Hypoglycemia


Sugar for Brains [Show Notes]

Sugar Basics

Sugar in your blood = glucose
Your body prefers glucose over any other sugar out there.

-ose = sugar suffix

GlucOSE
FructOSE – fruit sugar
SucrOSE – table sugar
SucralOSE – Splenda

Your body can turn any of these other sugars in to glucose.  It can actually turn other carbohydrates, and even non-sugar molecules into glucose if it really needs to.  This all happens in your liver…

If you were in a long-term starvation or malnutrition situation, your body would circulate non-glucose energy sources to try to get energy, since the process of making glucose can be relatively slow.  This is because your body would prefer to live than die.

Brain Food

The brain is a picky eater, and refuses to utilize non-glucose sources of energy.  This is because your brain works A LOT!  And it doesn’t have time to use inefficient sources of energy.  Therefore, it will hog the glucose from the rest of your body.

Your skeletal muscles use glucose to do work.  This is why people with diabetes have to be extra cautious when they exercise.

Extra glucose gets saved for those times when you’re not eating.  It gets put in a really long chain called glycogen.  But getting the glucose back from the glycogen can be relatively slow.

Recovering from an episode of low blood sugar takes time and requires rest (so you’re not burning through the fuel as fast as you replenish it).  But it can also be emotionally stressful because you may be required to eat “unhealthy” amounts of sugary or carb-heavy foods to get back to normal.

Energy Production

Glucose has a very complex metabolism cycle – the Krebs cycle.
One intermediate is glucose-6-phosphate (G6P) – there is a genetic mutation where a protein for this step doesn’t do it’s job very well.  If this step gets delayed or clogged up, then there is a detour metabolism step that leads to triglyceride production, when then leads to fat storage.  *womp womp*  (note: triglycerides are useful in the right amounts for cell repair)  This is also why eating large amounts of sugary plus fatty foods can lead to quick weight gain.

The end result of this cycle is Adenosine Triphosphate (ATP).  It is super energetic when a phosphate piece is removed.  It’s like the body’s dynamite.  This is how a sugar high works – all the sugar leads to all the dynamite exploding at once, but then it takes a while for it to get replenished, and that’s why you crash after a sugar-high.

Low Blood Sugar is Bad

To immediately recover from low blood sugar, you need simple sugar (orange juice, regular soda, sugar-full hard candy, glucose tabs or paste or gel).  To continue to recover, you need carbs plus something that will help it not absorb so fast (i.e. protein, healthy fats).

If you ever look at the underside of your tongue, you can see the blood vessels really clearly because they’re really close to the surface.  So if someone is unconscious due to low blood sugar, you can use a glucose tablet or gel under their tongue and it will absorb into the blood stream.  This is also how you can absorb sugar quickly from sugar-full gum.

Low blood sugar can lead to emotional fluctuations (aka crabby and grouchy) and short-term memory loss (and not just because you passed out).

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Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/


Special Episode #3: Meds & Blood Sugar

People with chronic diseases don’t get holidays or vacations from their medication.

4 ways medication can affect blood sugar

Type of medication

The goal of the medication that people with diabetes take is to lower blood sugar – either by increasing insulin sensitivity, encouraging the pancreas to make more insulin, or to replace insulin that’s not naturally made anymore.  Metformin is like insulin’s wingman; it helps make the cells ready for insulin when it comes by.  So usually these medications (including insulin) will lower blood glucose no matter if you eat or not.

Timing of medication

Most of the medications should not be taken if a meal is going to be skipped.

Dose of medication

The more sugar you eat, the more insulin you need.  The higher the blood sugar level, the higher the dose is needed.  It needs to stay proportional.  Any form of sugar you eat gets turns into glucose, the complexity of the sugar determines how fast it raises your blood sugar.  Even diabetics are at risk for hypoglycemia.  If one little thing gets out of whack, it can cause a drop in blood sugar and require a “rescue”.  Favorite hypoglycemia rescue “go to” is orange juice (lots of simple sugars).  Regular soda can be used, as well as hard candy or glucose tablets.  NO DIET SODA – artificial sweeteners do not affect sugar enough.  High blood sugar can cause coma, lower blood sugar can cause coma.  Bottom line: Coma is bad.

Interaction with medication

Fluoroquinolones can causes changes in blood sugar control and require a person to check their levels and adjust their medicines more often.  Steroids can also cause blood sugar to be more uncontrolled – this is true for acute (short term) use or chronic (long term – like autoimmune diseases) use.  Beta blockers used for blood pressure control can mask the symptoms of low blood sugar because the symptoms are very similar.  Symptoms of low blood pressure:  tiredness, weakness, dizziness, shakiness, inability to focus.  The only way to know which one you’re experiencing is to check your blood sugar and your blood pressure.

The Nashville chapter of JDRF is having their annual One Walk on September 24th. Friend of the show and previous guest, Rachel Mayo has been #T1D for over 10 years and she is passionate about the cutting edge research and support JDRF provides for people and their families. Her goal is for her team to raise $5000, you can contribute!

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Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/


Special Episode #2: Food & Blood Sugar

Blood Sugar Basics

Your blood sugar affects how tired you are, your productivity, and your moods.  This is 1000x more true for those with diabetes.

Hypoglycemia = Low blood sugar

3 main energy sources in your food

Carbohydrates are some complex form of sugar that your body can turn into glucose very quickly.  Glucose is the main form of sugar that your body uses for energy.  Because your liver is very efficient in this process, you can get a blood sugar spike (sugar high) and then you crash after it’s over.  Insulin is the key to the door to let the glucose in your cells.

Fats can be turned into sugar by your liver is your glucose stores are depleted.  So, this can affect your blood sugar levels, although it’s less of an impact that carbohydrates.  Insulin has another job – fat storage.  If there’s a lot of fat, the insulin is being used up storing fat rather than allowing glucose into cells.

Proteins are promoted as a counterbalance to the carbs.  It causes a traffic jam in the absorption and metabolism processes that allows the sugars into the blood stream much slower.  The liver does have a process called gluconeogenesis (the creation of new sugar) where it can make sugar out of protein, but it’s a last resort.

Other things in your food

There is some evidence that shows caffeine causes temporary insulin resistance while it’s in the body.  You still get an “energized” feeling b/c caffeine increases the heart rate but the energy usage is not very efficient because the glucose is not being used well.

Alcohol can drop your blood sugar initially, especially if it’s consumed on an empty stomach.  When the liver is steadily detoxing the alcohol out of your bloodstream, the replenishment of the glucose supply slows down.  This contributes to what make you feel sleepy after drinking alcohol.  On the flip side, it will increase your blood sugar because 1) alcohol is usually mixed in a sugary drink (i.e. cocktails) and 2) alcohol is distilled from “high carb” sources (grapes, wheat, barley, rye, corn, etc).

Any changes to eating habits need to be exactly that – new habits.  It can’t just be a program that you do once without permanent change.  If you’re cutting out all or most of one of the 3 main energy sources, you have to make sure you keep up with your caloric needs.

Calorie Math

1 g of Fat = 9 calories

1 g of Carb = 4 calories

1 g of Protein = 3 calories

Calories are calories when it comes it energy, so the other nutrients from your foods are a more important to consider when choosing what to eat.

There are lots of things your body would have to adjust to when changing eating habits (digestion adjustments, for one) and 30 days may not be enough to get it “normalized”.

JDRF

The Nashville chapter of JDRF is having their annual One Walk on September 24th. Friend of the show and previous guest, Rachel Mayo has been #T1D for over 10 years and she is passionate about the cutting edge research and support JDRF provides for people and their families. Her goal is for her team to raise $5000, you can contribute!

Connect with me

Support us on Patreon

*NEW* Join the Pharmacist Answers Podcast Community on Facebook

Subscribe: iTunesStitcherGooglePlayTuneIn Radio

Like the Facebook page

Music Credit: “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/