Gastroparesis Casts Type-1 Diabetic Into A Night of Hypoglyceamic Hell

Last night, this type-1 diabetic barely had any sleep. My blood sugar was frozen at 2.4 mmol/L (43 mg/dL) from 8pm onward. I was trapped in “hypoglyceamic hell.” Taking three glucose tablets couldn’t raise me one millimol. Gastroparesis (delayed stomach emptying) had struck again!

Now, by “hell” I don’t mean I was on the verge of suicide. Nonetheless, spending 12 hours at 2.4 mmol/L is very unpleasant. The brain feels confused. The body exhuasted. And all you want to do is eat; except eating won’t help when you’re stomaching isn’t emptying.

Why A Big Dinner Didn’t Raise My Blood Sugar

At about 6pm I had dinner. Before dinner my blood sugar was on target (more or less): 6.0 mmol/L (108 mg/dl). Following Dr. Bernstein’s low-carb diabetic diet (from his book Diabetes Solution) I sat down to a meal containing only 12 grams of carbohydrates. 12 grams of glucose will raise my blood sugar about 3.6 mmol/L (65 mg/dL). To counter such a rise, I  took 1.3 units of Humalog (insulin lispro) before the meal.

Two hours later, my blood sugar dropped exactly 3.6 mmol/L (6g mg/dL). It went from from 6.0 mmol/L (108 mg/dl) to 2.4 mmol/L (43 mg/dL).

Obviously the food I ate had not found its way into my bloodstream. The insulin, however, was doing its job with mathematical precision.

“Why is this happening?” I asked myself. I hadn’t broken any of the cardinal laws a type-1 diabetic most follow who has gastroparesis (as outlined in chapter 22 of Diabetes Solution). I didn’t eat any raw food. I drank plenty of water with my meal. I had chewed it so thoroughly it took over 40 minutes to get the meal down.

After some brainstorming I concluded the transgression took place before the meal. In order to correct high blood sugars before meals, I avoid snacks between meals. Well, at least snacks containing carbohydrates…

I was having some cravings so my husband John generously made me a snack of coconut oil and cinnamon. Coconut oil won’t raise your blood sugar at all. It seemed a harmless indulgence. To make it even more delightful, John froze the coconut oil, so that it looked like fudge. It may have also acted like sticky fudge with my pylorus valve (the splincter which connects the stomach to the small intestine where nutrients are absorbed). I may of had a big chunk of coconut oil blocking up the pylorus; in the same way grease can block up your kitchen sink drain.

Glucose Tabs Prove Useless Against Gastroparesis

Of course, because I was low two hours after dinner I tried taking 3 glucose tablets (containg 12g of sugar) which would normally bring me back to 6.0 mmol/L (108 mg/dL). Of course, since they couldn’t get past the dinner still sitting in the stomach, they proved useless.

The next morning, however, when the food (plus the glucose tablets) finally dumped into my small intestine I had a new challenge. My blood sugar went from 2.4 mmol/L (43 mg/dL) to 9.6 mmol/L (172 mg/dL). The dinner of 12g of carbohydrates brought me back up to 6.0 mmol/L (108 mg/dL). Then those three glucose tablets pushed me up another 3.6 mmol/L (64 mg/dL).

High-Fat Meals May Actually Help Gastroparesis

Of course, mixing or cooking plenty of coconut oil (or any other fat) into a low-carb diabetic meal doesn’t seem to cause any harm. I’ll have up to five tablespoons of butter, coconut oil or olive oil with each meal and my stomach empties within 45-60 minutes.

High-fat meals may even  help food slip through the pylorus valve; encouraging stomach emptying through lubrication. Once the food has entered the small intestine, fat actually helps slow the release of sugar into the bloodstream; and is quite useful if you rely on insulin injections. The slower release of carbohydrates avoids a temporary spike in blood sugar while the insulin catches up.

And, of course, if I had eaten a high-carb meal and suffered gastroparesis the results could have been deadly. Even a moderate 30g meal would have required 3.6 units of insulin — which would have sent me plummeting 10.8 mmol/L (194 mg/dL). Such a drop would require drastic intervention to keep me from dying from hypoglyceamia.

So high-fat, low-carb is probably harmless, even if you’re a type-1 diabetic with gastroparesis like myself. The key thing, though, is to mix  the fat with a full meal and a glass or two of water. In otherwords, no snacking on frozen chunks of coconut oil until the gastroparesis heals. Otherwise, the pylorus valve may get clogged and you could be cast into a night of “hypoglyceamic hell.”

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