How low is too low?

[bbarkow]

Hi all,

I'm new to LC and I have a question about blood sugar. Hope some of the experts here can help.

I have type II and have been on glucophage for about 6 months. Began Atkins on July 27 (after being warned against it by my doctor - I'm in for it when I go back in November).

Anyway, after reading in Atkins that the diet would stabilize blood sugar, I stopped taking the glucophage. I've been checking my sugars three or four times a day and I'm getting low readings consistently. About an hour after eating I show about 85. After exercising I show 65-70. Last night, however, I got a reading of 58 after exercising.

How low is dangerous? I'm in induction, so I'm eating under 20 grams of carb per day. All low-glycemic.

Thanks,
Brent

[doreen T]

hi Brent,

Blood sugars below 70 are too low. Ideally, you want to keep your sugars around 90. What is your fasting sugar, first thing in the morning?

You seem to be hypoglycemic right across the board. And my hunch is that you're not eating enough, not just carbs but not enough PROTEIN. To help keep blood sugars more stable, you'd do best to have 5 or 6 smaller meals and snacks that contain protein and some fat (never eat carbs alone) .. rather than 3 large meals a day. How are you counting your carbs? Did you know that you can subtract any grams of fiber that's in a food from the total carbs listed, and that's the number you use to calculate your carb intake. For example, a stalk of broccoli has 7.9g total carbs and 4.5g fiber. You'd count it as 3.4g carbs. If you're not subtracting fiber grams, you could be eating way fewer carbs than you think.

Exercise-induced hypoglycemia is usually more of a concern for Type 1's who inject insulin, but some Type 2's do have problems as well. If you're doing weight-lifting/ resistance exercise, you'll use up your muscle stores of glucose (glycogen) quickly. As well, resistance exercise improves insulin sensitivity, so the blood sugar gets transported into the cells (and out of the blood) more efficiently ... Which means if your sugar is lowish to start with, the exercise is going to make it drop even further, and will stay down for a prolonged period after the exercise session is over.

The treatment is prevention ... ie, eat a small amount of carbs and protein before the exercise, and during if it's for a prolonged period of time. Dr Richard Bernstein has a detailed chapter on exercise and blood sugar control in his book Dr. Bernstein's Diabetes Solution (http://www.amazon.com/exec/obidos/ASIN/0316093440/lowcarbcanad/). I highly recommend that you get your hands on a copy of this book. He promotes a low-carb diet and tight blood sugar control, and many practical tips for achieving normal blood sugars. And preventing them from dropping too low :) In fact, his recommendation is that you get the blood sugars stabilized FIRST before embarking on a rigorous exercise program.

hth,

Doreen

[doreen T]

Forgot to add ... it may not be wise to have stopped the glucophage suddenly. Hypoglycemia will result not just from insuffincient carb and protein intake, but also from too much insulin in the blood. As a Type 2, you no doubt were showing signs of insulin resistance, and that's how glucophage works, by increasing the cell's sensitivity to insulin. Too much insulin can lead to other problems besides just hypoglycemia ... such as high blood pressure and high cholesterol, to name a few.

It would be worth making an appointment to see the dr ASAP. Let him know about your consistently low blood sugars even off the glucophage. He may want to check your serum insulin levels.

Doreen

[bbarkow]

Thank you. I have placed both a call to my doctor and an order for Dr. Bernstein's book.

Brent