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September 23, 2002

Complications

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Question from Virginia, USA:

I have type 1 diabetes. About three weeks ago I came down with what I thought was a gastrointestinal bug (severe nausea, dizziness, headache, and heartburn and I passed out twice at work), and my blood sugars went bazooka to the point where anything under 200 mg/dl [11.1 mmol/L] felt like a very bad low. (Normally, my blood sugars are 90-140 mg/dl [5-7.8 mmol/L].) Needless to say, most of the time I was running near 300 mg/dl [16.7 mmol/L], which coupled my eating problems. When I was able to eat something, the calories quickly got urinated out. Well, the heartburn got worse, and the dizziness and headaches continued so I went to the doctor.

My doctor did an EKG (normal, but high pulse) and an upper GI series (waiting on results). Three weeks later, I still cannot eat much and my blood chemistries are getting messed up (with a magnesium level of 2.1). If its nutritious, I inevitably can’t handle foods like salads, milk,meats, acidic fruits, breads, etc. Do you have any suggestions for a healthy, easy to digest meal?

My blood sugar control and general health are not good from living on juice (for lows), crackers, and get-the-calories-in foods (i.e.,Twinkies). Thus far, I have lost 7 pounds, which, while not horrible, is hardly a good way to lose weight. I have no energy, cannot stand still for a minute without getting dizzy and falling down.However, the heartburn has started responding to medications. Exertion makes my heart pound for hours (which is why my doctor did the EKG). Could all of this stuff be related to malnutrition? My symptoms of lows have also changed, whereas before the primary symptom was getting hungry and weak, now I get extremely dizzy even sitting down.

Answer:

From: DTeam Staff

I would be concerned that you may have diabetic gastroparesis. Obviously, a diagnosis like this cannot be made over the Internet. You need to see your physician.

The problem in gastroparesis is that the nerves the innervate the muscles in the gut do not work correctly. Food tends to stay up in the stomach delaying absorption, causing nausea and vomiting, and making it difficult to digest high fiber meals. There are medications your physician may use to help you with this problem. The diagnosis is made on the basis of clinical findings and a gastric emptying study. The emptying study utilizes a foodstuff with a radioactive tracer to follow its movement through the gut. It is a perfectly safe test to have.

JTL