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New
approaches to hypoglycemia
July 20, 2006
Suzanne Havala Hobbs
Have
you ever felt like someone washed the starch out of you?
It’s how some people feel when their blood sugar level
dips too low. People who have had low blood sugar, or hypoglycemia,
for years may not realize the approach to treating it has
changed over time.
What is hypoglycemia?
It’s a condition caused when your body’s blood
sugar, or glucose, level is too low to meet your body’s
energy needs.
Here’s how it works:
When you eat a meal, food is digested and broken down into
smaller components that can be absorbed and used by your body.
Carbohydrates from breads, cereals, fruit, beans, vegetables
and milk break down into sugars, including glucose, the body’s
preferred source of energy.
Glucose is absorbed directly into the bloodstream. There,
insulin produced by your pancreas helps move sugar out of
the bloodstream and into your body’s cells, where it
can be burned as fuel.
But that process can sometimes go awry. Other symptoms of
hypoglycemia include hunger, lightheadedness, weakness, tremors,
changes in vision, perspiration and confusion.
Hypoglycemia is usually associated with diabetes. Diabetes
is a disease that causes high blood sugar, but medications
and other factors can cause diabetic blood sugar levels to
swing the other direction, too. Diabetics – especially
those taking insulin injections – need to be closely
followed by their health care providers who can advise them
about how to handle varying blood sugar levels.
But non-diabetics can experience hypoglycemia, too.
One form in non-diabetics occurs when blood sugar levels drop
to very low levels overnight, between meals or after exercise.
Fasting hypoglycemia can be caused by alcohol, certain medications
or other health problems.
Another type, reactive hypoglycemia, occurs within four hours
after eating, when blood glucose levels fall below 70 milligrams
per deciliter. The person has symptoms, but the symptoms are
relieved after eating or drinking something with calories.
The cause of reactive hypoglycemia is unclear.
Years ago, people were given an oral glucose tolerance test
to diagnose reactive hypoglycemia. The test is no longer considered
a reliable indicator. Instead, your doctor may now go by a
description of your symptoms and a blood sugar check while
you are experiencing symptoms. The diagnosis is confirmed
if eating brings relief, according to the National Institute
of Diabetes and Digestive and Kidney Diseases.
If you had reactive hypoglycemia 30 years ago, the dietary
advice was to eat three meals and three snacks each day. The
typical snack: peanut butter and crackers, cheese and crackers,
or hard-boiled eggs. Cholesterol? Nobody worried about it.
The emphasis then was on protein, the idea being that meals
high in protein would slow the release of sugar into the bloodstream
and help control your blood sugar level. Research does not
bear this idea out, however.
Skip the eggs and cheese. If you have reactive hypoglycemia,
consider these tips:
* Eat frequently. Old advice about eating a small meal or
snack every three hours still holds. Whatever you eat should
be in the context of a health-supporting diet, though. The
saturated fat and cholesterol in eggs and cheese don’t
fit.
* Eat a variety of foods. Fortunately, dietary advice for
controlling hypoglycemia conforms to general recommendations
for healthy eating: plenty of whole grains, beans, fruits,
vegetables, low fat or nonmeat sources of protein, and nonfat
dairy products.
* Limit sweets. If you eat sweets, eat them with a meal, rather
than between meals. Drink calorie-free beverages instead of
regular soft drinks and sweet tea.
* Get your fiber. Fiber-rich whole grains, beans, and fresh
fruits and vegetables contain soluble fiber that helps minimize
fluctuations in blood sugar.
* Exercise. It supports overall good health and helps control
blood sugar.
If you are having, or think you might be having, problems
with hypoglycemia, see your health care provider for individual
advice.
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