Dietary Management of Dysglycemia Patterns
The nutritional management of all patterns of dysglycemia must start with proper lifestyle and dietary changes. Individuals with dysglycemia must take changes to their diet; there are no exceptions to this. A person who exhibits insulin resistance cannot simply eat what they please when they please anymore, and a patient with hypoglycemia cannot continue missing meals during the day.
The first and most important change that all dysglycemic patients must perform is to eat a healthy breakfast. A healthy breakfast for dysglycemics consists of a protein-dominant meal, preferably rich in essential fatty acids and low in simple sugars. Ideal meals include eggs, salmon, chicken, vegetables, or even a high quality (low-sugar) protein shake. Fruit juice and sweets must be avoided for dysglycemics. They must eat low-glycemic snacks during the day such as nuts, seeds, vegetables, deli meats, or protein shakes. They cannot snack with sweets, fruits, juices, or smoothies. The best for dysglycemic will basically be lean meats, vegetables, and legumes.
It is difficult to calculate an exact ratio of protein to carbohydrates. Dietary changes such as the “Zone Diet” can be used as general guidelines, but the most important factor is to assess how the patient feels after they eat. Specifically, it is important to monitor symptoms of insulin surges after meals. If a person eats a meal and develops fatigue or cravings for sugar they have exceeded their carbohydrate tolerance and are exhibiting the symptoms of an insulin surge. If they continue to eat with insulin surges their potential to improve their blood sugar imbalance will be grim. Each individual has their own level of carbohydrate tolerance based on the amount of metabolic integration they possess with their blood sugar stabilizing system. Therefore, they must become observers of how many carbohydrates they are able to consume after they eat a meal. It is also important to note that insulin surges may be exacerbated by hypersensitivity reactions from food intolerances. For example, if an individual is gluten intolerant, eating even a small amount of gluten with low-glycemic meal may cause insulin surges and the symptoms of fatigue and cravings for sugar after meals. It is important for the healthcare provider to teach their dysglycemic patients how to observe the symptoms of carbohydrate intolerance and to modify their diet accordingly. The identification and removal of food intolerances is crucial in managing dysglycemic insulin surges.
Some patients will present with symptoms exceeding their carbohydrate intolerance while eating very little or no carbohydrates. For example, a patient may state that they had extreme fatigue after they ate a chicken breast with nothing else. In these cases, the healthcare provider must first rule out potential exposures to food intolerances such as a gluten-based marinate on the chicken breast with a gluten sensitive individual. If food intolerances are ruled out, then the patient needs to be supported with additional insulin receptor site co-factors. In our office, we place them on Supplementation starting with two capsules per meal, if they continue to present with symptoms of insulin surges after they eat low-glycemic meals, we will have them increase their dosage until their symptoms of fatigue and/or cravings for sugar after meals improves.
With hypoglycemics the most important dietary and lifestyle change is that they must not go long periods without eating. The three worst things a hypoglycemic can do are to skip breakfast, eat quick sugars as meals and snacks, and eat sugar before they go to bed. Most hypoglycemics will complain that they are not hungry in the morning; as a matter of fact, they complain of nausea and therefore cannot eat. It is important to understand that they are exhibiting nausea because they are in sympathetic overdrive from hypoglycemia and therefore nauseous. They must eat regardless of their appetite and nausea. They can start with small bites to engage their parasympathetic system and gradually finish their meal. After two or three days of stabilizing their blood sugar and taking themselves out of sympathetic overdrive, they will no longer wake up with nausea or loss of appetite. Hypoglycemics must eat a high quality breakfast, snack between breakfast and lunch, and lunch and dinner. They cannot snack with fruits alone, however if they want to eat a fruit after a protein rich meal they can. They must not eat sweets after they eat dinner.
The most clinically challenging factor in managing cases of dysglycemia is to have patient compliance with their diet. This is hard at times because individuals develop such intense cravings for foods sweets, carbohydrates, and foods that they have developed intolerances to. Exposure to food intolerances cause the release of catecholamine that the body begins to crave, and it is not uncommon for individuals to be sensitive to the foods they like most.
If the patient is compliant with their dietary and lifestyle requirements, and they are also taking supplements to support their blood sugar system, and they are not improving, the clinician must rule out stressors that are activating the adrenal axis. Most common stressors include: unidentified food intolerances, exposure to food intolerances (usually gastrointestinal or oral), and even possible sub-clinical autoimmune reactions such as antibody production against the beta cells or antibody production against cell signaling receptor sites or proteins.
Quick Re-Cap –
- Start day with high protein breakfast
- Do not eat quick sugars as a meal or a snack
- Do not eat sugar before bed