by Dr. Richard P. Holm, MD.
Balance is so important. For example, too much food causes obesity. Too little food causes starvation and sometimes death. Like Goldilocks, our bodies are always in search of balance: not too much or too little, but that which is "just right."
It's sweet news that a healthy pancreas makes a hormone called insulin to keep blood sugars from going too high. When something goes wrong and either the pancreas fails to make enough insulin or the body becomes resistant to it, diabetes mellitus with elevated sugars will occur. This, however, is only half the story. What happens to keep blood sugars from going too low?
A couple years ago, a patient of mine came in having sporadic nervous spells of fast heart rate, tremors, sweating, hunger, butterflies-in-the-stomach, and poor sleep with night sweats. These spells were all from low sugars, which he documented on his home blood sugar monitor. He was not taking insulin or medications that lower sugar, was eating correctly, not drinking alcohol, and not excessively exercising. His was a rare case of a pancreatic insulin-making tumor, and after tests supported that diagnosis, referral to an endocrinologist allowed for effective treatment.
Last week I spoke to a middle aged woman who once-daily was taking long-acting insulin and multiple-times-daily short-acting insulin before meals and as-needed depending on measured blood sugar levels. She had been experiencing roller-coaster sugar levels sometimes above 300, but, far more dangerous, sometimes below 70 with nervous spells similar to the man with the pancreatic tumor. The spells were happening from too much insulin, and now-a-days, this situation is too common.
These are two different causes for low sugars, and there are others, but for whatever reason, low sugars can deteriorate brain function, and when low enough, bring on loss-of-consciousness and even death. We've learned that when blood sugar drops much below 70, the body produces five different hormones to bring it back up. It's that important! The list includes well-known hormones like adrenalin and cortisol, and some lesser-known like glucagon, noradrenalin, and growth hormone. Once sugars go too low, it’s a week before these hormones settle down, making it extraordinarily difficult to find the correct dose of insulin.
Of course enough insulin is important in preventing complications from elevated blood sugars and diabetes mellitus, but when there's too much insulin, dosing becomes more difficult and the danger becomes more significant. That's why balance is so important and we need to get the insulin dose, "just right.
To hear more from Dr. Holm, visit his website, www.PrairieDoc.org. On Call with the Prairie Doc is produced by the Healing Words Foundation in association with the South Dakota State University journalism department and airs Thursdays on South Dakota Public Broadcasting Television at 7 p.m. CT, 6 p.m. MT, and streams live at www.PrairieDoc.org.