Slim Fast Scare

This article is an Archive Favorite, originally published in October 2001.

| Jan 30, 2008

I just had a frightening experience. A severe hypoglycemic, I took my regular 5 units of R Humulin 30 minutes before lunch. Instead of my normal sandwich and milk at lunch, I drank a glass of Slim Fast with milk. I carefully read the label and figured out that it was almost identical to the sandwich in calories, carbs and sugars.

Later that afternoon I laid down for a nap and, after a couple of hours, my wife was unable to wake me. She knew it was a low, but was unable to force anything down me, as I was virtually comatose. The paramedics arrived shortly and measured my blood sugar at 22 mg/dl. They are not allowed to give an injection, so they could not administer Glucagon, but rushed me to a nearby hospital where they started me on an IV of glucose. Even then, it was over an hour before they could wake me.

I am a constant reader of Diabetes Health magazine and have never read anything that would have warned me of such an experience. My doctor thinks that Slim Fast acted very rapidly, and was gone before the insulin wore off—leaving me extremely low.

I write this as a warning to others who might not know to consider the rapidity of absorption of sugars. I am 69 years old and have been a type 1 for 30 years.

John Hooper
Coronado, California

Editor's Note: We asked nutritionist Marion Franz, MS, RD, CDE, to comment on this reader's experience.

Your letter raises some very interesting questions. There could be several factors that may have contributed to your severe hypoglycemic episode. Although there are some differences in how rapidly blood glucose levels increase after consuming different foods or beverages, the peak responses tend to be within minutes regardless of the carbohydrate eaten.

However, the duration of the glucose response also differs and may well have been less for your lunch of Slim Fast versus your usual lunch. Therefore, the peak insulin response from your Regular insulin would occur as your blood-glucose levels were dropping. This is one of the main advantages of using rapid-acting insulin, such as lispro or aspart, in place of Regular insulin. The peak insulin response correlates better with the peak glucose response and it can be taken immediately before eating.

However, other factors may have contributed to the hypoglycemia. Did you do any additional physical activity that morning? Hypoglycemia is more likely to occur after exercise than during, and especially after exercise that is sporadic. Have you had frequent episodes of hypoglycemia? People who have frequent episodes of hypoglycemia are also more susceptible to hypoglycemia in the future. You may have heard "hypoglycemia begets hypoglycemia." Individuals need to make adjustments in their insulin regimens and glucose goals to try and reduce the frequency of hypoglycemia.

It may also be that the carbohydrate content of the Slim Fast lunch was less than your usual lunch. However, even if it were less you would not expect such a severe hypoglycemic event from the difference. Of course, there is always the possibility of taking the wrong insulin dose as well. However, it sounds from your letter as if it is more likely that there was not enough glucose from the carbohydrate you ate when the Regular insulin was at its peak activity.

As you well know, it is often frustrating trying to determine exactly what is the cause of hypoglycemia (and hyperglycemia) in persons who take insulin. Good luck in the future and check with your doctor in regard to changing your insulin regimen.

Marion Franz, MS, RD, CDE
Nutrition Concepts by Franz, Inc.
Minneapolis, Minnesota

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Categories: Blood Glucose, Blood Sugar, Diabetes, Diabetes, Food, Insulin, Low Blood Sugar, Professional Issues, Type 1 Issues


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Comments

Posted by Anonymous on 31 January 2008

what was the fiber content of the Slim Fast?

Posted by Anonymous on 31 January 2008

The writer states that his SlimFast "was almost identical to the sandwich in calories, carbs and sugars". What about the milk? The carbohydrate content of milk is significant in this meal. If only matching the SlimFast to the sandwich there is a deficit of carbohydrates in the SlimFast meal.
Another important aspect of the SlimFast is that it contains 5 grams of fiber. Usually in calculating carbohydrate for food, the rule is to subtract the grams of fiber from the total carbohydrate if the fiber is five grams or more. This is because most of the carbohydrate in fiber is not absorbed as glucose in the blood stream. We call this "the five gram rule".

Posted by Anonymous on 31 January 2008

What was your blood sugar BEFORE your lunch? Taking the "usual 5 units" of Regular insulin is not appropriate, even with the same carbohydrate content of meals if your blood sugar is below or above your target range. If your blood sugar was low before the meal, you need less insulin for the same carbohydrate.
Where did you inject your insulin? Insulin that is accidently injected into a muscle is absorbed much more quickly that insulin injected into fat (where it belongs).
Did he subtract the fiber content of the Slim Fast in his carbohydrate calculations? There are 5 grams of carbohydrate in Slim Fast, and if fiber is five or more it should be subtracted from Total Carbohydrates.
This is a frustrating situation, because so many variables come into play. It may have been that several variables led to this situation. I hope that this persons spouse has since obtained a prescription and training for the use of glucagon.
Diabetes Educator from New York

Posted by Anonymous on 31 January 2008

You may be used to eating a sandwich for lunch every day and sandwiches usually have protein and fat in them. You only get 10 grams of protein in a Slim Fast drink which is equal to only 1 1/2 ounces of meat. You are probably used to eating more protein and fat in your sandwich and they also work to keep blood sugar levels up even though we only dose our insulin based on carbs...RD,CDE, 48 yrs Type 1

Posted by Anonymous on 31 January 2008

Just in case of future severe hypos I'd also suggest you get a couple glucagon kits and educate your wife on how to use glucagon. You're wife could have treated you immediately rather than delaying treatment till you get to an ED.
VA FNP

Posted by Anonymous on 29 February 2008

This story scares me, I am 13 years old & have just been diagnosed with type 1 diabeties. I haven't had a major hypo yet, only little where I am shaky but i would like to know does having diabeties mean I am going to get fat?

Posted by Anonymous on 6 November 2008

Slim-Fast is useless

Posted by Anonymous on 30 December 2008

SLIM FAST IS NOT USELESS IF USED AS DIRECTED. I HAVE SEEN GREAT RESULTS USING SLIM FAST. MY MOTHER USED SLIMFAST AND WENT FROM A SIZE 24 TO A SIZE 16 AND IT DIDN'T TAKE A WHOLE YEAR FOR HER TO GET THERE. I WOULD SUGGEST SLIMFAST TO ANYONE WHO HAS THE MOTIVATION TO GO BY 'RULES'.

Posted by Anonymous on 1 January 2009

slim fast is not useless i've had tremendous results on slim fast. I would recommend anyone to use slimfast as a means to lose weight. My mother had great results from slim fast. She was also diabetic and she went from a size 24 to a size 16 in less than a year, so I wouldn't put all the blame for this tragedy on slim fast.

Posted by Anonymous on 2 March 2009

This story is very interesting, I do not have diabetes, and I started using slim fast about 3 weeks ago. Around the same time I noticed I was starting to get waves of nausea and fuzzy thinking, just didn't feel good. I thought i was getting the flu or something. Anyways, I my dad came over and checked my blood (he has type 2 diabetes) and it was 60. I had just had a slim fast with some toast an hour prior. Anyways, I don't think slim fast agrees with my system, I've been off 3 days and feel much better.

Posted by Anonymous on 14 September 2009

Slim fast is seriously not a good diet to go by. Your body was not made to go on shakes and processed foods. This "diet" is breaking muscle also known as your lean tissues which affects your metabolism. As soon as someone gets of of this the lost fat/muscle will come back faster than they lost it. The user has no idea if they lost the fat or muscle nor do they know what they have done to their body by intaking this useless product by starving their body!


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