Hypoglycemia Collapse & Recovery times/symptoms

[brucemillar]

Folks

I had another Collapse and period of unconsciousness last Friday. I had forgotten to take my Acarbose Tablet before lunch and had eaten some biscuits (I know). My wife was with me when I went down and was able to get an ambulance as I was fitting (violent shaking & bit through my tongue). I recovered within 15 minutes and did not require hospital. Four days on and I am still feeling exhausted and very sore around my lower back. The soreness is gradually going but the drowsiness is still here.

Is this drowsiness normal?

Bruce

[Spikey]

Dear Bruce,

This sounds more serious than the normal hypoglycemia associated with dumping syndrome, which many of us are familiar with. Drowsiness is normal after an attack, but not four days on. Suggest you see your GP or Consultant and get it checked out - full blood work up possibly.

[deveretth]

My issue is Iron and Hemoglobin levels determined by a blood test. A level

of 12 being normal if the Hemoglobin level is below 8 you may need a blood

transfusion. The effect of low levels, Hemoglobin is a fitness survey a determination

of your Oxygen access. Too low and you obviously are spaced out and can

pass out. it has to be remedied immediately.

[gutlesswonder]

Hi Bruce

How many times does it take before you get the message !?!

What would have happened had you been alone with just those dogs?

You did not have a 15 minute inconvenience you had a major incident with the CNS (Central Nervous System). Unconsciousness = Brain Damage, albeit relatively minor and hopefully temporary.

Also from the sound of it the muscular spasms have had an effect on your spine; you would be well advised to go straight to Casualty for an Xray to check whether or not you sustained a compression fracture of the ventral process of one or more vertebrae.

Drowsiness is the least of your worries, but it could well eventuate from trauma to the spinal cord.

I make no apologies for preaching -- it happened to me -- exactly!

[gutlesswonder]

Hi Bruce

What was the rationale for you being prescribed Acarbose?

This enzyme blocker can precipitate a more serious form of hypoglaecemia.

Has it been explained to you that if you go hypo,having taken Acarbose then complex sugars such as table sugar, fruit juice, starchy foods will not counteract the hypo and that the only remedy is a monosaccharide IE Glucose, urgently?

[brucemillar]

Hi

The rationale was that they believe that I am suffering from severe hypoglycemia triggered by sugar. That was based on extended blood monitoring, food diary and recent collapses/symptoms.

No it was not explained about any issues with Acarbose, were I to suffer a further collapse. I did have a further collapse but that was after I had forgotten to take my Acarbose tablet. All the time I take them (three per day, before meals) I remain upright.

I feel like a passenger here just reading out the symptoms then awaiting the instructions.

I am seeing my surgeon again the Monday. He is arranging bone and neurological scans (I have already had this, with an all clear).

[gutlesswonder]

Hi Bruce

Yes, we are all sailing on the Titanic!

The fact that you were not warned about the potentially grave consequences of going hypo whilst taking Acarbose indicates to me that whoever prescribed it for you is ignorant to the point of negligence.

This is further aggravated by the extremely complex and subtly altered way in which the glucose/insulin mechanism operates in us gastro-eosophageal patients.We are quite different from ordinary folks BUT also quite different from either Type 1 or Type 2 Diabetics.

Firstly - initial (postprandial) Insulin secretion does not occur in response to blood sugar levels, it is driven by (Enteroendocrine 'L') cells lining the small intestine in varying concentrations along the length,which sense the levels of mono/simple/complex sugars (and at least certain artificial sweeteners) in the Bolus (Ball/Blob) of Chyme (foodstuff plus digestive chemicals) as each one passes by driven by peristalsis (muscular contractions).

Remember that the size and frequency of each Bolus is determined by the opening and closing of the Pyloric Sphincter -- which in our case tends to be abnormal -- too much too soon or, in some patients, too little too infrequently.

Now factor in the variable mixture of sugars which you originally ingested.

Now factor in that 'L' cells are also stimulated by fats.

Result: you have a mindbogglingly complex dance going on which defies prediction, quantification and control.

Bear in mind that I have hugely simplified the foregoing.

For instance, when stimulated 'L' cells, (acting in concert with other specialised cells, notably 'K' cells whose function and role is unknown) together secrete at least 7 or 8 hormones (of which the most noticeable is GLP-1) which then interact with the entire body, including the brain and serving to regulate GI transit, respiration, mood, etc etc.

The action of Acarbose is to inhibit the working of alpha-glucosidase which is the enzyme (secreted by the Pancreas) responsible for breaking down carbohydrates, not simple sugars.

So, pop the Acarbose pill and lo and behold your wholemeal sandwich is not broken down into monosaccharides and adsorbed into the blood stream -- GREAT! ---BUT----and here comes the counter-intuitive bit ---- the carbohydrates persist in the gut lumen and continue to stimulate the 'L' cells which continue to 'call for' more Insulin. In other words an Hypo is provoked/exacerbated/prolonged. And worse still only monosaccharides (pure Glucose) can counteract this,by raising blood sugar, since the action of digesting any other sugars is blocked.

You should also have been warned that, since carbohydrates persist undigested and pass into the Bowel, where they will fuel bacteria,then you may experience flatulence and diarrhoea.

All the foregoing is just my hypothesis and I am hardly qualified. Why not print it out and discuss it with your Practitioner; if he wants to sue me for defamation .....bring it on.