My doctor told me I have reactive hypoglycemia.

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Recently, my doctor told me I have a condition known as reactive hypoglycemia, which he explained could be a precursor of diabetes. I know I have to change the way I eat to stabilize my blood sugar, but I don’t know what to eat to both lose weight and treat these sudden drops of blood sugar. Right now I follow a diet that is 17 – 25% fat, I have given up fruits because they seem to cause a “urinary tract infection” type sensation. I rarely eat sugar or sugar products. I like vegetables, basically raw (and of course the ones I like are high in sugar, i.e. corn, carrots, onions, peas)!

He told me to eat more often, but not MORE .. since I have suffered from compulsive overeating most of my life, I am scared to open that “can of worms” again.

Can you give me any help?

At first, this may sound like the opposite of diabetes because your body makes too much insulin. Hypoglycemia is generally considered a pre-diabetic condition. It can be diagnosed by symptoms, but more accurately with a 4-hour fasting glucose tolerance test. The good news is simply eating six small meals and avoiding simple sugars can reverse your symptoms.

Reactive hypoglycemia is an overproduction of insulin in response to eating simple sugars. Some persons who experience hypoglycemia don’t eat regular meals and may overeat simple sugars. I have worked with hypoglycemia patients who have a can of soda and a candy bar for lunch. The pancreas over responds by producing too much insulin which causes a rapid and sharp decrease in blood sugar, usually falling below fasting blood sugar levels (normal fasting blood glucose 70 – 90 milligrams per deciliter) 2 hours after the meal. If your blood sugar falls below 45 milligrams per deciliter, you may experience symptoms such as weakness, sweating, shaking or a headache.

Unlike a diabetic who eats something sweet when having an insulin reaction, you should eat protein. Try eating cheese, luncheon meat or a hot dog with or without the bun. If you were to eat sweets to get your blood sugar back up, you would experience hypoglycemia again within another 2 hours or less.

Your blood sugars can be evened out by eating six small meals per day. Usually, the carbohydrate is restricted to 50% of total calories or about 200 grams per day. The protein is usually higher around 20% of total calories because protein does not increase blood sugar. Fat intake is recommended at 30% of total calories, not as low as your diet at 17 25%. In fact, when the fat content of a person’s diet goes much lower than 25%, it can negatively affect satiety and lead to binge eating.

Your eating plan should include increased complex carbohydrates like starch and fiber (corn, peas, carrots, and onions are OK in normal servings) and decreased simple sugars like candy, soda, and desserts. Caffeine is sometimes restricted because it can produce the same symptoms as hypoglycemia. Also, you should avoid alcohol, which can lower blood sugar. If you were overweight, weight loss would improve your body’s ability to use insulin because fat increases your resistance to insulin. What that means is that your body may need more insulin to get past the cell membrane and metabolize glucose to energy.

First, work on leveling out your blood sugars, then reduce the number of calories you eat to no less than 1200 per day.

Sounds like you could use some individual nutrition counseling. Call your doctor and ask to see a dietitian.

Also, fruit does not usually cause a “urinary tract infection” type sensation. A urinary tract infection is usually described by patients as a burning sensation when urinating. I would encourage you to discuss this with your doctor.