Sorry this has taken so long to answer Mary, but I have been tied up at the hospital, working extra because of all of this nasty flu going around. Just decided to pick out your post and put it here--then reply to it. Hope you don't mind if we do it that way.
Mary wrote:
First of all, I had never taken the Glucose Tolerance Test before being diagnosed as diabetic.....Type II, only a fasting blood test. That was almost 2 years ago. My D.O. put me on a supplement which along with diet modifications controlled my sugar. However, about 4 months ago my endocrinologist informed me that he didn't want me on anything because the fasting sugar was borderline, and he believes that it is tied in to my thyroid disease... which we have been trying to get under control. So far, we've not been successful....sigh.
Anyway, years ago my mother was diagnosed with low blood sugar after passing out and falling down a flight of stairs. Many years later she developed diabetes, but is doing very well with medication and diet.
Monty's numbers were elevated if I remember correctly (178) and then way down to 64 on the low end. Now, just today I was reading that there are 2 kinds of hypoglycemia. Hypoglycemia WITH diabetes and hypoglycemia OUTSIDE of diabetes. I'm not asking for a diagnosis here, but wonder what the differences are between the two?
Seeing as it is extremely hard to eat so many small meals on the road, what are some good carbo snacks to munch on during the day to help keep the insulin level stable?
One other question.....would it be beneficial to carry a glucometer to keep track of one's sugar level?
Thanks a bunch!
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~ Mary ~
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First of all, you did something I am beginning to see would be extremely beneficial to anyone who had blood sugar problems--and that is run not walk to a good endocrinologist. I probably could not emphasize that enough.
I want to say something up front before I start into this discussion on hypoglycemia. Whatever is said here is no substitute for having a good doctor who makes a correct diagnosis and gives you a plan of treatment to follow. Self-diagnosis and self-treatment can lead to fatal and harmful consequences.
Hypoglycemia is a condition in which there is an abnormally low level of glucose or sugar in the blood. Most often this results from the oversecretion of insulin by the pancreas--a gland that sits over behind the stomach area in your body. Insulin helps transport glucose from the bloodstream into the cells, especially those of muscle and fatty tissue, and causes glucose to be processed or synthesized in the liver. If the pancreas is not functioning properly, normal carbohydrate metabolism is impossible.
A person suffering from hypoglycemia may display any or all of the following symptoms: fatigue, dizziness, light-headedness, headache, irritability, fainting spells, depression, anxiety, cravings for sweets, confusion, night sweats, weakness in the legs, swollen feet, a feeling of tightness in the chest, constant hunger, pain in various part of the body (especially the eyes), nervous habits, mental disturbances, and insomnia. People with hypoglycemia can become very aggressive and lose their tempers easily. Any or all of these symptoms may occur a few hours after eating sweets or fats. The onset and severity of symptoms are directly related to the length of time since the last meal was eaten and the type of foods that meal contained.
More and more Americans today may have this condition due to poor dietary habits that include eating large quantities of simple carbohydrates, sugars, alcohol, caffeine, and soft drinks, and insufficient amounts of complex carbohydrates. High stress levels are believed to be a contributing factor in the increasing incidence of hypoglycemia.
Hypoglycemia can be inherited, but most often it is precipitated by an inadequate diet. This is referred to as functional hypoglycemia(FH). Many other bodily disorders can cause hypoglycemic problems as well,among them adrenal insufficiency, thyroid disorders, pituitary disorders, kidney disease, and pancreatitis. Immune deficiency and candidiasis--in my opinion the most least recognizable and the most rampant problem among the general population in the U.S.today are strongly linked to hypoglycemia. Glucose intolerance and hyperinsulinemia (high blood insulin levels), producing hypoglycemia, frequently occur in people with chronic liver failure. Other common causes are smoking and the consumption of large amounts of caffeine, found in colas, Mountain Dew, chocolate and coffee. Though it may seem paradoxical, low blood sugar can also be an early sign of diabetes (high blood sugar).
Diagnosis of hypoglycemia can be difficult because symptoms often mimic those of other disorders, including allergies, asthma, chronic fatigue syndrome, digestive or intestinal disorders, eating disorders, malabsorption syndrome, mental disorders, neurological problems, nutritional deficiencies, and weight problems. To diagnose hypoglycemia, a health care provider may perform a glucose tolerance test (GTT). However, many people have symptoms of hypoglycemia even though the results of a five-hour GTT are within normal limits. For example, Monty's blood sugar went down to 64--the normal being between 60-100 or thereabouts. But he was symptomatic. Our open-hearts who have been running blood sugars of 200 or better before surgery and you give them insulin after surgery--their blood sugars go to 70--they will become symptomatic and you will have to treat that. When we have a patient with high blood sugars after surgery--we start an insulin drip and bring the blood sugar down gradually. Bringing the blood sugar down too rapidly also causes the brain cells to swell.
The production of insulin is affected by the functioning of the adrenal glands. The adrenal glands produce epinephrine, or adrenalin, which acts to "turn off" insulin production, among other things. If the adrenal glands are overstressed and exhausted, they cannot function properly and an over abundance of insulin may result. This causes the blood sugar level to sink below normal, creating a low energy syndrome in the body--especially around 10 in the morning and 4 in the afternoon.
I am going to break this up now and reply to this section with another one on the adrenals. The point I am eventually going to try to make is that low blood sugar is just a symptom of the lifestyle we live while we are out there trying to make a living. So bear with me.
[This message has been edited by RunningSoLate (edited January 08, 2000).]
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Before I start a discussion on the adrenals and how stress/adrenals lead to low blood sugar problems let me say one thing Mary--it is estimated that half the people with hypoglycemia who are over fifty have reduced thyroid function and hypothyroidism.
The adrenals are two small glands about the size and shape of a flattened prune that sit on top of the kidneys. Each adrenal gland is composed of an outer and inner part: the outer cortex and the inner medulla. Both the medulla and the cortex produce important secretions that are part of our stress reactions.
The adrenal medulla plays a role in regulating the sympathetic nervous system: It speeds up the heart rate, narrows blood vessels, and raises blood pressure and blood sugar by secreting two hormones called epinephrine or adrenalin and norepinephrine or noradrenaline. You probably recognize the name epinephrine because synthetic variations of this hormone are found in over-the-counter cold and allergy remedies that work by narrowing the blood vessels (ephedrine). Epinephrine is the hormone your body produces when you are under stress, including the infamous "fight or flight" reaction in our bodies that help us survive by fleeing or fighting off attackers. When epinephrine is released, many things occur simultaneously and quickly in the body: The heart speeds up; blood is sent flooding into the heart, lungs, muscles, and brain and away from the digestive system; sugar is dumped into the blood in large quantities to provide quick energy; and breathing is faster. This is a great system if you need to run from or turn and fight a saber-toothed tiger. If your boss is yelling at you, the flight or fight response still occurs, but its manifestations are suppressed by "higher" parts of your brain telling you that fleeing or physically fighting would not be a cool thing to do in that situation. Your body is now flooded with contrdictory messages and reactions. This in itself is a factor in disease, eventual fatigue, and physical disease.
Events that provoke a fight for flight response are called stressors. Stress is a household word these days--we all have it to one degree or another. We have the day-to-day stressors of hectic schedules, traffic jams, colds and flus, pressure on the job, mechanical breakdowns, and troublesome relationships.Then we have the really big stressors such as the death or serious illness of a loved one, losing or gaining a job, moving, having a child, marriage, divorce, and so forth. Any of these types of stressors can send the adrenal medulla into action with epinephrine.
When we are stimulated by epinephrine we tend to be very alert, focused, and energetic. This is good in some instances. The bad news is that epinephrine is not a hormone meant to be used all the time--it's designed to be used in emergencies for short bursts of intense energy. If we are always calling on our epinephrine to get us up and going, eventually we fall prey to an imbalance and our adrenal medulla becomes exhausted.
On the other hand the adrenal cortex secretes three classes of hormones--glucocorticoids, mineralcorticoids, and androgens--they play literally dozens of ongoing roles in regulating bodily functions. While the secretions of the adrenal medulla provide quick and short-term responses to immediate stress, the adrenal cortex hormones provide longer-term responses for stress and homeostasis, the maintenance of balance in bodily functions. The adrenal cortex hormones are often considered essential for life. Animals with the adrenal glands removed will survive for a long time if maintained in an environment providing proper nutrition and freedom from stress. However, if put to any significant stress such as infection, trauma, hunger, or fatigue, they will quickly die. Adrenal cortical hormones are essential for life because life as we know it is stressful.
The most important glucocorticoids are cortisol and hydrocortisone, which play a role in regulating blood sugar, how carbohydrates, proteins, and fats are moved in and out of cells, inflammation, and muscle function. If too many cortisols are present (as from adrenal cortical tumors or dosages of cortisol--cortisone medication), the symptoms of weight gain (especially around the midsection), blood sugar imbalances, thinning skin, muscle wasting, and other signs of aging. People whose glucocorticoid pathways are not functioning properly or who are deficient in the cortisols (as from adrenal exhaustion or lack of adrenal reserve after overly prolonged stress or malnutrition) may have fatigue, low blood sugar, and sometimes weight loss. Women may have menstrual dysfunction to boot.
The mineralcorticoids, especialy aldosterone, regulate the balance of minerals in the cells, mainly sodium and potassium, but magnesium is also affected. Stress triggers the release of aldosterone, which raises blood pressure by its action on body cells to hold onto sodium and lose potassium and magnesium. Long-term release of stress-level mineralcorticoids can cause a potassium deficiency and a magnesium imbalance as well as chronic water retention and high blood pressure. Magnesium loss is an exceedingly important factor in our overall health, being the most common cofactor or optimal enzyme function, but magnesium deficiency is not commonly done on standard blood tests. We routinely do this test in CCU and after open-heart surgery--magnesium is important (as well as potassium) for the functioning of the heart.
The adrenal cortex also makes all of the sex hormones, but in very small amounts. One cortical hormone, DHEA, which is weakly androgenic (producing masculine characteristics), is made in large amounts in both men and women; its production is greater than that of any of the other corticosteroids. Its full range of function is yet to be understood. A small amount of estrogen and progesterone is produced by the adrenal cortex.
I hope you can begin to see where this is leading--that chronic stress can cause hormone imbalances. I think that truck driving is rated very high among stress-filled jobs. But also, a woman who works full-time, has a couple of kids, and a husband who also works has a recipe for imbalance and stress. She's likely to be chronically exhausted, always "on," never taking time for herself. She is constantly forced to push the limits of her endurance to keep up. In an effort just to maintain her lifestyle, her adrenal glands are constantly pumping out hormones meant to be used sparingly for "fight or flight" situations and they eventually become tired, sluggish, and depleted. Her body gets the message that survival is at stake. Blood sugar becomes constantly unstable. Digestion goes awry so she isn't absorbing nutrients properly. The ovaries respond by shutting down in favor of survival. When her ovaries shut down, progesterone production occurs only at the adrenals, but they aren't working and she's not getting any progesterone from poor dietary habits, so she becomes progesterone-deficient and estrogen dominant and that is a whole thread in its own.
The problem here is that many women are so stressed out trying to work, raise children and be wives that by the time they're in the mid-to late thirties or early forties their adrenal glands have nothing left to give. When the ovaries stop producing progesterone, the adrenal cortex and brain need to pick up 100 percent of that function to produce corticostroids, there isn't much the adrenals can produce. Progesterone is the precursor, or what the body uses to build ALL your other bodily hormones, including the coritcosteroids and balance the estrogens in your body.
The estrogen dominance causes the all-too-familiar signs of fatigue, depression, little or no desire for sex, weight gain, water retention, headaches, and mood swings. By her late thirties and early forties, she probably has fibrocystic breasts, uterine fibroids, or endometriosis. The estrogen dominance interfers with thyroid action, which increases her fatigue, so she's cold all the time and she's gaining more weight. But her doctor gives her a thyroid function test and it comes out normal: she produces the normal amount of thyroid, but it's not being used effectively. Not realizing the role of estrogen dominance, her doctor often prescribes thyroid supplements.
She diets continuously (binging in between on sugar, caffeine, and refined carbohydrates in a desperate attempt to get her adrenals jump-started), but it does no good because her metabolism has also gone into survivial mode, which is to say it's very very slow. Due to her sluggish adrenals, she finds it very difficult to get out of bed in the morning. Does this sound familiar?????????
To add insult to injury, once progesterone, the bone-building hormone, is missing and you add poor diet and lack of exercise, calcium is being pulled off the bone faster than it can be put on. Many women arrive at menopause with osteoporosis well under way, already having lost 25 to 30 percent of their bone mass.
Now you asked about snacks and the glucometer. Well, I have to go cook dinner now--I'll be back later and discuss that. SIBYL
If you continue down past the next three posts--this discussion is continued. But please read the next three posts too. I just mean I didn't get back after dinner to finish what I was discussing. Thanks
[This message has been edited by RunningSoLate (edited January 09, 2000).]
Answer
WOW! How do I begin to say "Thank You"? You can't begin to know how personally informative what you have posted is to me....and I hope to Monty and others also!
I first got on the web in order to research health conditions. That was my SOLE reason for getting on. And I have done much, much research. But you have just explained some things to me in a way that makes sense and more importantly......it all connects!
I'm going to print this out and take to a NEW endo. Trying to find a good one.....one that's willing to listen and is not being bought by certain drug companies is tough.
Thanks so much for your time, Sibyl! When you find some more free time.....and I feel guilty asking.... could you please address the issue of who should monitor their sugar level with a glucometer and what types of food and snacks a hypoglycemic and diabetic OTR driver should have on hand with them in the truck?
Your disclaimer is so noted.
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~ Mary ~
[This message has been edited by Mary (edited January 08, 2000).]
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I echo Mary's sentiments RSL. WOW! THANKS!
I have recently ordered and received a book that will allow me to plan and post dietary information for diabetic concerns and weight loss. It will take a day or two to research and post so please bear with me. I will place it in the 'read only' section but will announce here when it is up and ready.
I will be taking the info from the book and adapting it for the trucking lifestyle.
It was comforting to see the part you wrote about diabetics with elevated sugars being brought down gradually with insulin drips.
I lost a very close friend yesterday, and I truly beleive he could have been saved had the medical personnel tried what I suggested. Maybe not, but that's how I feel at the moment.
My friend was 44 yrs old. He was diagnosed with hyperglycemia 10 years ago and was totally non-compliant. In denial if you will.
He ate and drank what he wanted, when he wanted. Period.
About 3 weeks ago, he developed the flu. I had offered to give him a flu shot earlier and he refused. He battled the flu for about two weeks and finally seemed to be getting better. So over the New Year holiday he went to visit some friends and partied it up over the weekend. He returned on Sunday sicker than before and told his roomate that he was coming in to see our Dr. on Monday morning if he wasn't better. Well, he never came over until his roomate forced him to come in late Monday evening. I took one look at him and called for a rescue squad. His vitals signs were horrible with elevated blood pressure, rapid heart rate with missed beats, rapid laboring respirations and a subnormal temperature. He resisted the ambulance ride and wanted his roomate to transport him to the ER. I stood my ground and said "NO!". The rescue squad arrived and did all the routine things. Pulse oximeter showed 93% oxygen saturation at that time. Normal is 100%. He arrived at the hospital as a working code. Meaning they were doing CPR as he went through the doors.
On arrival his blood sugar was 600 +. They were able to resuscitate him and get him into CCU. They initiated insulin therapy and insisted on taking him down to normal levels.
He lost consciousness and never regained it.
I argued with the Intensivist that this was a man who was used to walking around with a glucose of 300+. His body was used to it and by trying to get him below 100, they were compounding the problems. He was already septic from untreated pneumonia, his kidneys were giving up, and his heart had already stopped once. Needless to say he was ,as we say in the ER, a "train wreck". I really can't help but feel that if they had tried allowing his sugar to go back up to 300 that he may have rallied to the point that they could have then brought it back down gradually. Maybe not, he had allowed himself to get so sick and stay sick for so long, that nothing would have helped. But I will tell you that if I ever have to go to that ER and that intensivist appears anywhere near me, he better be wearing body armor!
That was the most narrow minded, stubborn MD with a HUGE God complex I have ever encountered.
Unfortunately my friend had no family in this area, they were all in Texas and the Dr. was calling the shots by phone with them. Needless to say, I was treated and blown off as a 'know it all nurse'.
The memorial service is today at 2. And I am SO DAMN MAD I could eat rocks! I'm mad at him for not getting medical help sooner, and I'm mad at the Dr. for being so bull-headed.
I'm going to get off my soapbox now.
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Keeping you safe, healthy, and on the road.
Nurse Red
Visit us at www.Truck.net/abmsVisit us at
Answer
Nurse Red: It's my turn to say WOW! I think it is so little understood about blood sugars. I try to update on diabetes once a year at a conference, since so many more people are developing it. The other nite I went to CCU to work and I had a gentleman who had gotten the flu, put a strain on his heart from it and had a rather large anterior-septal M.I. Kidneys were also marginally functioning because of his low CO, and fluid had built up in his lungs because of the poor kidney function. He had eaten poorly the past few days, being very nauseated. The trouble was, was that he was a diabetic. His blood sugar was initially at the start of my shift 176 or something like that. First thing I did was treat his nausea. Believe this or not, he had an SVO2 on--Swanned and all and his CI was 1.7, even with Dobutamine (and other drips) He had been nauseated all day and by treating it, we got his CI up to 2.2. Then called the PA and got the Dobutamine switched to Primacor, with the CI getting up towards 2.8. He could finally rest and take a little fluid,etc. But after awhile he began to complain of a headache. Could have given him some Tylenol, but checked his blood sugar instead. It was 72. Said to him, "that's kind of low for you isn't it?" He said yes. So got him some cheese and crackers and got his blood sugar up there--around 110 and the headache disappeared. So blood sugars are relative and by running them up and down, you do more harm to your body. I could have given him orange juice and ran that blood sugar back up to 170 or so, but gradual is the key word here.
I am so sorry about your friend. 44 is too young to die. I got up this am thinking to write you a note to maybe put something in the recipe section on hypoglycemic/diabetic diet foods, because I had seen where you had written Monty to e-mail you if he was diagnosed with hypoglycemia--you could give him diet pointers. So glad you are going to share that with us. Did you see my post in the recipe section on holidays and diabetic eating? That came up more than once over the holidays here, because in my neck of the woods, diabetes is rampant among the general population.
Well, I will be thinking about you today at the memorial service. I am going back now and try to finish this post I started above. Sibyl
Answer
Well, I got side-tracked after dinner last nite and never got back to finish this line on hypoglycemia. And this am we had big thunderstorms here in Al, so stayed off-line.
I think we had started out talking about hypoglycemia, but because there are so many underlying causes, we wound up talking about how stress affects out body over-all through the hormonal system, particularly our adrenal glands. Again, I cannot emphasize enough how important it is to get a correct diagnosis--to find a doctor that is going to look at you holistically--one that you trust and can get you on an appropriate treatment program Self-treatment is fatal; this discussion is for informational purposes only.
Having said that, let me continue on just a minute with bone loss. This is not just a woman thing. Guys have it too. I would say that truck drivers who spend the better part of a day sitting in a truck would be particularly also at risk. Those who smoke cigarettes, are underexercised, deficient in Vitamin D, calcium, or magnesium, and in those who diet is meat-based rather than vegetable-and whole-grain-based are at risk. Alcholism is also a potent risk factor.
Bones are living tissue and, unlike teeth, they can grow as the body grows, mend when broken, and continually renew themselves throughout life. Bone can be thought of as mineralized cartilage. The skeleton begins to develop early when the baby is still in the womb and grows under the influence of the pituitary growth hormone until puberty, when the sex hormones come into play. Our bones allow us to operate in gravity by supporting out weight. Muscles attached to bone allow movement by imposing the force of torsion when we lift heavy objects or move against resistance. Thus bones are designed for compression strength (weight/force) and tensile strength (lengthwise pressure and force).
When we talk about bone loss--there are two types of bone cells that are important to this process: Osteoclasts and Osteoblasts. Osteoclast cells continually travel through bone tissue looking for older bone in need of renewal.They dissolve or resorb the old bone and leave tiny, unfilled space behind. Osteoblasts then move into these spaces and produce new bone. At any stage in life, our bone status is a product of the balance between these two processes. If the two processes are in balance, bone mass and bone strength remain constant. Of course, during the years before puberty, new bone formation dominates.
The rate at which bone tissues renew themselves is in itself pretty astounding. Our long bones, like our leg bones, are dense and their structure provides strength for activities like walking and running. The turnover rate for these long, dense bones is about 10 to 12 years.
Other less dense bone, is constucted as an open meshwork of little struts, looking like the ceiling in a Gothic cathederal. These bones are mostly found at the ends of long bones, in the heel bone, and the spinal or verterbrae bones. The 100 percent turnover rate for these bones are only two to three years.
What is interesting is that progesterone (the female hormone) and testosterone (the male hormone) are equivalent hormones in regard to new formation. They and the corticosteroids (from the adrenal glands--cortisone) compete for the same osteoblast receptor sites on the bones. Testosterone and progesterone stimulate new bone formation and the corticosteroids inhibit it. So if you are under constant stress, constantly producing cortisol--the bones are going to weaken also over a period of time. So you see, this is not just a woman thing.
Among men with prostate cancer, the goal of treatment is to reduce the testosterone levels to as low as possible in the belief that this suppresses prostate cancer growth. The abrupt, almost total absence of testosterone creates a sort of male menopause, often complete with hot flashes. Perhaps, even more important is that the lack of testosterone will bring on an acceleration of osteoporosis within just a year or so.
So, guys I did not leave you out. Another aside is that DHEA is something of an alternative health food fad. While DHEA and DHEA-S are the most abundantly produced steroid hormone in the body, the full spectrum of its actions is not yet completely known. We do know that it is important to the growth and repair of protein tissue. We know that is especially important during preganancy, when the placenta becomes the major source of both estrogen and progesterone. Because the mother is no longer ovulating--the placenta makes estrogen from the mother's adrenal DHEA-S. As the pregnancy proceeds, more DHEA-S is also made by the baby's adrenals. Blood levels of DHEA peak for men and women around the age of 20 and gradually decline with age. About this time of decline, there is a marked increased risk of many degenerative diseases (like heart disease, breast cancer, obesity, diabetes, high blood pressure,etc.) However, what is not clear is whether DHEA plays a true preventative role in this correlation or whether it is merely a marker of increased risk.
There is also a mistaken impression that DHEA is a precursor to all of the adrenal and ovarian hormones when in fact it is a precursor to androstenediol, testosterone, and the estrogens. In real life, DHEA rarely seems to act as an estrogen precursor in women; instead it goes down the androgen or male hormone pathways. Estrogen can be produced by conversion from androstenedione but the conversion rate is only about 1 percent. In healthy postmenopausal women, higher androgen (male) levels (which are created by DHEA supplementation) are also associated with weight gain around the middle and insulin resistance. Because of the insulin resistance effect, DHEA is really contraindicated in people with diabetes.
Current research shows, though that in men, DHEA, which is a direct precursor to testosterone, may be of value in preventing and treating cardiovascular disease, high cholesterol, diabetes, obesity, cancer, Alzheimer's disease, other memory problems, immune system disorders, chronic fatigue, and aging. But it is my experience that one thing along, like DHEA, is not responsible for over-all health. Only a balanced lifestyle, balanced eating habits, emotional, mental, physical and spiritual well-being will bring on health.
Enough said of that. Now let us recap on some of the considerations concerning hypoglycemia.
- Avocados contain a seven-carbon sugar that depresses insulin production, which make them an excellent choice for people who have hypoglycemia.
- The production of insulin is affected by the functioning of the adrenal glands. Epinephrine acts to turn off "insulin production" as one of its functions. If the adrenal glands are over-stressed and exhausted, they can't function properly and an overabundance of insulin might result. This causes the blood sugar level to drop.
- It is estimated that half the people with hypoglycemia who are over fifty have reduced thyroid function and hypothyroidism.
- Caffeine, alcohol, and tobacco cause profound swings in blood sugar levels. Insomnia can result if any type of sugar is consumed after dinner. Consuming sugar at any time tends to cause drowsiness and fatigue. I think that if you look back at some to the posts newyorktwo posted in this medical section, he spells it out very well.
- Some studies have shown that reducing the amount of meat protein in the diet and adding some complex startches may be beneficial.
- Milk allergy is common as this disorder progresses. Allergy testing is recommended.
WHAT ARE SOME OF THE THINGS YOU CAN DO TO HELP YOURSELF
- Remove from the diet all alcohol, canned and packaged foods,refined and processed foods, salt, sugar, saturated fats, soft drinks, and white flour. Also try to avoid any foods that contain artificial colors or preservatives.
- Avoid sweet fruits and juices such as grape and prune. If you drink these, mix the juice with equal amount of water.
- Eat a diet high in fiber and include large amounts of vegetables, especially broccoli, carrots, artichokes,raw spinach, squash, and string beans. Vegetables should be eaten raw or steamed. Also eat beans, brown rice, lentils, soy products (tofu), and fruits, especially apples, apricots, avocados, bananas, cantaloupes, grape-fruits, lemons, and persimmons.
- For protein, eat low-fat cottage cheese, fish, grains, kefir, raw cheese, raw nuts, seeds, skinless white turkey or white chicken breast, and low-fat yogurt.
- Eat starchy foods such as corn, hominy, noodles, pasta, white rice, and yams in moderation only.
- Do not eat fatty foods such as bacon, cold cuts, fried foods, gravies, ham, sausage, or dairy products (except for low-fat soured products.)
- Do not go without food. Eat six ot eight small meals throughout the day. Some people find that eating a small snack before bedtime helps.
- If your doctor determines you have allergies, you may consider using a rotation diet; food allergies are often linked to hypoglycemia and can make the symptoms more pronounced.
- During a low blood sugar reaction, eat something that combines fiber with a protein food, such as bran or rice crackers with raw cheese or almond butter. This will gradually raise your blood sugar, which is your goal.
- Instead of eating applesauce, have a whole apple, which has more fiber. The fiber in the apple will inhibit wide swings in your blood sugar. Fiber alone (found in popcorn, oat bran, rice bran, crackers, ground flaxseed, and psyllium husks) will slow down a hypoglycemic reaction. Take fiber half an hour before meals.
I can just relate an anectodal story, which means it is was never tested scientifically. My husband's mother is an adult-onset diabetic, in the past uncontrolled (by her choice, which I think in medicine we term as non-compliant). When I met Barry, my husband, 13 years ago he had been already been driving trucks for 17 years. At four o'clock in the afternoon he would turn from Dr.Hyde (nice and loving) to Dr. Jekel (irritable and hard to get along with). Blood sugar drop!!! to say the least. Well, we did some of the things mentioned above. Because if he had a drop--he might sleep overnight at the job site--then if things didn't go right with the unloading--it would be hours before he ate--then off to pick up the next load--drive all-day---yada, yada, yada--you all know the drill. It took time (lots of time) but eventually he got used to eating more whole grain foods, carries bananas and apples with him--will carry cottage cheese in his cooler--turkey sandwiches--although one word of caution about turkey. It releases serotin in your brain which brings about a relaxed state--good to eat before you go to bed. Remember you want to combine a fiber with a protein. Also I got him started on vitamins. Again let me say that what we do may not be in the best interest for you, because I don't know what medicines you might be taking or medical condition you have. So check with your doctor first.
But anyway, having said that, the vitamins he takes are B-complex. B-complex in important in carbohydrate and protein metabolism, and proper digestion and absorption of foods; helps the body tolerate foods that produce low blood sugar reactions. Also helps counteract the effects of malabsorption disordres, common in people with hypoglycemia. Zinc--30 mg. daily. You should not exceed a total of 100mg daily from all supplements. Zinc is needed for proper release of insulin. People who have hypoglycemia (and diabetics) are often zinc deficient. Vitamin A and Vitamin E. Vitamin E is a staple in our household. You can use 400IU and up. We use 800 IU of d-Alpha tocopheryl. This is an antioxidant and improves energy and circulation. Helps keep your heart healthy too. Magnesium--800 mg. a day, in divided doses, after meals and at bedtime. Important in carbohydrate (sugar) metabolism and is another heart-healthy drug. Calcium1,500 mg. daily, in divided doses and at bedtime. Works with magnesium and helps build strong bones. Manganese--take separately from calcium. Important also for the maintenance of blood glucose levels. Most people with hypoglycemia have low levels of this trace mineral in their blood. Vitamin C with bioflavonoids--for adrenal insufficiency--common in people with hypoglycemia. Fiber as mentioned before. Then several years ago I read about Chromium picolinate which is vital in glucose metabolism and is essential for optimal insulin activity. And that has been for Barry, a very important addition to his stuff he takes. He was reluctant at first, but it made a big difference in his overall blood sugar drops around 4 p.m. Chromium is the central atom in the "glucose tolerance factor" (GTF). GTF works with insulin to transport glucose from the blood into the body cells, regulating blood sugar levels.
Again, let me emphasize that this regime is not for everyone--just what we do. You don't want to start messing around with something you don't understand because you think you might have such and such a problem. Believe me, driving a big truck and dropping your blood sugar to a dangerously low level will only put yourself and others in danger. Barry sees his doctor faithfully every three months in order to keep on top of his blood sugar to make sure he does not develop adult onset diabetes like his mom. In addition he has lost weight gradually. In the 13 years we have been married, Mary that is as far as we have come in the health department and it has been a battle at times. Now if I could only figure out a way to get him to quit smoking.
In answer to the glucometer. That is an individual thing--We have one at home, but use it only occasionally. We had it here mainly because his mom stayed with us so long (over a year) and I insisted, until she finally got one of her own to take home with her. It depends, I guess how bad your blood sugar problem is. If anyone out there reading this is a diabetic, I would hope your doctor would have encouraged you to get and use one. I guess for hypoglycemia, it would depend on what your endocrinologist wants you to do.
Well, I know I have been long-winded Mary, but I hope this answers some of your questions. I am not an expert by any means. I have learned alot through reading and by talking to the endocrinologists who practice at Saint Joseph's in Atlanta. Sibyl
[This message has been edited by RunningSoLate (edited January 13, 2000).]
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Thanks Sybil for the GREAT information. I can see many of the symptoms you mention in myself. While the Dr. did say I am "clinical" in my readings, I do believe I will start a self help plan.
But you really cut deep when you mention to loose the coffe and nicotine!
The brocolli I can tolerate, but NO Waffle House! Oh my gawd!
It would be my thoughts that even moderating ANY of the above behaviors would be benefical. No?
As an example .. perhaps I can "save" the Waffle House for Saturday mornings .... and I do like the coffee ... but perhaps just in the morning, not all day.
While I am VERY interested in not smoking, it ain't likely to happen. (And I know this). But perhaps a reduction ... that's do-able.
Perhaps as some of these things take place, other changes will be easier.
Monty
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I know what you mean. I once gave up coffee in the last century (isn't it fun we can say that now), but it was too traumatic. Can't live without that. And the cigarettes, well I don't smoke, but Barry does and he is like you--it just ain't going to happen. So, what is a person to do?
But as a truck driver going long hours without food is probably the key--moderating your blood sugar by eating small meals would probably be the best thing--I know it helped Barry alot. Like tonight, Barry had supper here--but ate half of what he normally did--then carried sandwiches, banana to eat when he got to the job-site tonight--because he has an appointment to be unloaded at 7 a.m. After he gets up--he has something to eat while being unloaded--not alot, but something to tide him over till breakfast. This way there isn't that wide swing in blood sugars that makes you feel so bad. SIBYL
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Once more .. thanks .... I'm going to archive this thread .. lot of good information here!
Monty