From: pburch@roc.mbcr.bcm.tmc.edu (Paula Burch)
Newsgroups: sci.med
Subject: Re: References on hypoglycemia
Date: 21 Aug 92 19:24:42 GMT
Reply-To: pburch@bcm.tmc.edu (Paula Burch)
Originator: pburch@roc.mbcr.bcm.tmc.edu


Hypoglycemia is one of those disorders where the patients know they have 
a problem, but many within the medical establishment scoff at the syndrome 
that is claimed to be responsible, and not without reason. Many people 
were diagnosed as having hypoglycemia when that diagnosis was `fashionable,'
and yet the current medical consensus is that hypoglycemia as an illness 
is rare.

I was diagnosed as a teenager as having hypoglycemia, based on the fact 
that my blood glucose fell to 42 mg/dl two hours after taking 100 g of 
glucose on an empty stomach. My blood sugar typically tended to vary 
widely, and when it was low I felt terrible and behaved disagreeably.
Sometimes I fainted, which alarmed others.

My doctor put me on the Harris diet, which was low in sugar and starch, 
and I felt even worse when I followed it. I craved sugar and had little 
ability to resist eating it. When I did eat sugar, my blood sugar would 
first increase and then rapidly decrease to the point where I felt 
miserable. I appeared to have a significant, chronic health problem.

Eventually I discovered by trial and error that I NEED to eat starch 
(preferably in reasonably nutritious, whole-grain forms, but that's 
probably beside the point).

As long as I eat when I feel I need to (no skipped meals, and sometimes a 
snack) and eat both protein and starch with every meal, I'm as normal as 
anybody (well, my blood sugar is, anyway). I can even eat candy bars 
without any ill effects. Following the low-carbohydrate diet that was 
the treatment for hypoglycemia is enough to destroy my ability to deal 
with sugar in a normal way. Eating a whole lot of sugar isn't good for 
me, but as I don't want to do so, this isn't a problem. 

These days my blood sugar generally hovers around 90 mg/dl after the same 
glucose challenge mentioned above.

Is the hypoglycemia I suffered real? It certainly seemed to be, and 
learning how to take care of it improved the quality of my life immensely. Furthermore, even now, if I skip a meal, I feel terrible later, although
I know some people can do this without experiencing anything worse than 
hunger. 

Was it a disease? I don't think so. I think it's a normal metabolic 
variation. So the medical establishment's common attitude about 
hypoglycemia is correct, in my opinion. 

Dr. Atkin's Diet, which Chuck Forsberg mentioned, would be a disaster 
for my blood sugar control.

Judging from my family, in which there have been a lot of Type II 
diabetics and everyone else has similar low-blood-sugar problems, I 
think that there's a close connection between the two. I suspect that 
hypoglycemia is an early manifestation of the (or a) Type II diabetes 
gene, and that I have a fairly high risk of developing diabetes in my 
later years if I don't stay in shape and stick to a low-fat diet. Just 
speculation, of course. 

References? You wanted references? Here's one:

AU McFarland-K-F.  Baker-C.  Ferguson-S-D.
TI Demystifying hypoglycemia.  When is it real and how can you tell?
SO Postgrad-Med.  1987 Nov 1.  82(6).  P 54-5, 59-60, 63-5.
AB Contrary to popular belief, hypoglycemia is an infrequently
   encountered condition and its presence is questionable until
   confirmed by appropriate tests.  In ambulatory patients, blood
   glucose levels obtained during intake of a normal diet are more
   reliable than those obtained during a glucose tolerance test.  If the
   blood glucose is actually abnormally low and the other two criteria
   of *hypoglycemia* are also satisfied, a search for the cause is in
   order.  In hospitalized patients, excessive doses of insulin or oral
   hypoglycemic agents, the effect of drugs, or chronic renal failure
   are the most common causes of hypoglycemia.  If these factors are
   absent, another chronic illness known to cause hypoglycemia may be
   the source.  If the cause is still obscure, a thorough evaluation of
   the endocrine status is warranted.  Author-abstract.

Paula Burch 
pburch@bcm.tmc.edu