Reactive hypoglycaemia Information for you

Transcription

1 Reactive hypoglycaemia Infmation f you Follow us on Find us on Facebook at Visit our website: All our publications are available in other fmats

2 What is it? Reactive hypoglycaemia is a condition that results in low blood sugar levels. These low blood sugar levels may make you tired, shaky, lethargic, irritable hungry. Why does it happen? The reason why you get this medical condition is currently unkown. You may need to have a series of tests assessments, including: 1. full dietary assessment; and 2. a prolonged glucose tolerance test which will take five hours and be perfmed in hospital. Occasionally, you may also need further tests. What is the treatment? Research has shown that symptoms improve by simply changing the type of food you eat and the timing of your meals. Foods containing carbohydrate increase blood sugar levels. It is suspected that a rapid rise in the blood sugar level also increases your insulin levels. 2

3 Insulin is a hmone that is secreted from your pancreas to regulate blood sugar levels. When your blood sugar levels rise too quickly, your insulin is quickly released and rapidly drops your blood sugar levels. It is when these levels drop that you can experience feelings of hypoglycaemia (low blood sugars). Treating low blood sugars When you have feelings of hypoglycaemia it is best to treat it as such. To get your blood sugar levels up quickly you need around 15 grams (g) of quickly absbed sugar. Try taking three to five dextrose tablets 170ml of Lucozade 150ml dinary soft drink (non-diet). Once you start to feel your blood sugars coming up, you should eat a small starchy snack ( have a meal if your next meal is due). This will keep them from falling again. Preventing hypoglycaemia It is best to prevent your blood sugars from falling. You may find your blood sugars are kept me stable by having regular meals smaller meals with snacks in between. To keep your blood sugars stable during the day, you could try small carbohydrate containing snacks 3

4 every two to three hours during the day rather than relying on three main meals. As long as your overall energy (calies) intake during the day is not me than your requirements you should not gain weight. Ideal foods to snack on are carbohydrate based. This includes bread/toast, fruit, cereal bars, crackers and cheese, glass of semi-skimmed milk yoghurt. (See GI Table). Are all carbohydrates equal? The simple answer is no. Carbohydrates are traditionally described as sugars and starches. But it is better to classify them accding to the rate at which they cause the blood sugar level to rise. (See next section). Glycaemic Index (GI) Scientists have evaluated carbohydrate foods and their effect on glycaemic (blood sugar) response. Foods can be ranked accding to this effect and this ranking is known as the Glycaemic Index (GI). High GI fast carbohydrates typically found in refined foods such as, white bread and breakfast cereals, are quickly absbed by the body and 4

5 produce a surge in blood sugar levels. In contrast, low GI slow carbohydrates take longer to be absbed and raise blood sugar levels slowly. The fast carbohydrates produce an instant spike in your blood sugar level. The body may release a lot of insulin in response, causing a drop in blood sugar levels. This is what triggers hypoglycaemia symptoms and cravings f me sugar. So, choosing foods with a lower GI as part of your meals and snacks is likely to help control your blood glucose better by preventing the swings in blood sugar described above. What are the best carbohydrates to choose? All carbohydrate foods contain useful nutrients. You do not need to stop eating high GI foods but less refined carbohydrate foods are usually richer in vitamins and minerals. If you are having a higher GI food, try to combine it with other low GI foods. F example, adding milk to a cereal will lower its GI. Use the table on page six and seven to see how you could improve the glycaemic index of your diet. 5

6 Use this table to see how you could improve the Glycaemic Index of your diet. Drinks Sugar-free drinks Low GI Cereals Bread, biscuits, cakes All Bran, no added sugar muesli, pridge, oat and wheat flakes, cooked puffed wheat Heavy grain bread f example, granary/ multigrain, oat bran bread, rye bread, chapattis, oatcakes, fruit loaf, sponge cake*, banana cake*, muffins* Potatoes, rice, pasta Fruit, vegetables Pulses, grains Snacks Sugars Dairy Yams, sweet potatoes, basmati rice, noodles, most types of pasta, macaroni Apples, dried apricots, bananas, cherries, grapefruit, grapes, kiwi fruits, mango, anges, peaches (canned and fresh), pears, plums and fruit cocktail. Apple juice, ange juice, grapefruit juice, pineapple juice (small glass). Carrots, peas and sweetcn Baked beans, butter beans, black eyed beans, chick peas, haricot beans, kidney beans, lentils and soya beans. Pearl barley, buckwheat, bulgar wheat Most chocolate*, plain popcn, crisps*, peanuts* Fructose, lactose Low-fat ice-cream, milk, yoghurt 6

7 Medium GI Spts drinks, nmal fizzy drinks Special K, Shreddies, Sustain, Granola, Weetabix, Shredded wheat, Branbuds, instant pridge Fibre enriched white bread, wholemeal bread, pitta bread, crumpets, Ryvita, oatmeal biscuits, shtbread*, muesli bar* flapjack*, croissant*, digestive biscuits, tea biscuits New potatoes, boiled potatoes, long grain rice, brown rice, Arbio rice Apricots (canned), beetroot, cantaloupe melon, pineapple, papaya, squash, sultanas and raisins High GI Lucozade TM and glucose drinks Cnflakes. Cocopops, Rice Krispies, Cheerios, Crunchy nut cnflakes Brown, white bread, French stick, bagels, mning coffee biscuits, water biscuits, puffed crispbread, rice cakes, donuts Instant potato, mashed potato, jacket potato, chips*, instant rice Parsnips, pumpkin, swede, broad beans, watermelon Couscous, cnmeal, millet Tapioca Some chocolate bars* such as a Mars Bar, taco shells Sucrose Full-fat ice-cream* Jelly Babies Beans Glucose, honey * These foods contain relatively high amounts of fat. Keep these to a minimum. 7

8 Your aims are to: limit sugary foods and drinks which can make symptoms wse; take regular meals and snacks during the day including an even balance of carbohydrate intake; choose low GI carbohydrate foods me often, try a low GI food with every meal; optimal nutrition - getting the right amount of nutrients, vitamins, minerals and fluids. Your dietitian can advise you; maintain a healthy body weight; and avoid excessive caffeine intake. This includes tea, coffee, diet/standard cola drinks, stimulant drinks and chocolate. If you take caffeine at a time when your blood sugar is falling, it might make your symptoms of hypoglycaemia stronger. Symptoms can often follow a sugary caffeine containing drink. 8

9 Sample meal plan Breakfast Mning tea Lunch Afternoon tea Dinner/ evening meal Supper Pridge with semi-skimmed milk 1-2 slices wholegrain bread toasted and low fat spread Low fat/low sugar yoghurt Oatcakes with reduced fat cheese Pulse based soup such as lentil, split pea 1 wholegrain bread roll with tuna and salad ½ tin beans on 1-2 slices granary toast Baked potato and beans 2 oatmeal biscuits Fresh fruit such as an apple, ange pear Meat/chicken/fish (grilled poached) 2 servings of steamed vegetables 4-5 small new potatoes 150g cooked pasta basmati rice Jacket potato 1 slice granary toast 2 oatcakes with low fat spread 9

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12 All of our publications are available in different languages, larger print, braille (English only), audio tape another fmat of your choice. Tha gach sgrìobhainn againn rim faotainn ann an diofar chànanan, clò nas motha, Braille (Beurla a-mhàin), teip claistinn no riochd eile a tha sibh airson a thaghadh Tell us what you think... If you would like to comment on any issues raised by this document, please complete this fm and return it to: Communications Department, 28 Lister Street, University Hospital Crosshouse, Crosshouse KA2 0BB. You can also us at: comms@aaaht.scot.nhs.uk. If you provide your contact details, we will acknowledge your comments and pass them to the appropriate departments f a response. Name Address Comment Last reviewed: August 2018 Leaflet reference: MIS CC/PIL