[ Nutrition ]

The story of blood sugar and the connection between Hypoglycemia, Diabetes and Obesity

Hypoglycemia is the rate-limiting factor that often prevents patients with diabetes from safely and effectively achieving their glycemic goals. But increasingly, she became confused and disoriented — a case of “intermittent dementia,” one doctor speculated. Reliability analysis of patients’ outcomes was performed to assess internal consistency of the ADDQoL-19. Because available interventions to manage hyperglycemia do not precisely mimic physiologic insulin secretion patterns, hypoglycemia can occur any time dosing exceeds demand. One NIDDM patient had only high-affinity antibodies (Kd, 22.9 x 10(-9) mol/L; binding capacity of 78 mU/L). Given the potential importance of fear of hypoglycemia in pediatric diabetes, there has been limited research in this area. Patients with type 1 diabetes may suffer an average of two episodes of symptomatic hypoglycemia per week, thousands of such episodes over a lifetime of diabetes, and one episode of severe, at least temporarily disabling hypoglycemia per year.

Hypoglycemia causes a cascade of physiologic effects and may induce oxidative stress and cardiac arrhythmias, contribute to sudden cardiac death, and cause ischemic cerebral damage, presenting several potential mechanisms through which acute and chronic episodes of hypoglycemia may increase CVD risk. As a result, diabetes and hypoglycemia are becoming increasingly more common. Primary care physicians play a key role in the prevention and management of hypoglycemia in patients with diabetes, particularly in those requiring intensive insulin therapy, yet physicians are often unaware of the multitude of consequences of hypoglycemia or how to deal with them. Older adults with diabetes are more likely than younger people to have bouts of low blood sugar because of altered kidney function, other medical conditions, other medications that interact with their diabetes drugs and a reduced ability to sense the warning signs of hypoglycemia: shakiness, sweatiness, dizziness, weakness, a feeling of intense hunger and blurred vision, among others. When the body isn’t responding to insulin, blood sugar remains high and can cause excessive weight gain even without overeating. Obesity precedes 90% of adult onset diabetes (DMII). Some signs and symptoms of diabetes mellitus include excess urination, hunger, fatigue, weight loss, vaginal itching, visual changes, poor wound healing, hyperpigmented skin tags, and chronic candida.

Lack of fiber, high sugar intake, too much iron or free radicals can also contribute to the exhaustion and destruction of the insulin producing cells of the pancreas, leading to DM II. Under the circumstances of insulin resistance and high blood sugar, fat tends to accumulate in the abdominal area, salt and water are stored at a greater rate, food cravings increase, acne and polycystic ovaries increase, blood vessels are narrowed, cholesterol production increases in the liver, atherosclerosis and plaques increase, and vitamins K and C are inhibited, leading to weak vessels and connective tissue. The combination of insulin resistance, high blood pressure, central/abdominal obesity, tendency toward blood clot formation, increased blood lipid levels and generalized inflammation is referred to as “Metabolic Syndrome”. Hypoglycemia occurs when blood sugar peaks and insulin decreases blood sugar levels to lower levels than the body would like. The purpose of this review is to discuss the importance of all hypoglycemic events in the successful management of patients with diabetes, with the aim of improving understanding of the impact and consequences of hypoglycemia, emphasizing new data regarding the incidence of hypoglycemia in type 1 and type 2 diabetes patients taking insulin, exploring new methods to aid the diagnosis and treatment of hypoglycemia, and highlighting the need for newer therapeutic agents with a lower risk of causing hypoglycemia. Further evidence that hypoglycemia deserves more attention in older diabetes patients comes from another study published earlier this year, also in JAMA Internal Medicine. Typically, patients with hypoglycemia feel better with food.

Over time, if hypoglycemia continues, it may develop into insulin resistance or type 2 Diabetes. Eat smaller, more frequent meals, at least every 3 hours, balanced in protein/complex carbohydrates/healthy fats. Avoid simple sugars, saturated/hydrogenated fats, and starchy vegetables. Include protein with each meal. Aim for at least 20 grams at breakfast. Eat plenty of fiber to decrease rapid rises in blood sugar. Legumes, oat bran, nuts, seeds, psyllium seed husks, pears, apples, and most vegetables are high in fiber and should be consumed with every meal.

Supplement with chromium or glucose tolerance factor (GTF). Chromium helps insulin sensitivity, allowing glucose to be transported in and out of cells more easily. Start exercising. Exercise improves many aspects of glucose metabolism, including enhancing insulin sensitivity, improving glucose tolerance in existing diabetics, and increasing tissue chromium concentrations. People with blood sugar issues should try to get some form of exercise on a daily basis. If you tend to wake up in the middle of the night due to hunger, eat a balanced complex carbohydrate/protein snack before bed.

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