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  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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