As stated by Dr. Janet
Travell hypoglycemia can aggravate myofascial trigger point
(TrP), which is a common cause of muscle and joint pain, and
recurrent hypoglycemic attacks can perpetuate myofascial
TrPs. Most
chronic diabetics, whether they are on pills or on insulin
injection occasionally to frequently experience hypoglycemia,
particularly at night during sleep. An often overlooked reason
for this problem was because patients were often advised by
their doctors to take their insulin at breakfast time in the
morning and at dinner time in the afternoon, routinely. No
consideration was ever given to the timing ("chronotherapy")
when the insulin reaches its "peak level" after injection, and
when the sugar reaches its "peak level" in the body after
eating. From experience we know that they can never be the
same during the day. Consequently, hypoglycemia occurs when
the peak level of the insulin reaches during a time when the
sugar in the blood is low, and thus lowering the sugar in the
body some more.
Most people eat light breakfast,
like a muffin, an egg or sausage, and perhaps a cup of coffee,
juice or plain water about half an hour after they get their
insulin injections, around 8:00 AM. Depending on what long
acting and short rapid acting insulins they inject themselves
with, Lantus and Novolog or Humulin NPH and Humulin R, the
peak level of these drugs varies. The peak level of the sugar
in the body after eating breakfast is usually taken care of by
the morning injections, if the amount injected is adequate and
the timing is correct.
During lunch
time most people eat more than during breakfast, such as
vegetables, bread, beans, hamburger, cheesecake, etc, but they
do not take anymore insulin during lunch time. The insulin
that they take in the morning may not be adequate to lower
their blood sugar after eating lunch. As a result their blood
sugar may be as high as, perhaps around 250 or 300 or more,
before eating dinner, which is not unusual. It is advisable
therefore to eat light lunch so when dinner time comes the
blood sugar is not already too high. The goal of good blood
sugar control is to achieve a "normal" blood sugar level
during the day and night without episodes of either
hyperglycemia or hypoglycemia, before breakfast, before lunch,
before dinner and throughout the night on AM and PM insulin
only.
I have found that if
we can "synchronize" the timing of eating and the
administration of the insulin so that the "peak level" of the
insulin meets the "peak level" of the sugar in the body, the overall effect
would result in a "normal" blood sugar level throughout the
day. Having said this, individuals still need to "fine tune"
what they eat (more protein and less carbohydrate), how much
they eat, and the time when they eat in conjunction with their
insulin. They also need to know when the "peak level" of their
insulin and the "peak level" of their blood sugar are by doing
a serial post-prandial (after meal) blood sugar tests. It is
also recommended that diabetics have their HgbA1C or
glycohemoglobin blood check done every so often, perhaps every
2 or 3 months, to determine their average blood glucose levels
in the body. Chronic diabetics who experienced frequent and
prolonged hypoglycemia may have an abnormally high HgbA1C even
though their pre-breakfast and pre-dinner blood glucose levels
are "normal".
Tempeh (soy) is low in
sodium, high in protein, is a complex carbohydrate, and has no
cholesterol. Vitamin C (ascorbic acid) is a powerful
anti-oxidant. Diabetics who are not consuming adequate
proteins in their regular diets, for whatever reason, should
supplement their diets with protein shake drinks (whey and/or
soy protein powder).
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