Carbohydrates:

The word carbohydrate--or 'carbs' for short--gets thrown around a lot not only between diabetics and medical professionals, but also weight trainers, coaches and dietary experts.  Sometimes fad diets come around saying to eliminate carbs altogether, or to mostly eat low glycemic index carbs and very little meat, or many other odd dietary restrictions.  But what are these enigmatic nutritional foods designated as carbs?  What is a carb?

Carbohydrates are one of the three primary ways the body gets energy, the other two being fats and proteins.  Fats, of course, are quite annoying for those trying to diet and lose weight, but are necessary to some degree for joint movement, insulation during winter or in cold environments, as well as helping a body to have more ease floating or swimming in general.  Proteins mostly come from meat, legumes and nuts, and are needed for muscle growth and retention, as well as providing a lot of energy with less side-effects than carbohydrates if the protein comes from lean sources.  Carbs, on the other hand, come from fiber, sugars and other sources.  Now, a human needs glucose for the regulation of almost all of the bodily organs, including the controlling organ, the brain.  Glucose is a type of sugar that the body easily absorbs but takes time to break down, providing steady energy over a long period of time.  Other sugars, sucrose, dextrose, maltose, fructose, lactose and others, are more complex and the body needs to use more energy to break them down, though fructose is easier than most others in this regard.  They do provide more energy, but as a result of the digestion process, most of that sugar gets absorbed too quickly and causes a sugar rush as well as raising the blood sugar levels.  Now, any form of carb can raise the blood sugar levels, but certain types of carbs don't raise it as much.  Fibers, being the third type of carb, are essentially filler, taking a lot longer to digest than even glucose, and sometimes are unable to be absorbed at all, leaving a fullness sensation for longer.  Sugar alcohols, on the other hand, taste sweet without being as risky as complex sugars, but on the other hand are more difficult to digest and may leave some people quite gassy if consumed in large quantities.

Total carbohydrate count is looked at for when a diabetic or dieting person wants to calculate out how many carbs a meal has.  Of course, they should also check the calories for weight loss, but maintaining a relatively stable carb dispersal will keep them feeling full for longer while still providing them the energy they need to perform daily tasks and exercise.  The total carbohydrate count, however, can be lessened when calculating for how it affects the blood sugar.  Fiber, as mentioned earlier, is harder to digest while making a person feel more full.  The amount of fiber in a meal can be cut in half and subtracted from the total carbohydrate count.  Likewise, sugar alcohols are less trouble, but should only be cut into one-third and have that subtracted from the total carbohydrate count.  The average individual should have about 225 to 675 carbs in any given day.  Exceeding or going under this amount is generally not recommended as it tends to shift one's blood sugar levels into hypoglycemia or hyperglycemia respectively.  Technically the total amount should be calculated respective to an individual's weight, height, age and gender (because yes, women do tend to have more difficulty with blood sugar levels, especially during or after pregnancy, due to hormonal shifts affecting insulin levels), however as a general rule of thumb it is best to stay somewhere between those values and look to cut the total calorie count instead of carb count if somewhere in the middle.

False Hypoglycemia:

Before you ignore this post due to thinking it is pretty much the same as the last one, lend me your ear.  Okay, didn't know it was detachable.  Was meant to be figurative, but, well, okay then.  Moving on.  False hypoglycemia is something that I've encountered for two periods in my life, both before I found out I was diabetic and after when my a1c test came back significantly higher than was expected.  Hypoglycemia is, as mentioned in the last post, when the body is receiving too few sugars in the blood stream and has a need to eat in order to balance itself once more.  The problem is, the body adapts to prolonged periods of deviation from the norm.  People who live in areas with extreme cold get used to more mild cold temperature changes much more easily than those that do not.  People who live in areas with high heat and humidity still hate both, but they get used to it much more than someone in a milder area does.  People living at extreme elevations get used to the thinner oxygen levels.  Everything is relative, yes, including your Aunt Georgina with the hairy mole on her chin despite your protestations to your parents.  The issue with false hypoglycemia is exactly that.

False hypoglycemia happens when the body thinks that it is getting too few sugars because it has been getting too many for too long.  Before I found out I was diabetic I thought I was fine and needed to eat more because my body kept wanting more.  After I was diabetic, there was a period I thought I had a good handle on it and started eating a lot more varied foods without testing my blood daily, instead just checking it once every three days.  Some foods I ate were much, much higher in carbs than they seemed though, even though they didn't taste sweet.  That's the issue with being diabetic, it isn't just 'traditional sugar' that comprises the problems with carbohydrates.  It is any form of carbohydrates, though those lower on the glycemic index are less of a problem.  As I felt I was doing fine, I was eating just a bit more as I felt hungry, not a lot and still taking my insulin, but I wasn't checking my blood daily, let alone more often.  It made sense, I mean, the blood strips are expensive and not covered by most insurance companies despite being anywhere from fifty cents to a dollar per test strip depending on the company.  Insane, isn't it?  Regardless, my blood would test fine in a few days because I wasn't typically eating as much the day before, but it was still coming up higher than before when I was testing regularly.  Not significantly enough to think there was a problem, but I should have been curious about that.  Most diabetics and even those who aren't who have blood sugar issues should though.  The issue was that my body was used to the highs more than the lows, and as a result I was consuming way more carbs on the days I wasn't testing and my blood sugars were still elevated a few days later, though not as much as the day after I tested.  My a1c read way too high and I resolved to simply trim out a small amount of carbs from my diet slowly and lower it.  I started feeling even hungrier, even getting the shakes, but I knew something was wrong since my insulin intake hadn't gone up enough to cause a crash.  So I tested my blood.

My blood sugars were still higher than they should be, on the upper threshold of normal.  I took to the internet and found out about false hypoglycemia, something which I had not even considered before despite my knowledge of individuals whose body had adapted to extremes.  My craving for carbs was merely my body crying out to be put back into what it thought was the new normal!  As I ate low glycemic index foods to take the edge off, mostly a small amount of peanuts and strawberries, I steadily fought back against the urges to eat much more.  I've brought my blood sugars back down to the level they should be, though I still have to test regularly in order to ensure I'm not going too far down (which I've been only twice since finding out I was diabetic) or that I'm too high.  Because the body adapts to resist using too much insulin, the only recourse to deal with it appropriately is diet control.  Exercise helps, but little burns enough carbs to make an impact.  Calories, yes, which is still good, but most of what is burned up through exercise is fat, with protein being broken down to rebuild itself stronger.  That's why a balance of carbs and protein is recommended when exercising, leaning more on the lean protein side than carb side.  My next a1c test won't be for a while, but armed with the knowledge of what false hypoglycemia was doing to my body and the ability to test frequently enough to ensure it didn't rear its ugly head again, I'm sure I'll do better on the next one.

Hypoglycemia:

On the opposite end of the spectrum from hyperglycemia, hypoglycemia is an insufficient amount of sugar in the bloodstream, which may also be a problem for diabetics.  In addition to the buildup of fat creating more resistance from overabundant use of insulin, too much causes the sugar levels to plummet.  This can cause dizziness, blurred vision, fainting, coma or even death.  It is just as serious as hyperglycemia and the reason most diabetics carry a few small pieces of candy or glycerin pills with them, the latter tending to be more expensive but easier to take on jobs where eating is frowned upon or outright denied despite this being discriminatory to diabetics under the 1990 ADA regulations all businesses have to follow.  Most jobs will willingly comply to the needs of the disabled diabetic once reminded of this fact, though for obvious reasons they may insist on an understandable give-and-take of simply going into the backroom of such an establishment even if not on break to be able to get a quick piece of candy or the like to raise one's blood sugar.  This is perfectly legal and something I myself have to do at my work from time to time when my blood sugar drops.

One of the reasons that blood sugar drops, especially in type I diabetics is that their body absorbs the insulin they take to counteract the carbohydrates consumed, however the quantity they calculated for is actually lower than anticipated, rather than being significantly higher as is more often the case.  Those with type II diabetes rarely have this issue as their body is producing enough insulin but it is being resisted, however it can still happen to them and those who are not diabetic if an individual does not consume enough carbs in a day, typically something more common for people who are fasting.  This may also lead to diabetes, though more rarely than prolonged hypoglycemic period fouling up their body's regulation of insulin.

Hyperglycemia:

Diabetes is a disability, a condition wherein the body struggles to regulate the absorption of sugar and proper production and absorption of insulin.  In type I diabetes, the kind I have, the body is absorbing insulin fine, but the pancreas is not producing enough to remove adequate sugar from the bloodstream, and is not releasing the sugar properly when blood sugar is low.  The balance of blood sugar is needed because too much weakens the blood cell walls and damages tissue, but too little doesn't give enough energy for daily necessity, especially brain activity.  As such, Hyperglycemia, the over-abundance of sugar in the bloodstream, is extremely dangerous.  As it damages tissue and blood, it increases the risk of stroke and heart attack, as well as seizures.

The unfortunate thing is that taking too much insulin beyond what is needed makes the body build it up as fat, which causes an increase in resistance.  Thus, one needs to not take too much insulin beyond what is needed, or it will be less effective in the future until the fat is exercised off.  As this is more difficult than just eating less, it becomes a necessity to be careful with how many carbohydrates someone with diabetes eats in a day, and if they are type I, how much insulin they use as a result.

Part of the problem many diabetics have with this is loving to eat out, or eat with friends and family, but having no idea how many carbs their meal has.  They can estimate it if they get used to making food on their own that is similar, or by asking friends and family to keep the ingredient labels and such so as to calculate it out, but restaurants typically don't have such things.  The more one tries to avoid eating out, however, the more stigma there is for not eating with friends, family and co-workers, or for turning down free food.  This, in addition to many people disliking the sight of the injections being done or being afraid of needles and becoming queasy, make some ask questions such as why they don't take a pill form, or have a pump instead that is more easily concealed and supposedly makes things easier.

There are no pill forms of insulin as that wouldn't properly integrate into the body with how it is produced, and the pumps are not only more expensive but still require the same amount of regulation as the needles themselves due to needing to know how many carbohydrates are being consumed and then inputting it into the machine for how many units to pump out.  By and large, this takes just as much time as using the needles directly, and yet when explaining this to some people, they just turn their noses at even kindly having this explained to them because someone they know or have heard of swears by the pump.  In the case of understanding after it is explained, that was just ignorance and now it has been replaced with knowledge.  In the case of those who bristle and sneer at explanations, this is stupidity.