solution possible.
I think that if you feel like you may have this problem, your best bet
is to ignore all of the experts and strenuously avoid ALL sugar and caffeine 
but not fruit and high carbohydrate foods.


Bert Campbell

"facts all come with points of view"