December 13, 2006
Diagnosis and Symptoms, Hypoglycemia
Question from Toronto, Ontario, Canada:
I’m 37 years old, of a healthy weight and eat a well-balanced diet. I am thirsty all the time and never go anywhere without water. This has been the case for about five years. I also feel the urge to urinate frequently, although the volume is not very high. I have had stress incontinence since having my baby seven years ago.
For a few years now, I also have had problems with what I have assumed is low blood sugar. Often, if I don’t eat within four or five hours of breakfast, I feel lightheaded, my hands shake, I feel nervous/jittery and I have an urgent need to eat something. I hadn’t noticed any problems at other times of the day until this past year.
A couple of years ago, I started drinking one can of cola every day at my desk, after lunch. Then, a year ago, I started having a “low blood sugar” problem soon after I was finished drinking the Coke. It has become progressively worse over the past year and feels so horrible that I have stopped having the Coke altogether. It makes me feel so lightheaded I almost think I can fall over or pass out. My hands tremble terribly and feel clumsy. The only thing that makes me feel better is eating something like a yogurt or cookies, but it takes a while to kick in, though.
I am not in a high risk group for diabetes, except that I don’t exercise much. With the Coke problem getting worse, it makes me wonder. Can diabetes or hypoglycemia cause these symptoms? What else could be the problem?
Answer:
It sounds like you have symptoms that fit the pattern of reactive hypoglycemia, reactive in the sense that some food challenge stimulates the insulin response. Instead of having a normal braking mechanism to shut off insulin secretion when glucose levels fall, you take longer to shut it off and the glucose levels fall to the point of symptoms. Whether this truly puts you at risk for diabetes is debated. I would suggest that there is not definitive data to highlight this relationship. It sounds like you need to think about modifying your diet and using fewer simple sugars.
Most of our patients that have symptoms of reactive hypoglycemia go to the dietitian. Try using diet colas that will not stimulate insulin. Try eating more small, frequent meals with high fiber content. Diet can usually modify the symptoms. I would make sure you speak with your physician about these symptoms. Making diagnoses over the Internet is not the best way to do things. You will want to make sure the symptoms are not from anything else related to medications or other problems.
JTL
