December 3, 2004
Hypoglycemia
Question from Washington, USA:
About two months ago, I was diagnosed with pre-diabetes. I am thin and active, so my doctor just recommended that I avoid sweets and excess carbohydrates. However, I have had lows for a month now; they are between 60 and 78 mg/dl [3.3 and 4.3 mmol/L]. My doctor says that these are normal numbers and if I am shaking, it isn’t from the number. But, if I really feel like eating something will help (placebo effect) have peanut butter, not orange juice.
However, this web site, and many others say this “Treatment should be given whenever the blood sugar drops below 70 mg/dl [3.9 mmol/l] or symptoms are present.” And several sites have commented that the brain does not work as effectively once the blood glucose has dropped below 70 to 75 mg/dl [3.9 to 4.2 mmol/L]. I don’t understand what I should do now, could you please advise?
Answer:
Your point is a good one. We should differentiate between what happens to the blood sugar when we treat with medications to lower it and what the lower limit of normal blood sugars are in people without diabetes. There are women, during pregnancy, that have fasting blood sugars in the 60s mg/dl [3.3 to 3.8 mmol/L] that are not taking any medications for diabetes. They are without symptoms or may wake up with an increased appetite. As you suggest, we should not recommend that people without glucose-lowering medications treat lows in a manner similar to those with diabetes on medications. I think it is reasonable to have your peanut butter snack when you have an increased hunger. At the same time, we need to protect people with diabetes on medications who get low.
JTL
