Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
July 24, 2002
Diagnosis and Symptoms
Question from Palm Harbor, Florida, USA:
I am a 30 year old woman who works out five to six days a week, and I try to eat a low carb, low fat, high protein diet, but I do have my cheat moments. I do have a hearty appetite too! My mother (at age 60) was diagnosed with type 2 diabetes this past year after first having been diagnosed with hypoglycemia several years ago. She is not an active woman, and I believe her diet was not up to par. Despite my healthy lifestyle, I cannot lose weight, and whenever I start off in the morning eating any type of carbohydrate, I continue to crave and eat carbs all day with little satisfaction. Several months ago, I had some lab work drawn around mid morning and my glucose level was 42 mg/dl [2.3 mmol/L]. I was not symptomatic so I excused it as a lab error. However, I was reading information about the carbohydrate addicts diet which says there is a increased amount of insulin released after a carb is ingested. Instead of converting it to energy, it is stored as fat and results in a low blood sugar which causes the cravings. I've been putting this theory to test by having a protein bar (3 grams carb) in the morning, and so far I have not had any cravings or cheating episodes. Based on this information, do I have hypoglycemia? What can I do to get my insulin to convert food as energy and not fat? Is my body over-producing insulin and can or will it suddenly stop producing insulin as I get older just like my mother? I know of someone who has type 1 diabetes and was never compliant until recently. He is now taking his medication, and as a result, he is gaining weight, even though his eating pattern has not changed. He claims it is because of the insulin storing fat and not producing energy. I really am concerned for my health, and I want to lose 10 pounds, but despite my exercise and good eating, something is not right. I do take thermogenics and have tried every diet pill in the book. Could this have altered my pancreas and liver to that of a prediabetic state?
The blood sugar of 42 mg/dl [2.3 mmol/L] does not categorize you as having hypoglycemia. Your previous history of trying other diet pills does not put you at increased risk for diabetes or hypoglycemia.
The theory about the increased insulin response after meals is not necessarily tested. It is hypothetical. I would be more conservative in the approach to goo health for you. Remain active, prevent weight gain and attempt weight loss, and have regular follow-up with your physician.
Additional comments from Delaine Wright:
There is a genetic component to
type 2 diabetes. It is also not uncommon for persons diagnosed with Type 2 diabetes to have experienced episodes of reactive hypoglycemia years prior, particulary in response to a high intake of carbohydrate. This occurs as a result of, as you have mentioned, an exaggerated release of insulin from pancreatic beta cells in response to a carbohydrate intake. While having hypoglycemia and a family history of Type 2 diabetes may put you at risk for developing diabetes yourself, you are currently doing much to prevent this occurrence. We do know that regular exercise, an active lifestyle, and appropriate weight management can delay or even prevent the development of Type 2 diabetes. It may also be true that following a lower carbohydrate diet than is typical might possibly do the same in your situation. There is quite a bit of debate amongst dietitians and medical professionals in this regard. No one can argue with the fact that you seemed to have found an effective way to keep your blood sugar levels in the normal range with a lower carbohydrate, low fat, higher protein diet.
Only a physician can make the diagnosis of hypoglycemia, and may chose to do so via results of specific laboratory blood tests, or may simply make that decision based on your clinical history. The questions that you ask regarding weight loss and how to make insulin work more effectively are things that we as healthcare professionals continue to struggle with. Remember that insulin is a hormone that not only is responsible for facilitating the transport of glucose into the body’s cells, but also plays a role in both fat and protein storage. We cannot affect one without affecting the others. We do know that one key to weight management lies in appropriate and not excessive total caloric intake.
Your friend with diabetes who is struggling with weight loss might benefit from consultation with a dietitian, who can assist in balancing appropriate caloric intake, as well as medical nutrition therapy in blood sugar management.
The question is then “why does insulin resistance and then the excessive release of insulin levels in response to carbohydrate loads
(hyperinsulinemia) occur?” Unfortunately that question remains the focus of much research and while we have developed a greater understanding of insulin resistance over the last decade, for now this question remains unanswered.
Congratulations to you on your active lifestyle choices.