Can frequent periods of low blood sugar be a precursor to diabetes?
June 19, 2008 10:12 AM   Subscribe

Can frequent periods of low blood sugar be a precursor to diabetes? I know that diabetes is actually high blood sugar.

I am obese with polycystic ovarian syndrome (which people say predisposes one to diabetes) and a family history of diabetes. If I don't eat for a certain amount of time (sometimes as little as 4 hours if I don't have a big meal), my blood sugar will drop... I get irritable, shaky, and nauseated. Eating solves the problem but since it takes about 20 minutes for the sugar in the food to hit my bloodstream, for those 20 minutes I feel like eating everything in sight. (This doesn't happen that often - I'm not a binge eater.)

It doesn't make sense to me that I am prone to diabetes but I experience the opposite so easily. My fasting blood sugar is always in the normal range, and when I had it tested last year, my cholesterol was actually slightly low. I've never had a glucose tolerance test and I currently don't have health insurance, so I'm nervous about being diagnosed with something that will prevent me from getting insurance later on.

I did read this thread but it doesn't indicate if hypoglycemia could be a precursor to diabetes.

Also, after reading in a previous thread about Emetrol, I'd like to try it for the nausea I experience when I have a migraine. Given that the ingredients are Dextrose and Fructose (Levulose) and the warning says "This product contains sugar and should not be taken by diabetics except under the advice and supervision of a physician," would it be harmful for me to take it since I am only predisposed to diabetes? Would it be okay to take it when I am feeling a low blood sugar attack along with eating food as soon as possible?

I know YANMD.
posted by anonymous to Health & Fitness (13 answers total) 2 users marked this as a favorite
Indeed IANAD, but my mother used to get similar hypoglycemic symptoms (shaking and nausea, and she'd need a really sugary drink or snack to get her back to normal), and she was recently diagnosed with adult onset diabetes. She's also overweight, which they said was a major precursor. So I can't tell you if YOU are on this path, but my mom certainly followed it.
posted by olinerd at 10:21 AM on June 19, 2008

I think the current scientific consensus is that there is no consensus. I was always told that it was a possible precursor, but I think the current thinking is less clear.
posted by caddis at 11:06 AM on June 19, 2008

I imagine if you have the insulin resistance associated with pre-diabetes then even if you maintain a normal levels of blood sugar it will feel like low blood sugar. This is just speculation, but it makes sense to me.
posted by robofunk at 11:20 AM on June 19, 2008

If I don't eat for a certain amount of time (sometimes as little as 4 hours if I don't have a big meal), my blood sugar will drop... I get irritable, shaky, and nauseated.

I weigh 100 lbs and I get this and so do many women in my family and some friends. My mother and I have had many tests and none of us have any indicators of diabetes. Some people are just more sensitive than others.

It's worse for me if I eat carbs. When presented with the choice of a bagel or not eating breakfast at all, I chose the latter, because carbs like that spike your blood sugar and if you aren't eating something else, it can crash. High glycemic index= bad. I rarely have these problems now that I have ditched soda and its ilk. If I'm going to eat something like cake, I know I need a chaser first of high quality protein or fat to buffer the sugar effect.

more info about carbs and their effect

You might not have diabetes yet, but you are obviously sensitive, which could mean a predisposition.

I would try something else for the nausea like ginger.
posted by melissam at 11:47 AM on June 19, 2008 [2 favorites]

Are you being treated by a doctor for the PCOS? I have a friend with this, and she has to carefully monitor her diet for carbs and is also taking Glucophage to combat the insulin-resistance.
posted by chiababe at 11:53 AM on June 19, 2008

I have similar symptoms; my fasting blood sugar was low enough to be tagged with an L in the lab report, but the doc told me that wasn't unusual for a young woman and that I was just hypersensitive my blood sugar level, so I'm not officially hypoglycemic. My mother had the same symptoms at my age and is now diabetic. I consider myself at risk for diabetes -- however, within my family, only (and all of) the significantly overweight people have become diabetic. So for me it's an extra incentive to watch my weight.

Eating whole grains instead of white bread/rice/pasta really does keep my blood sugar stable for longer, as does only eating desserts in moderate portions and after healthy meals. Basically, with either diabetes or hypoglycemia your body isn't great at regulating its blood sugar, which is why they are related -- you want to avoid eating patterns that will cause spikes. Regular exercise (cardio and resistance/weight training) also helps, possibly because it conditions your body to be able to use fat as an energy source, or possibly for more general reasons. I feel best when exercising about two hours after a healthy meal -- a blood sugar "crash" is definitely worse in the middle of cardio.
posted by ecsh at 12:10 PM on June 19, 2008 [1 favorite]

I just did a PubMed search and I would have to say it is unknown whether symptomatic hypoglycemia warns of the future development of diabetes. In my practice, it has been reported by patients and so I've assumed that it *can* happen. And it makes intuitive sense: Type II Diabetes is basically characterized by a sluggish hormonal response to a glucose load, it makes sense that the counter regulatory hormone response that prevents blood sugar from diving too low would also be sluggish. In fact, this *has* been shown to occur later on in the course of type II diabetes -- these people are at greater risk for hypoglycemia and not just because of the medicines they may be on, but also because the glucagon secretion by those pancreatic cells in the pancreas becomes just as impaired as the insulin secretion.

I wonder though, if it has something to do with what you are eating. I mean foods with a high glycemic index generate a higher blood sugar and presumably a more robust insulin response and perhaps a greater risk of post prandial hypoglycemia. And obviously, high glycemic foods are what seem to cause diabetes. So maybe those low blood sugar spells *do* spell a future of diabetes. On preview, ecsh said it better.

From the ingredients, Emetrol has 3.5 grams of sugar per dose. I'd say go for it.
posted by Slarty Bartfast at 1:12 PM on June 19, 2008

I have this and my MD says there's no danger of diabetes.

Like melissam, eating white flour and white sugar are worse than eating nothing. When I crash a sugary snack will lift it- for about 15 minutes. And then I'm worse off than ever.

Here's what works for me:

Tiny amount of sugar. Fruit juice or honey is slightly better.
Followed by: whole grain something.
Followed by real meal that had better include a huge whack of protein.

When I can tell I'm getting close a banana and a handful of almonds does wonders. I keep them both on hand.
posted by small_ruminant at 1:38 PM on June 19, 2008

Oops. On non-preview, esch said it better.
posted by small_ruminant at 1:40 PM on June 19, 2008

I am a diabetic. (IAAD?)

For many diabetics, the problem isn't so much insulin-resistance, but the inability to regulate blood-sugar levels at all. It's just as easy to have a sugar crash for me as it is a sugar spike.

The first actual signs for me for a diagnosis of diabetes was severely low blood sugar - hypoglycemia. It can be a scary experience, and it ruins me for a couple of hours when it happens (always at the most inopportune moments)... picture Julia Roberts in "Steel Magnolias" - drink your juice Shelby! In those kinds of emergency situations, don't worry about what sugar you eat, just GET SOME IN YOU. Juice works best for me... but a doctor would probably frown on that. My dad - also a diabetic - keeps hard candy on hand.

A dietitian can point you in the right direction as to what you should be eating to maintain the proper blood sugar levels... and will probably tell you what you already know - watch the sugar and the carbs, processed flour and anything with a glycemic index.

So yeah, my vote would be to say that you are indeed pre-diabetic. You say you're obese. I'm willing to bet that your predisposition to diabetes will conveniently disappear if you get the weight down.
posted by matty at 5:04 PM on June 19, 2008 [1 favorite]

with a *high glycemic index. Oops.
posted by matty at 5:14 PM on June 19, 2008

PCOS can cause you to be very sensitive to blood sugar weirdness, whether or not diabetes follows. I've found that, for me, eating a lot of protein helps smooth out the terrible crashes. When I get crazy hungry, I eat some chicken or lunch meat or a protein bar. Your body is telling you SUGAR SUGAR SUGAR because it will get some instant relief, but if you can eat something a bit more substantial you'll feel better. The trick is to plan ahead, and to not go too long without eating. Keep snacks around.

Also, PCOS can cause migraines. I don't know if you're on hormonal birth control, but if you can get on it continuously (without the placebo week) then the headaches might stop.

BTW, matty, willing to bet doesn't meant a diagnosis. PCOS goes hand in hand with insulin resistance, and even thin people have symptoms of both. Your vote doesn't mean anything without the OP getting actual blood sugar numbers, so please don't scare her.
posted by sugarfish at 9:00 PM on June 19, 2008

Oh, and feel free to email me if you need to talk about PCOS. I've learned a lot about it in the last few years.
posted by sugarfish at 9:01 PM on June 19, 2008

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