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May 5, 2002

Daily Care, Type 2

Question from St. Marys, Pennsylvania, USA:

I am a 50 year old woman, diagnosed with type 2 diabetes 15 months ago and exercise/diet controlled, and my A1c stays around 5.5%. My problem occurs on those mornings when I do not eat within an hour of rising. I get chilled and sweaty at the same time. My ears buzz, I begin to lose my vision, and I also get very nauseated. I assumed it was low blood sugar, but my sugar seems to go up during these attacks instead of going down (117-135 mg/dl [6.5-7.5 mmol/L]). Often, they have climbed from the 70s mg/dl [3.9 mmol/L] without eating. I have to eat something immediately, and in a few minutes, the effects begin to subside. This has also happened after swimming. What is happening?

Answer:

I cannot be sure what is happening. However, one thing you may want to do is perform a time course. Measure your blood sugar on rising and then see what happens when you do not eat. Sometimes, a large interval change in your glucose will cause symptoms when the absolute glucose level is not low. It also sounds like your body is telling you not to miss breakfast.

JTL