Different Types of Hypoglycemia – Different Treatment

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Many people don’t realize that there are different types of hypoglycemia, and therefore, very different treatment options. Let’s talk about the more common one first, medication induced hypoglycemia.

Medication Induced Hypoglycemia

For insulin dependent diabetes (Type 1 and Type 2), there is a greater chance of hypoglycemia due to the imperfect science of matching insulin to carbs. The more carbs we eat, the greater doses of insulin are needed. This INCREASES the chances of hypoglycemia. The BEST way to reduce this type of hypoglycemia is to reduce carbs, which will reduce insulin usage, which will lessen the chance of hypoglycemia. (See Dr. Bernstein’s “Law of Small Numbers” HERE). Despite a controlled low carb diet however, some Type 1’s will still experience occasional hypoglycemia. Glucose tablets are the optimal treatment for this type of hypoglycemia, as noted in this link I posted earlier this week. (HERE)

(For Type 2’s that are insulin dependent, adopting a low carb approach and getting vigorously active is the best way to reduce or eliminate insulin usage. I highly recommend insulin dependent Type 2’s to pursue this remedy.  Type 2 is reversible for most people.  Reversing diabetes should be the primary goal for those with Type 2.)

Now let’s talk about a hypoglycemia that has NOTHING to do with medication. This type of hypoglycemia can be experienced by Type 2’s on NO insulin (and no meds that increase insulin.) More often, it is happening to pre-diabetics, people who don’t know they are pre-diabetic, and people who will soon be pre-diabetic or type 2…those on the road to Type 2. It is called “reactive hypoglycemia.”

Reactive Hypoglycemia

Why is it called “reactive.” Because our body is typically reacting to a stimulus…something we typically have done. Here’s how it goes. Most of you that follow this page already understand that Type 2 diabetes is a condition of too much insulin for many years, even decades leading up to a diagnosis. The most common factor that causes the high insulin levels is poor diet (too many processed and refined sugar and carbohydrates) and poor lifestyle habits (lack of sleep, sedentary, uncontrolled stress, medications, etc). We call high insulin levels hyperinsulinemia (literal translation:  hyper = too much / insulin / EEMIA=because we have to make it sound complicated…😜)

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When a person with hyperinsulinemia eats a meal loaded with carbohydrates, the body will try to match this carbohydrate load with insulin. But remember, the body was never designed to make these huge doses of insulin, and often, the body overshoots the target, making too much insulin. This causes blood sugar to fall rapidly after a meal. A person can start to feel symptoms of hypoglycemia even when their blood sugar is still high due to the rapid rate that the blood sugar is dropping. Eventually, the blood sugar really will go low, lower than it was before the meal. Most people at this point are craving more carbs to bring the blood sugar back up again.

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This is a vicious cycle that can only be stopped with a healthy diet low in carbohydrates. The source of carbohydrates is also important. The carbs that one DOES consume on a low carb diet should NOT be sugar or refined carbs, but rather, carbs derived from real, whole, unprocessed foods (non-starchy vegetables, etc)

As an adult with first signs of pre-diabetes at 40, I can say that I can remember bouts of (reactive) hypoglycemia in my late teens. I didn’t know what it meant but I knew that if I drank juice, it went away…for a while…I wish I would have known the path I was on and what to do about it.

So for ALL types of hypoglycemia, the best treatment is a low carb, whole food diet. Getting active is also a great tool, as it improves insulin sensitivity. For those that inject insulin, that means you will need less. For those that make all of their own insulin, it means the body will need to make less.

Finally, if you take insulin (or medications that increase insulin), and have frequent hypoglycemia even with your healthy lifestyle, it’s time for a chat with your healthcare provider to discuss reductions in medication.

Be safe and be well 😉

(This article does not discuss other disorders of hyperinsulinism.)

Difference Between Type 1 and Type 2

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Type 1
  • Autoimmune destruction of the insulin producing cells (beta cells) of the pancreas.
  • Diagnosed more often in childhood or early adulthood, but can be diagnosed at any age.
  • Due to inability to produce insulin, injections of insulin must be administered daily.
  • Best treatment: a healthy, low carb whole food way of eating, plus exercise and insulin.
  • There is no cure, YET, for Type 1 diabetes, and no way to prevent it that we know of.
  • When we talk about needing to find a “cure” for diabetes, this is the Type of diabetes we are speaking of.
Type 2
  • A condition of insulin resistance. Is related to family history and, significantly, to lifestyle factors.
  • The body often makes adequate insulin but the insulin is not able to be used properly (due to insulin resistance), causing yet more insulin production and more insulin resistance.
  • Can lead to an insulin deficiency over time, especially if not treated early and appropriately.
  • Diagnosed most often in adulthood, but is increasing in the childhood population.
  • Best treatment: a healthy, low carb whole food way of eating, plus exercise. These should be pursued early and aggressively, preferably in the “pre-diabetes” stage. Medication may need to be added if these measures are not effective enough.
  • There is no cure for Type 2 diabetes.  In other words, you cannot completely regain lost beta cell function.  However, with aggressive lifestyle management, many can reverse the process of Type 2 so that they are able to live within their bodies ability to produce enough insulin for their healthy lifestyle. Many are able to eliminate some or all medications.  (Some consider this being “cured.” 👍 So if someone says their diabetes has been “cured,” this is the diabetes they are talking about.  I prefer the term “reverse.”)
  • The best “cure” for Type 2 diabetes is PREVENTION.  Type 2 is most often highly preventable, even if one has a strong family history.

People do not progress from Type 1 to Type 2 or vice versa.  These are two completely separate diseases with completely different etiologies.  (However, Type 1’s can develop insulin resistance IN ADDITION to their autoimmune diabetes.  LADA is a slower onset autoimmune diabetes and is sometimes called Type “1 1/2”.  Although slower in onset, once reaching the point where insulin is needed, those with LADA are treated as, and considered, a Type 1.)

The Top Worst Dietary Advice

Here is a great article about some of the worst dietary advice ever HERE

Among these five pieces of bad advice is another piece of dietary advice that I have to “undo” in almost every one of my diabetic patients, and that is “eat 6 small meals a day” or “eat every 2 hours.” UGH!!!! This is the worst advice ever! Here is WHY the advice was given to those with diabetes…

When the nutrition industry starting telling those with diabetes to eat less fat and tons of carbs, they were crashing all of the time. Carbs produce rapid fluctuations in blood glucose, ESPECIALLY in the absence of adequate fat and protein.  Carbs don’t provide long term satiation. Therefore, diabetics were told to eat frequently to “keep their blood sugar up.” We don’t want our “blood sugar UP”, we want it normal and stable.

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When we eat, blood glucose and insulin levels raise.  This triggers our body to stop burning stored fat and start addressing the incoming load.  At mealtimes, our bodies burn what they need for fuel at the time, and store the rest of the energy for future use.   In between meals, our blood glucose and insulin levels are SUPPOSED to return to normal, allowing us to burn stored energy. If we eat frequently, or snack often, we NEVER normalize blood glucose and insulin levels, and we NEVER burn stored fat, hence higher glucose/insulin levels, hence more insulin resistance, hence weight gain, hence worsening diabetes.

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Having plenty of blood-sugar-stabilizing-healthy-fat and adequate protein in the diet allows us to eat less often, allows blood glucose and insulin levels to return to normal and burn stored fat in between meals, hence lower glucose/insulin levels, hence lowering insulin resistance, hence weight loss, hence diabetes (type 2) reversal is possible. (This benefits type 1’s also.)

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The ideal eating pattern is one that keeps blood glucose and insulin levels normal and stable, and then has adequate periods to allow for burning of stored energy.  This means slow acting carbohydrates (such as non-starchy vegetables) with adequate protein and ample healthy fats at mealtimes, preferably no less than 4-5 hours apart, 2 or 3 times a day without snacking.  If you find a snack absolutely necessary, reach for a boiled egg, some raw veggies, a handful of nuts and/or olives, or a few chunks of cheese.  Focus on food that will not significantly raise blood glucose between meals.

Wishing you great health and blood glucose control 😉

 

Do Medications Heal Chronic Disease?

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In the early 20th century, an amazing, a life saving class of medications first came to be used, anti-biotics. Since then, antibiotics have saved millions of lives. However, sometime between this amazing discovery and today, less than 100 years later, we, as a society have come to believe that medications are a cure all. Don’t get me wrong, medications in an acute setting, or for an acute problem, like an infection, ARE life saving. But what about chronic disease? Particularly, what about diseases that are lifestyle related or even lifestyle induced? Why are we taking a lifestyle problem and addressing it with a medical answer? Doing so is like putting a band-aid on a bleeding head wound. The first rule of treating a bleeding patient is to find the source of the bleed, and stop it, not to cover it with a bandage. The bandage would only mask the problem, and it would continue to worsen. Why are we not diving into the roots of chronic diseases and trying to treat the underlying causes? We have GOT to stop seeking a pill for every ailment and look deeper, if we really want good health.

Let’s take the biggest health epidemic plaguing our society, metabolic syndrome. Metabolic syndrome is a cluster of diseases/conditions which center around high blood pressure, cholesterol problems, insulin resistance/pre-diabetes/type 2 diabetes and obesity. If we tackle this syndrome with medications, we will take one, two or even three medications to treat each component of this condition. But the reason these diseases have been clustered together, is because they have a common cause. If we treat the cause, we need only treat it with ONE approach…healthy lifestyle. Medications do NOT reverse chronic lifestyle-induced illness. In fact, most of these medications CREATE other conditions that then need to be treated.

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Medications should be used as aids to assist us while we are using lifestyle modification to heal from chronic disease. Depending on how long we have had a particular health condition, and how much damage it has done, we may not be able to stop all medications used to treat chronic disease. But if we are using medication ONLY, with no change to lifestyle, and we think that medications will make us well, we are very much mistaken. Deep down, I think we all know this. We know it because all of these medications make us feel terrible!

To return to my previous analogy, let’s stop ignoring the bleeding. Let’s stitch the wound, and let’s use a smaller bandage to catch any remaining bleeding until we are healed. Then rip off the bandage and throw it in the garbage when it is finished doing its job.