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October 23, 2003

Diagnosis and Symptoms

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Question from Wellington, Kansas, USA:

I am a 44 year old male (6 feet 3 inches tall; 325 pounds) who does not have diabetes at this time. My wife, mother and two siblings had/have diabetes. Since I suffer from hypoglycemia, I use my wife’s blood glucose monitor to check, and my blood sugar is normally 50-80mg/dl [2.8-4.4 mmol/L]. If I skip breakfast and begin physical labor in the morning, I suffer from a drop in blood sugar to below 50 mg/dl [2.8 mmol/L]. If I eat something extremely sweet for breakfast (e.g., pancakes with syrup), I have a drop. I can even eat something such as cheese/peanut butter crackers and a couple of candy bars, and one hour later, my blood sugar is only up to 90 mg/dl [5 mmol/L]. My wife says these are simply warning signs for the onset of diabetes. Is this true?

Answer:

From: DTeam Staff

Although there are a number of causes, and ideally you need a diagnosis via testing through a physician, hypoglycemia can be a common occurrence years before the onset of type 2 diabetes, particularly when its runs in the family as you have stated. The reasons for the tendency towards low blood sugar are related to the underlying issue of type 2 diabetes which is insulin resistance and “hyperinsulinemia” (your body’s attempt to control this resistance and your blood sugar by circulating larger amounts of your own insulin than should ideally be necessary). Your own insulin response may also not be timed correctly, something referred to as a slow or missing first phase and hyperactive (more than needed) second phase response. This makes you very prone to low blood sugar, particularly if you are active around a skipped or delayed meal, or if you eat something sweet or of high carbohydrate content, like a candy bar or pasta meal.

It is most important to recognize your family history of type 2 diabetes, and the hypoglycemia you are experiencing as an early warning signs, and your chance to make some changes in your health status. You have an opportunity to control your symptoms and slow or even prevent the progression to type 2 diabetes through weight loss, regular exercise, good nutrition, and self-management/prevention education.

You would benefit from the expertise of a dietitian who will work with you to develop a plan for both weight loss and blood sugar maintenance. You may wish to supplement your plan with some reading of your own on the subject. You’ll also want to incorporate exercise and activity into your weight loss plan.

DMW