THE G.I. FACTOR AND HYPOGLYCAEMIA
Hypoglycaemia is a condition in which the sugar level in the blood fails below normal levels. From the Greek words hypo meaning under and glycaemia meaning blood sugar—hence blood sugar level below normal.
These days, hypoglycaemia is a popular diagnosis for all sorts of problems which cannot be attributed to a more specific diagnosis. There has been considerable publicity about hypoglycaemia which is often blamed for many non-specific health problems ranging from tiredness to depression. Unfortunately, it is often wrongly blamed which can delay a proper diagnosis and correct treatment.
Nevertheless, genuine hypoglycaemia does occur in a few people, and the G.I. factor has a role to play in treating some forms of this condition. The most common form of hypoglycaemia occurs after a meal is eaten. This is called reactive hypoglycaemia.
Normally, when a meal containing carbohydrate is eaten, the blood sugar level rises. This causes the pancreas to make insulin which ‘pushes’ the sugar out of the blood and into the muscles where it provides energy for you to carry out your regular tasks and activities. The movement of sugar out of the blood and into the muscles is finely controlled by just the right amount of insulin to drop the sugar back to normal. In some people, the blood sugar level rises too quickly after eating and causes an excessive amount of insulin to be released. This draws too much sugar out of the blood and causes the blood sugar level to fall below normal. The result is hypoglycaemia.
Hypoglycaemia causes a variety of unpleasant symptoms. Many of these are stress-like symptoms such as sweating, tremor, anxiety, palpitations and weakness. Others affect mental function and lead to restlessness, irritability, poor concentration, lethargy and drowsiness.
The diagnosis of true reactive hypoglycaemia cannot be made on the basis of vague symptoms. It depends on detecting a low blood sugar level when the symptoms are actually being experienced. This means a blood test.
Because it may be difficult (or almost impossible) for someone to be in the right place at the right time to have a blood sample taken while experiencing the symptoms, a glucose tolerance test is sometimes used to try to make the diagnosis. This involves drinking pure glucose which causes the blood sugar levels to rise. If too much insulin is produced in response, a person with reactive hypoglycaemia will experience an excessive fall in their blood sugar level. Sounds simple enough, but there are pitfalls.
Testing must be done under strictly controlled conditions and capillary (not venous) blood samples collected correctly. Home blood glucose meters are not sufficient for the diagnosis of hypoglycaemia in people without diabetes.
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