You may be concerned about high blood sugar levels (hyperglycemia, diabetes), but don’t worry about hypoglycemia (low blood sugar). This may be a mistake.
I recall a patient some years back that had a short story to tell. He was having anxiety attacks every day around 11:30. He asked me if I could help because he had already received 3 (yes–count them–3 prescriptions) from 3 different providers. Valium, Ativan and one other that I can’t recall right now.
Those of you familiar with anxiety attacks may be scratching your head right now thinking that it is strange that the anxiety attacks were at the same time every day. I was thinking the same thing. Hypoglycemia, on the other hand, can very commonly occur before a next meal and is well known to wreak havoc on the brain causing things like anxiety attacks.
Patients mistakenly believe that there is a blood test for hypoglycemia, but this is not really true. Anytime blood sugar levels drop too low, the brain immediately responds by releasing hormones like cortisol and epinephrine (adrenaline) to break down muscle and put sugar back into the bloodstream for the brain to use. Your doctor can order a test like the 2 or 4 hour postprandial glucose tolerance test, but quite frankly, it sucks. Drink a nasty tasting liquid that is like flat orange Crush and get your blood drawn every half hour. Not exactly my idea of a picnic.
Rather, a better way is to look at the timing of whatever symptoms are of concern. In the earlier patient’s example, it was anxiety attacks. If the symptoms fit into a pattern, add in some food or a healthy snack a few hours after a meal to see if that helps.
So that was it. An earlier lunch miraculously cured the anxiety attacks in this patient without the medications that were prescribed. But what if he had taken the medication and the episodes of hypoglycemia were allowed to continue unchecked?
According to this particular study, it’s far more dangerous than we thought.
Researchers looked at what happened in normal patients and in Type 1 diabetic patients when a state of hypoglycemia was created. They then followed up with 1 of 3 scenarios:
- After the low blood sugar levels, one group brought to a state of high blood sugar.
- After the hypoglycemia, on group was brought back to normal blood sugar levels.
- High blood sugar after hypoglycemia was was initiated along with an infusion of vitamin C
So basically, the participants were put into a low blood sugar state and then the hypoglycemia was corrected, either by bringing blood sugar levels back to normal or by sending them too high. In the group that was sent into elevated blood sugar levels, they were given a hit of vitamin C to see if it could help. Here is what they found:
- It was discovered that hypoglycemia itself was associated with all kinds of bad things for our bodies, including endothelial dysfunction (problems with the blood vessels), oxidative stress, and inflammation.
- In the hyperglycemia group, all of the above were found to get worse, and this bad effect last for at least 6 hours.
- When vitamin C was added, the negative effects of hyperglycemia were blunted.
The take home message is that hypoglycemia is a very bad state that contributes greatly to our risk of cardiovascular disease. This happens to us when we are not careful and go too long without eating. It is also a side effect of overmedicating in diabetics.
Fixing the hyperglycemia by rushing to the fridge for an apple juice or candy bar is very likely to swing you the other way, creating an even worse state for your health and blood vessels. This will last for hours afterwards.
This study would also suggest that decent levels of vitamin C (3-4 grams per day) may prove to be a smart and blood vessel-protecting approach to in anyone prone to low blood sugar and ALL diabetics, Type 1 and Type 2 included.
Of course, the BEST answer is to prevent the hypoglycemic crash in the first place by not eating any foods that rapidly convert to sugar (referred to as a high glycemic index) and not skipping meals, especially breakfast.