So we’ve all dealt with the symptoms, shaky, lethargic, confused, sweaty and the list goes on and on but what happens when we don’t realize or notice these symptoms? People who don’t have diabetes start to feel hypoglycemic when their blood glucose reaches 50- 55 mg/dl. In people who have diabetes, hypoglycemia can’t really be defined as a specific blood glucose level, because the point at which they feel “low” changes, depending on their usual BG level.
So, individuals who are not properly controlled can “feel low” at normal or high BG levels, and individuals whose blood glucose runs consistently in the low-normal range and have frequent hypoglycemia may not “feel low” until their BG falls to a dangerously low level. This has happened to me once and it was not fun. So lets take a look at what hypoglycemia unawareness is and what we can do prevent it!
Hypoglycemia Unawareness Causes:
Hypoglycemia unawareness is actually quite common. Studies show that 17 percent of those with Type 1 diabetes suffer from some sort of hypoglycemia unawareness. Symptoms of a low blood sugar become less obvious after having diabetes for several years because repeated lows tend to impair the body’s release of stress hormones. As we are probably aware at this point, or maybe not if your newly diagnosed, the major counter-regulatory hormone that causes glucose to be released by the liver to raise the blood sugar is glucagon, but is reduced in most people who have Type 1 diabetes within the first two to ten years after diagnosis.
Drinking alcohol increases the risk of an unacknowledged low because the mind becomes less capable of recognizing what’s happening, the liver is blocked from creating glucose needed to raise the blood sugar, and free fatty acid (the backup to glucose for fuel) release is also blocked. These factors make symptoms milder and harder to recognize and personally after a couple trips to the ER due to severe low blood sugars…lets just say I’m not a fan of alcohol any longer.
Over the past couple of days, we’ve been discussing several diabetes related topics but what about one of the most important ones, especially when it comes to keeping us type 1 diabetics alive. No I’m not talking about okra, some exotic fruit, cinnamon, or essential oil I’m talking about insulin!
For those of you who make these claims (especially about okra and cinnamon) in regards to treating or as many of you like to say “cure” type 1 diabetes, you really need to stop. Over the past year I’ve been getting bombarded with sales pitches and I’m honestly tired of it. Cinnamon is a great antioxidant and comes with some fantastic health benefits but when it comes to type 1 diabetes, don’t you think if it was that easy, it would be mainstream information and the millions of us that battle with this disease day in and day out would avoid the BS that we deal with daily?
Or perhaps the miracle lies within the specially formulated product you are trying to sell me? Its utterly ridiculous, and the fact that you know nothing about the disease itself or how it works, you need to take a step back and take your products with you.
I mean, you realize that you produce insulin naturally, its a normal human bodily function. What makes you think that okra, cinnamon, or your essential oil is going to magically wake up my dead beta cells (these are the cells that actually produce insulin, feel free to google, its a fascinating read). Perhaps your cinnamon, shake or oil defies all science and type 1 diabetes research?
Or perhaps you have magic okra that you purchased from the same person who sold Jack his beanstalk beans? Perhaps the laws of physics cease to exist in your potent concoction? Either way you need to stop before you seriously put someone in a very bad predicament.
Now I can only talk about type 1 diabetes as this is what I eat, breath and live with daily. With type 1 diabetes, the body’s immune system attacks part of its own pancreas. Scientists are not sure why, but the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is known as autoimmune disease.
Insulin is vital for survival because without it, simply put, life would cease to exist (including yours). So what is insulin and why is it so important for type 1 diabetics, lets take a look!
What Is Insulin?
So the most basic question, what is insulin? When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin (zero in the case of type 1, unless your in your honeymoon phase) or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems.
All people who have type 1 and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal is to keep your blood sugar level in a normal range as much as possible so you’ll stay healthy. Insulin can’t be taken by mouth. It is usually taken with injections (shots). It can also be taken with an pre filled syringe or an insulin pump.
Types Of Insulin:
Manufactured insulin comes in several types that differ in the way in which they act inside the body. Each type differs in three ways:
- Onset: The length of time after injection that the insulin begins to work
- Peak: the length of time after injection that the insulin takes to reach its maximum effectiveness
- Duration: the length of time in which it remains effective
The four basic types and their respective onset, peak and duration are as follows:
- Rapid Acting: begins to work after 15 minutes, peaks in 30 to 90 minutes, and has a duration of three to four hours.
- Short Acting: begins to work in 30 to 60 minutes, peaks in two to three hours, and has a duration of three to six hours.
- Intermediate Acting: begins to work in 90 minutes to six hours, peaks in four to 14 hours, and has a duration of up to 24 hours.
- Long Acting: begins to work in six to 14 hours and remains effective for 24 to 36 hours.
As diabetics, we are all well aware of fast acting insulin and the vital role it plays when it comes to keeping us alive and upright, but for those newly diagnosed diabetics (type 1 and type 2), Insulin is secreted by the beta cells in the islets of Langerhans in the pancreas, a small organ between the stomach and liver. This hormone regulates the sugar levels in the human body. When the pancreas stops secreting insulin, it results in hyperglycemia which is a common and lethal symptom of diabetes.
There are several rapid acting insulin brands, and as a type 1 diabetic, I am extremely reliant upon fast acting insulin, Novolog in particular. When discussing a topic over on The Organic Diabetic Facebook page, we got onto the subject of all the negative side effects associated with insulin and blood sugar regulation. So for all you newly diagnosed type 1’s, lets take a peek at some of the most dangerous side effects associated with fast acting insulin. Also, what drives the cost of insulin and are there programs to help defer the costs? Lets take a closer look!
Diabetes And Insulin:
Less common, but potentially more serious, is generalized allergy to fast acting insulin, which may cause rash (including pruritus) over the whole body, shortness of breath, wheezing, reduction in blood pressure, rapid pulse, or sweating. Severe cases of generalized allergy, including anaphylactic reaction, may be life threatening. Localized reactions and generalized myalgias have been reported with the use of cresol as an injectable excipient (preservative to keep insulin potent).
Fast Acting And Hyperglycemia:
Hyperglycemia, diabetic ketoacidosis, or diabetic coma may develop if the patient takes less fast acting insulin than needed to control blood glucose levels. This could be due to insulin demand during illness or infection, neglect of diet, omission or improper administration of prescribed fast acting insulin doses. A developing ketoacidosis will be revealed by urine tests which show large amounts of sugar and acetone. The symptoms of polydipsia, polyurea, loss of appetite, fatigue, dry skin and deep and rapid breathing come on gradually, usually over a period of some hours or days. Severe sustained hyperglycemia may result in diabetic coma or death.
Fast Acting Insulin And Lipodystrophy
Long-term use of fast acting insulin, can cause lipodystrophy at the site of repeated insulin injections or infusion. Lipodystrophy includes lipohypertrophy (thickening of adipose tissue) and lipoatrophy (thinning of adipose tissue), and may affect insulin absorption. Its extremely important to rotate insulin injection or infusion sites within the same region to reduce the risk of lipodystrophy.
Gastroparesis (also called delayed gastric emptying) is a progressive disorder that causes food to remain in the stomach for longer than normal periods. Because the nerves that move food through the digestive tract are damaged, the muscles do not work as they normally would. As a result, food often sits in the stomach undigested. So what are the signs and symptoms of gastroparesis? Lets take a closer look!
Symptoms Of Gastroparesis:
The following are the most common symptoms associated with gastroparesis:
- vomiting of undigested food
- early fullness after a small meal
- weight loss
- stomach spasms
- blood glucose levels that are hard to stabilize
- loss of appetite
- acid reflux
What Causes Gastroparesis:
While a high percentage of gastroparesis has been reported in people with type 1 diabetes (40%) and type 2 diabetes (10% to 20%), per the Mayo Clinic, it’s not always clear what leads to gastroparesis. In many cases, gastroparesis is believed to be caused by damage to a nerve that controls the stomach muscles (vagus nerve).
The vagus nerve helps manage the complex processes in your digestive tract, including signaling the muscles in your stomach to contract and push food into the small intestine. A damaged vagus nerve can’t send signals normally to your stomach muscles. This may cause food to remain in your stomach longer, rather than move normally into your small intestine to be digested.
The vagus nerve can be damaged by certain diseases (Parkinson’s and MS for example), and diabetes in particular, or by surgery to the stomach or small intestine. As for diabetics, the fact that we deal with higher than normal blood sugars, over time these high blood glucose levels can damage the vagus nerve.
Its should also be noted that for reasons that gastroparesis is more commonly found in women than in men. Researchers believe that this is possibly due to the effect of hormones on the GI tract, particularly estrogen and progesterone, and those seem to delay stomach emptying, but more research is still needed. You can check out the study here.
So check this out, your body has the amazing ability to take the foods you eat and literally turn them into you. Pretty cool don’t you think! Whether you eat an apple, a steak or a kale salad, your body is able to break that food down into its chemical parts and reassemble those parts into your cells and the energy you use all day. This is flat out awesome considering outside the plant and animal kingdom, nothing else that can do that!
Here is the deal though, your body is only as amazing as the material it has to work with, like a fine tuned machine, the quality of the food you put into your amazing body has a huge impact on your overall health. An apple is not just an apple, nor is a steak just a steak. As stated above, your body is able to break those foods down into their chemical parts, like macronutrients and micronutrients. So what makes these nutrients so important, lets take a closer look!
What Are Macronutrients:
Macronutrients are nutrients that provide calories or energy. Derived from the prefix makro (Greek), which means big or large, used because macronutrients are required in large amounts. There are three broad classes of macro-nutrients which make up your primary food sources know as proteins,carbohydrates and fats.
The main function of macronutrients is to provide energy, counted as calories. While each of the macronutrients provides calories, the amount provided by each varies. Carbohydrates provides four calories per gram (I think we are all pretty well versed here),proteins;also four, while fats provides nine calories per gram.
Macronutrients also have specific roles in maintaining the body and contribute to the taste, texture and appearance of foods, which helps to make the diet more varied and enjoyable.
Macronutrients broken down:
- Carbohydrates – are required for energy. As diabetics we all have varying opinions on carbohydrates and the amounts that we like to ingest , but glucose, which is a monosaccharide, is the most essential source of energy in the body. The brain works entirely on glucose alone. When an immediate source of energy is required, glucose is converted into glycogen which is stored in the liver. When energy is needed it is converted into glucose again and used to release energy. Carbohydrates provide 17 kilojoules of energy per gram.
- Fats – have the highest caloric content. This means they provide the largest amount of energy when burnt. When measured by a calorimeter, fats provide about 37 kilojoules per gram, making them twice as energy-rich than protein and carbohydrates. Extra fat is stored in adipose tissue and is burnt when the body has run out of carbohydrates. Fat is also needed to take up fat-soluble vitamins.
- Proteins– are the third and last source of energy. They are the last to be used of all macronutrients. In cases of extreme starvation, the muscles in the body, that are made up of proteins, are used to provide energy. This is called muscle wasting. Proteins also provide 17 kilojoules per gram.
Hypoglycemia is the clinical syndrome that results from low blood sugar. The symptoms of hypoglycemia can vary from person to person, as can the severity as I’ve personally dealt with in the past when my severe low was accompanied with a seizure.
This was the first time this as ever happened to me since being diagnosed as a type 1 diabetic over 10 years ago now. While I don’t remember the seizure itself, lets just say we made it a memorable experience for the community as it happened at my sons fall soccer tournament. So what is a hypoglycemic seizure and what are the warning signs of having a seizure? Lets take a closer look!
What Is A Hypoglycemic Seizure:
So what causes a seizure? A hypoglycemic seizure may be triggered by injecting too much insulin, or failing to eat soon enough after using a fast acting insulin (exactly what happened to me); excessive use of alcohol, skipping meals,or exercising vigorously without adjusting insulin dosages or eating properly.
A seizure may also be triggered by oral diabetes medications that cause the pancreas to produce more insulin. Whatever the cause of the seizure, it needs to be treated as a medical emergency. To identify the onset of ahypoglycemic seizure,look for the following warning signs of seizures and symptoms:
- Feeling faint or too sleepy
- Feeling cold or clammy
- Unexplained emotional behaviors
- Uncontrollable crying
- Unaware of surroundings
- Changes in vision
- Loss of ability to speak clearly
- Loss of muscle control
- Muscle weakness
So after have a couple of amazing conversations over on the Facebook page, a lovely young lady asked me if injecting insulin was the reason why she was gaining weight after her type 1 diagnosis. While I’ve heard this several times, is it the insulin that is causing the weight gain, or could it be something else? Perhaps a hormone that as type 1 diabetics we also stop producing since our beta cells have died off.
Have you ever heard of Amylin? Could the lack of this hormone be the reason why she is seeing an increase in her weight? What is amylin anyway, and is it something we should be concerned with if we are no longer producing it?
These are all great questions and honestly this was news to me as well as I’ve never heard of it. So lets take a closer look at what this little hormone does and if it has a direct impact on our overall health as type 1 diabetics!
Function Of Amylin?
So what is amylin or as its also called pramlintide and how can it help us? Amylin is a peptide hormone (insulins partner in crime) which is released by the beta cells in response to ingesting food. This hormone, is also released at the same time as insulin, but in different quantities and its primary function is to help aid in the digestive process by helping to control the rate of digestion.
The complete range of functions of amylin is still not fully known, but its main function has been determined to be to help to slow the speed at which food is digested and glucose is released into the bloodstream after a meal. Essentially, amylin keeps too much glucose from appearing in the blood in the first place.
Amylin accomplishes this in a number of ways. It decreases appetite by promoting a feeling of fullness, hence reducing food intake. It slows gastric emptying and inhibits the secretion of digestive enzymes, all of which slow the appearance of glucose in the blood after a meal and it also slows the secretion of glucagon, which otherwise causes additional glucose release by the liver at mealtimes.
In short, the release of amylin minimizes glucose spikes that often occur after meals. I know, frustrating right! I mean this disease is already hard enough, now this. Fortunately for us, we do have another option to replace this important hormone that has also died off with our beta cells so go ahead and keep on reading.
As diabetics chances are we’ve all experienced those dreaded lows, but what are they? What can we do as type 1 diabetics to avoid them and more importantly, what can we do to prevent them? Lets take a closer look and examine hypoglycemia!
The body’s most important fuel is glucose, a type of sugar. When you digest most foods, sugar is released, and that sugar ends up in your bloodstream as glucose. Your body, particularly your brain and nervous system, needs a certain level of glucose to function — not too much, and not too little. If your blood glucose level isn’t right, your body will react by showing certain symptoms.
Hypoglycemia occurs when a person’s blood sugar levels are abnormally low, and it’s a potentially serious condition. If you know someone who has diabetes, you may have heard them talk about “insulin shock,” which is the common name for a severe hypoglycemic reaction.
People with diabetes may experience hypoglycemia if they don’t eat enough or if they take too much insulin — the medicine most commonly used to treat diabetes with those who suffer from type 1.
Causes Of Hypoglycemia:
Most cases of hypoglycemia in adults happen in people with diabetes mellitus. Diabetes has two forms, type 1 (loss of all insulin production) and type 2 (inadequate insulin production due to resistance to the actions of insulin). People with type 1 diabetes must take insulin to control their glucose level; if they skip meals or have a decreased appetite without changing their insulin dose, BAM, you guessed it, bring on the low! Insulin is also used to treat some people with type 2 diabetes. If a person with type 1 diabetes accidentally takes too much insulin, or a person with type 2 diabetes accidentally takes too much of their oral medications or insulin, he or she may develop hypoglycemia. Even when a diabetic patient takes medications correctly, improper meals, odd mealtimes, or excessive exercise may result in hypoglycemia.
Classic Signs Of Hypoglycemia:
Symptoms of a low blood sugar will vary depending on the individual, but here is a list of most of the common ones that I’ve personally experienced. It should be noted that low blood sugars can occur suddenly and the most common low sugar symptoms include:
- blurry vision
- rapid heartbeat
- sudden mood changes
- sudden nervousness
- unexplained fatigue
- pale skin
- difficulty sleeping
- skin tingling
- trouble thinking clearly or concentrating
- loss of consciousness
If you have hypoglycemic unawareness, a condition in which you do know your blood sugar level is dropping, your blood sugar can drop so quickly you may not even have warning symptoms. When this occurs, you can faint, experience a seizure, or even go into a coma.
Ok, I get peppered with questions all the time especially from individuals pushing products telling me all natural is just as good as organic, so what’s the actual difference between organic and all natural? Isn’t “natural food” just as safe and healthy as organic food? No, no its not, and here’s why.
Unfortunately, natural does not mean organic and comes with no guarantees. “Natural foods” are often assumed to be foods that are minimally processed and do not contain any hormones, antibiotics or artificial flavors. In the United States, however, neither the FDA nor the USDA has rules or regulations for products labeled “natural.” As a result, food manufacturers often place a “natural” label on foods that still contain heavily processed ingredients.
So how about organic? Organic is the most heavily regulated food system. Only organic guarantees no toxic synthetic pesticides, toxic synthetic herbicides, or chemical NPK fertilizers are used in production, and no antibiotics or growth hormones are given to animals.
Organic producers and processors also are subject to rigorous announced (and unannounced) certification inspections by third-party inspectors to ensure that they are producing and processing organic products in a manner you and your family can trust. As you can see there is quite the difference from “all natural”.
Regulation of Organic vs. All Natural:
According to the Food Marketing Institute (FMI), “natural” foods are minimally processed and free of artificial sweeteners, colors, flavors and additives like hydrogenated oils, stabilizers and emulsifiers. But there is no certification or inspection system to ensure that the label is accurate.
Also, the term “natural” does not usually relate to growing methods or the use of preservatives, whereas organically-grown foods have strict regulations in these areas. The National Organic Program, part of the United States Department of Agriculture, holds the food industry to strict standards in the production and sale of organic foods.