Hypoglycaemia and what to do about it

Low blood sugar, or hypoglycaemia is an unpleasant condition that causes symptoms of weakness, hunger, sweating, heart palpitations, tremor or shakiness, fainting, dizziness, nausea, headache, and disturbed vision. In severe cases mental confusion may occur and the patient finds it difficult to think straight.

Hypoglycaemia commonly affects diabetics who inadvertently use too large a dose of insulin, but it can also occur in non-diabetic individuals who have a tendency to produce abnormally large quantities of insulin. Marathon runners who do not take sufficient readily available glucose during a strenuous race also often develop hypoglycaemia.

In this article we will concentrate on hypoglycaemia that occurs in non-diabetics.

  1. What happens in non-diabetics when they produce too much insulin?
    When individuals with a normal metabolism eat a meal, the level of their blood glucose (blood sugar) rises. In response, the pancreas releases insulin into the blood stream to help remove the glucose and transport it into the body cells where the glucose is used as a source of energy.

    In persons who suffer from hypoglycaemia, the pancreas often release excessive quantities of insulin which make the blood glucose level fall so rapidly and to such a low level, that the abovementioned symptoms develop. These symptoms are unpleasant and interfere with normal activities. It is, therefore, essential that non-diabetics who suffer from hypoglycaemia take certain precautions to prevent the condition.

  2. Dietary tips to prevent low blood sugar
    The basic dietary principles that are used to combat hypoglycaemia, are designed to prevent two things:

    • That the pancreas makes too much insulin
    • That the blood glucose (sugar) level drops too rapidly and to too low a level

    To prevent these things from happening, it is necessary to eat foods that do not stimulate excessive insulin production and to ensure that meals are eaten regularly, and often. The following foods and beverages are inclined to stimulate insulin production and should be avoided, or only eaten, or drunk, in very small quantities, and preferably as part of a meal:

    • Highly processed, sweetened foods such as cakes, biscuits, sweets, chocolates, honey, white bread, white rice, very sweet fruits (grapes)
    • Alcoholic drinks
    • Very sweet fruit juices, cold drinks

    The following foods are less inclined to stimulate insulin production and should form the basis of the diet:

    • Whole, unprocessed cereals with a high fibre content such as high-bran cereal, oats, unsifted maize meal, Maltabella, wholewheat or rye bread, pasta, brown rice
    • Legumes (dry beans, peas and lentils) and products made with legumes (tinned baked beans), "Toppers" and other foods which contain textured vegetable protein
    • Low fat beef, chicken, lamb, pork, fish and eggs (prepare eggs by boiling, poaching or scrambling in a non-stick pan and make sure that the other foods are not cooked in fat)
    • Skim or low-fat milk, yoghurt, cottage cheese and other low-fat cheeses (mozzarella, Edam and Tilsiter)
    • Fresh fruit and vegetables, but avoid very sweet fruits such as grapes
    • Dried fruit such as raisins for emergencies (see below)
    • Oils and margarines with a high polyunsaturated fat content, avocado, peanut butter, and nuts

    Meal planning
    To prevent the blood sugar level from falling to such a low level that symptoms of hypoglycaemia develop, the following meal planning tips are useful:

    Never, ever skip breakfast. After nearly 12 hours of overnight fasting, the blood sugar level is very low and must be replenished before you start your daily activities. If breakfast is important for people without hypoglycaemia, it is even more important for those with hypoglycaemia.

    Eat regular meals and never, ever skip a meal. If you know that you are not going to be able to sit down for lunch because of a full schedule, then make some wholewheat sandwiches with polyunsaturated margarine and grated cheese, cottage cheese or slices of lean roast beef, plus lettuce, tomato, carrot sticks and cucumber, to take along and eat on the run.

    Divide your daily food intake into 6 small meals instead of three larger ones to ensure that you don’t go without food for longer than three hours at a stretch. For example:

    Eat a moderate breakfast (bowl of oats with skim milk, wholewheat toast with polyunsaturated margarine and cheese, peanut butter or marmite), have a wholewheat sandwich and an apple at morning tea, a light lunch (salads and cold lean meat with wholewheat bread, or baked beans on wholewheat toast), a mid-afternoon snack of low-fat cheese and rye bread, a light supper (cooked vegetables, legumes and grilled fish), and an evening snack of high-fibre biscuits.

    Always keep an emergency supply of high-fibre biscuits (bake your own using oats and/or wheat bran added to a standard biscuit recipe), or wholewheat snack bread, or dried fruit and peanuts handy - in your handbag, your tog bag when you go to gym, and at the office, so that you can nibble something when you start feeling lightheaded, tired or weepy, especially in the late afternoon.

    Eat a light snack before, and after, you do exercise to prevent yourself from getting the shakes and feeling nauseous. Sports drinks which contain complex carbohydrate polymers and release energy slowly, plus minerals such as potassium and magnesium, may also help when you are exercising, but don’t use products that are high in pure glucose as these will stimulate insulin release and make you feel ill.

    If you can’t do without alcohol, then only drink one glass of very, very dry wine with meals (not on its own), or one tot of whiskey and water just before a meal. Sweet wines and liqueurs are a no-no.

    Other factors

    Certain factors can make hypoglycaemia worse:

    • Stress - combat stress by doing deep breathing and relaxing exercises, and regular gentle exercise like going for a walk in the fresh air or doing yoga
    • Excessive exercise - never exercise so much that you induce a hypoglycaemic attack and always eat a small snack before and after an exercise session
    • Lack of sleep - get enough sleep so that you don’t increase your stress levels To combat these influences you may find that taking a complete vitamin and mineral supplement (buy a product that contains all the B vitamins, vitamins C and E, chromium, zinc, selenium, magnesium and potassium), will help to make you more relaxed and control excessive insulin production. - (Dr I.V. van Heerden, DietDoc)
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