Hello everyone. I was just diagnosed with "pre-diabetes". I am a little confused. I've been having suprise low blood sugar attacks if I didn't eat every few hours for the past few years. I passed out a few times. I get high blood sugar in the 200 range for many hours after I drink something like orange juice. I've been reading about pre-diabetes and it seems to focus more on having high blood sugar. My sugar is typically running too low. Could I have been mis-diagnosed?

The "pre-diabetes" that you describe is likely a result of insulin resistance in the tissues, combined with a slightly hyperactive pancrease that can produce excessive amounts of insulin when bloodsugar levels are high (hyperinsulinemia). This results in high and low bloodsugar swings when you consume high carbohydrate foods such as orange juice. First thing that happens is your bloodsugar shoots up after you consume too much easily digested carbohydrate, the normal circulating insulin levels aren't able to control this onslaught of sugar because your muscle cells have become resistant to the action of insulin, so then your pancreas responds by flooding your bloodstream with insulin to get the bloodsugar down to prevent nerve damage. With all of this insulin circulating, eventually the sugar is driven into the cells and your bloodsugar may in fact go too low then (reactive hypoglycemia). This low bloodsugar stimulates hunger which then causes you to eat more high carbohydrate food and the cycle repeats.

This is fairly common in fact, but still cause for concern. And it is an early indication that you could be heading for Type II diabetes if diet and lifestyle changes are not made.

Cut out the sugars, starches, fruit juices and other highly refined and concentrated sources of carbohydrate if you want to improve your health and possibly avoid the diagnosis of Type II diabetes.

Alan

If you have blood sugars running in the 200 hundred range at times then I would most certainly think this constitutes diabetes. The latest that I read on the ADA site is that the new guidlines for diabetes is BS of 120 or above where it used to be 140. You need to eat your three meals a day and eat a healthy snack between each meal and at bedtime. You need to try to keep your blood sugar as level as possible. If you have already passed out in the past from low BS then you need to be sure to carry a form of sugar with you at all times and anytime you begin to feel the symptoms of hypoglycemia be sure to have some instant sugar be it a regular soda, candy bar or OJ with a packet of sugar in it. Be sure to follow up with a high protein snack as the sugar will cause a quick rise in the BS but then it will drop suddenly if you don't follow up with a high protein snack such as cheese and crackers. You may want to consider seeing an endocrinologist or checking back with your regular doctor about the pre-diabetes since the longer diabetes is left untreated the more damage it does. I am not comfortable with BS in the 200 range and only calling it pre-diabetes since many of the doctors at the nursing home I work at give their patients sliding scale insulin coverage for BS as low as 150. One other option before heading back to the doctor is to test your BS 4 times a day before meals and at bedtime for a couple of weeks and write this down and if they are consistently out of the norm range be it high or low show this to your doctor and see what is recommneded.

DeeDee -
It's hard to say what your doctor means by "pre diabetes", as the term is used differently by different people and in fact is not used much anymore because it's so misleading.

As Alan pointed out, you do sound as if you might have hypoglycemia, or low blood sugar. That is usually the result of an overactive pancreas that produces too much insulin. Since an increase in blood sugar causes the pancreas to respond by producing even more insulin, eating carbohydrates by themselves, without protein, will result in a low blood sugar a short time after eating. By reducing the amount of carbohydrates at a meal and adding protein (which is converted into glucose much more slowly than carbohydrates), you provide a steadier source of fuel that won't cause such an overreaction by your pancreas. However, it should be noted that this condition is often a precursor to diabetes, as the islet cells in the pancreas that produce insulin eventually wear out, and you end up with diabetes.

As for the highs of 200, that is fairly unusual with hypoglycemia, but quite common with hyperglycemia (diabetes). Have you had a glucose tolerance test? That's still the best way of diagnosing true low blood sugar.

Once you determine if you are hypoglycemic or diabetic, you can determine the best diet for your condition. In the meantime, you may want to keep those packaged peanut butter crackers with you at all times, as they are a great way of treating low blood sugar, no matter what it comes from. The carbohydrates in the crackers will raise your BS quickly, and the protein in the peanut butter will help keep your BS level over a longer period of time.

The prepackaged crackers are fine but this poster needs some ready sugar handy at all times as she has said that she has passed out before. I would never try to feed someone who is unconsious any real food as they cannot chew and could easily aspirate if you gave them something like crackers with peanut butter or cheese. Just wanted to point this out for safety reasons for all who read these boards.

Thanks for all your posts and great advice. I always carry a chocolate bar and some hard candy with me just in case. I'm really glad I found this board because its been answering alot of my questions and providing alot of enlightenment about myself and my health. Thanks to all of you.

By the way, my brother is type 1 diabetic and just got the insulin pump. He is doing really well and much more stable with it. I hope that this can be a way to make all diabetics lives a little easier.

MLGable -
Good point re not giving food to anyone who is passed out. Guess I didn't make myself clear enough...the peanut butter crackers should only be used if the person is conscious. The reason I suggested them is that the carbs in the crackers are absorbed nearly as quickly as candy, but the peanut butter will prevent the rebound effect if the person is hypoglycemic.

In fact, if a person is unconscious, someone should call 911 immediately. If someone has frequent episodes of passing out due to low blood sugar, they can get a glucagon kit, but they need to have a friend with them who is trained to use it.

One other thing I've heard recommended for someone who has already passed out due to low BS is rubbing frosting (from one of those squeeze tubes) between their gum and cheek...it gets absorbed right through the skin of the gums and cheek and can start raising the BS before the paramedics get there.