June 29, 2002
Diagnosis and Symptoms
Question from Rhode Island, USA:
I’ve been plagued with recurring hypoglycemia for at least 20 years, have had three bouts of gestational diabetes, feel physically and mentally better when chubby than at “goal weight”, and have had strange mental effects from my wild swings in blood glucose. The neurologist I’ve recently consulted about the mental anomalies asked if I’d ever been investigated for an insulinoma.
So, perhaps I’ve never had normoglycemia! I’ve always thought that the lows and highs of my blood glucose where a character flaw or a result of bad food choices and relative unwillingness to exercise. In a given day, like yesterday, my blood glucose ranged from 66-170 mg/dl [3.7-9.4 mmol/L]. I’m presently nine weeks pregnant and have gestational diabetes with diet and exercise alone.
Please tell me that my never having had normoglycemia (having had reactive hypoglycemia, unexplained hypoglycemia, gestational diabetes, and impaired glucose tolerance) is not a character flaw, but perhaps symptomatic of an abnormal pancreas. Do “normal” folks have even blood glucose throughout the day despite what they do? Oh, how I would love an answer that would explain a lifetime’s misery!
Answer:
This does not sound like a character flaw. If you are overweight, then you must make relatively more insulin than those who are not overweight. If this “thermostat” is not set ideally, then you could have some overshooting and undershooting. More than 95% of the time, appropriate meals and snacks, balanced for proper total calories and avoiding most fast acting carbohydrates will stop such swings and any associated symptoms.
If you really have blood glucose values up to the high 170s [mg/dl, 9.4 mmol/L], then you have insulin deficiency, at least relatively and/or some insulin resistance. You should be in touch with a diabetologist who understands these intricacies so that you can get proper advice individualized for you, whether or not you are pregnant or post-pregnancy, etc.
SB
