But when I talk to patients, friends - even my sister - all of whom have problems controlling their symptoms, the majority will utter dismay at the thought that hypoglycaemia is a modern stress-related phenomenon and that, according to Professor Williams of University Hospital, Liverpool, it 'has nothing to do with low blood-sugar levels'. He believes that identical symptoms can be induced by stress, and particularly by overbreathing or hyperventilation. He also said at a recent media event, that 'it is simply a myth that certain sugar-rich foods cause blood sugar levels to rise dramatically and then crash shortly afterwards. This does not happen in non-diabetic subjects, because various hormones keep blood sugar levels within a very narrow range.'
But, that said, as a practitioner I am reluctant to turn around to patients who present classic hypoglycaemia symptoms and tell them that diet has nothing to do with it and they should just start breathing properly. Typically, hypoglycaemic patients can feel weak, shaky, extremely moody, nauseous, acutely tired, have problems sleeping and suffer headaches - they can even break out in a cold sweat. Children can be hard to appease, and adults can feel violent when they haven't eaten for a while. Even if some doctors and the Sugar Bureau profess that these symptoms have nothing to do with blood-sugar levels (in the majority of cases), I think it is extremely worthwhile to look at the way you're eating to see whether symptoms can disappear. For the majority of sufferers, nutritional changes can have profoundly positive effects - as soon as you eat in a way that enables your blood-sugar levels to remain as constant as possible (in your own terms), symptoms can disappear.
One of the reasons why many specialists believe hypoglycaemia to be a disorder diagnosed (frequently by oneself) incorrectly, is that the diagnosis is in itself difficult - blood tests frequently fail to reflect what and how you're feeling. Even then, everyone is different. In some people, symptoms can even appear when they haven't eaten for a while but their blood-sugar level is above the point at which it is technically considered to be low. Others experience symptoms which make them feel unwell after they have eaten a very sweet food - they just appear to be overly sensitive, for whatever reason. In a way we don't need to know the reason (as long as you have seen your doctor to exclude the issue of tumours or diabetes, etc). What matters is how to help yourself - which is where food comes in.
Usually, when you eat carbohydrate (sugar-containing food), in either a simple form, such as chocolate, or complex form, as in a piece of bread, the body secretes the hormone insulin, enabling it to use the sugar as fuel or store it as fat for later use. If too little insulin is secreted, the blood-sugar level remains too high, and you become diabetic. Hypoglycaemia is the opposite condition and is thought, in many cases, to be due to too much insulin being produced, which causes blood-sugar levels to plummet beyond a point you are comfortable with. The first and foremost guideline is to eat a well-balanced diet: plenty of fresh vegetables, fruits, wholegrain cereals, lean proteins, dairy foods, small amounts of fat and plenty of water. Eating regularly helps you 'stabilise' your sugar levels, so try not to leave more than three or four hours between meals or snacks. I cite the example of a friend who finds that unless she eats a substantial breakfast as soon as she wakes up, she feels dizzy, sick and can (according to many level-headed observers), appear to be in a daze. As soon as she eats, she becomes a functioning human being.
Eating regularly throughout the day should prevent your blood sugar from dropping below the point at which you're comfortable and helps you refrain from overeating at meal times, which could cause you to become overloaded with sugar-containing foods (which can trigger similar symptoms to those caused by low blood-sugar levels in some people). The majority of people I see feel a lot better if they have five or six snacks a day rather than two or three large meals. If you're worried about excess calories, split meals up - save your dessert for later.
It is best to avoid eating sugary foods on an empty stomach, as the rise in blood-sugar level may stimulate your body to secrete a larger amount of insulin than desirable: your sugar level falls quickly, followed by dizziness or other symptoms. Patients frequently find that all types of sugar food - sucrose, glucose, fructose, brown sugar, molasses, honey - have similar effects. I recommend fruit as a healthy snack, as the fruit's fibre cushions the effect of the natural sugar (fructose) and thereby the changes in blood-sugar level. Products labelled 'no added sugar' are by no means sugar-free; usually they are high in natural sugar of one kind or another. Although artificial sweeteners do not directly aggravate sugar levels, I don't recommend them as they don't taste good and can aggravate digestive complaints. It's far better to wean yourself off the desire for excessively sweet things if you find that they cause symptoms. Eating sweet foods after a meal containing a lot of fibre (vegetables and wholegrains such as brown rice, wholewheat pasta or pulses), or choosing a sweet dessert based around fibre - apple crumble with a wholemeal topping - are both measures which appear to be acceptable in a lot of 'sugar-sensitive' people.
Boosting chromium can sometimes help you feel less sensitive to sugar levels, so lean towards chromium-rich foods - cheese, shellfish (molluscs, such as scallops, clams, oysters), baked beans and wholemeal products. Better to do this rather than reach for the chromium supplement, as it is still uncertain exactly how much chromium we need and therefore there is the potential to overdose. (The majority of people absorb sufficient quantities if they include in their diet a good-sized portion of chromium-rich food daily, or every other day.)
Since caffeine causes your pancreas to secrete more insulin, overloading with tea, coffee or cola can aggravate symptoms - so the cup of coffee to perk you up can be disastrous. Instead, drink plenty of water, herb teas and the occasional freshly squeezed fruit juice. Avoid drinking alcohol on an empty stomach, as this causes blood-sugar levels to drop. Wait until your stomach contains some fibre (a banana or a slice of wholemeal toast), before you go out drinking. If you find yourself feeling horribly 'low' here's the survival plan: have a sweet, high-fibre snack to help bring your sugar level up to normal.
Sweets and chocolates may cause your body to produce more insulin than you're happy with, which causes even more problems - so watch these quick fixes. Fruit combines sugar and fibre, so a fruit-based snack is ideal. Try to eat a well-balanced meal as soon as possible afterwards. Avoid caffeine. Above all, rest - vigorous exercise will make symptoms worse. Relax, concentrate on breathing calmly, keep warm and have a hot drink, such as a mug of hot milk or camomile tea - all of which should soon bring the 'swing' to a stop.
