I was reminiscing about the early days of diabetes, well early is subjective, but for me it was when you were given one shot a day and they measured control with urine dip sticks and your ability to gain weight. Scary, but I survived, and so did many others. Imagine dipsticks for control, crazy!
|"Those were the days"|
I didn't feel all that bad on one shot a day, and actually started to feel worse when my control tightened and was consistently near normal range. The body is amazing, it got used to the high levels, and that was that, it equalized, so to speak.
When the levels normalized, the body said "What the hell is going on!" and sent the signal to produce the good old epinephrine (fight or flight Response) and wham, you start feeling like crap with your good numbers.
For some, including me, it was discouraging not knowing that the feeling would subside in time. Why torture my self, why shoot for normal levels when I feel shaky, and low all the time. That's where knowledge is power, and motivating! It took one Diabetic Educator in 1990 to say, "you know it is only temporary, and then you will feel great!" One moment, one snippet, is all it took!
I get the above scenario a lot from patients and those with higher A1C's. They say " I feel fine, why should I change anything" or "Well, I took the night time insulin and my fasting is 5 mmol, but boy I feel like crap" or they claim, that their normal is actually 10mmol (multiply by 18 for U.S.) The point is, they don't feel the need to change if they feel good. Of course I jump at the opportunity to share my snippet, in hopes to motivate them to keep there levels down just long enough to feel fab!
Most folks have never been told the reason behind feeling worse with better numbers. I am fortunate to be in a position to explain these pearls of experience with folks trying to better manage their diabetes control. I hope anyone going through diabetes and feeling "great" and not worrying will take the snippet for themselves or a loved one, and shoot for those normal targets!
I did find one research article written by Gill Spyer and colleagues titled, "Hypoglycemic counter-regulation at normal blood glucose concentrations in patients with well controlled type-2 diabetes." They took 7 type 2 diabetics with a mean A1C of 7.4%, and tightened their control. This is what they found:
"Symptom response took place at higher whole-blood glucose concentrations in diabetic patients than in controls" and they also commented "This effect might protect type-2 diabetic patients against episodes of profound hypoglycemia and make the achievement of normoglycaemia more challenging in clinical practice."
Most of my experiecne is purely anecdotal. But this study certainly supports the theory.
Have you ever Been High for a period and dropped low?
If so please share your comments.
G Spyer MRCP, Prof A T Hattersley FRCP, K M MacLeod MD, (2000) Hypoglycaemic counter-regulation at normal blood glucose concentrations in patients with well controlled type-2 diabetes,