
September 25, 2002
Diagnosis and Symptoms
Question from Gulfport, Mississippi, USA:
For the last four years, I get weak spells. I wake up at night with cold sweats, hungry, shaky, very weak, and food relieves it. I fight a weight problem so I’m on a 1400 calorie diet, and I exercise three to five times per week. Both parents had type 2 diabetes, but my fasting blood sugars are normal.
My doctor says nothing is wrong, but now the weak spells happen during the day also. I have to eat every hour and have to pull to the side of the road while driving. A second doctor did a fasting blood sugar which was normal, and a third doctor did a C–peptide level which was 5.2 with a random blood sugar of 97 mg/dl [mmol/L]. This doctor says I have insulin resistance syndrome due to a history of polycystic ovaries. He says I can only continue my diet and exercise.
However, now I am very weak. I can only walk on treadmill for 20 minutes before the severe weak spells. I feel like hell, and it’s absolutely almost impossible to make 1400 calories last over day. I have continuous weakness with weight gain. Is there any other treatment? I will die soon in an accident if I don’t stop the weak spells, and I’m only 44 years old.
Answer:
Several issues are not clear. Are you taking medications? What are you doing to prevent the low sugars? I agree the C-peptide of 5.2 is consistent with insulin resistance.
There may be other ways to treat this problem. One possibility may be to relax the calorie restriction and use medications, if not already. Above all, you sound like you need to find a physician you can trust.
JTL