Q&A With Dr. Richard Bernstein

Dr, Richard K. Bernstein

| Oct 7, 2013

Is there anything you can do to treat hypoglycemia unawareness?

Answer: Yes, very simple: You minimize the episodes of hypoglycemia.

There are two possible causes or likely causes for hypoglycemic unawareness. One is autonomic neuropathy, which maintaining normal blood sugars for a long period of time can reverse.

The other is frequent hypoglycemic episodes. Whenever you're hypoglycemic, hopefully, you're making epinephrine which is one of the mediators that raises blood sugar and also gives you the hypoglycemic tremors, and dry mouth, and so on.

However, the epinephrine down regulates* its own receptors, If you have hypoglycemia often enough, you'll have down regulated the epinephrine receptors and they will no longer produce the signals--the tremors, racing heart and so on--that would normally warn you of hypoglycemia.

So the trick is to cut back on the episodes.

(* Down regulation is when the number of drug or chemical receptors on a cell surface decrease, usually from long-term exposure to the agents acting upon them.)

What's your recommendation for the best colon preparation that will not affect blood sugars to use before a colonoscopy?

Answer: There are two problems here. One is what you eat during the previous 24 hours. The other is what colon prep solution you use.

What you eat should be very low in carbohydrates. They usually tell you to intake liquids, such as Jello and soup, and similar foods. What I tell my patients is you want a zero-carbohydrate soup like chicken broth. If they tell you to eat Jello, it should be sugar-free and conain no maltodextrin.

Also, the prep they give you should not be sweetened. How do you check the prep? You can look at the contents in the package insert. You don't want a prep that has sorbitol in it because that's a sugar, and will raise blood sugar. You also don't want a prep that has any known sugar in it, such as sucrose, dextrose, or glucose.

Richard K. Bernstein, MD is one of the most knowledgeable, committed, and successful pioneers in the field of diabetes today. He invented blood sugar self-monitoring and basal/bolus insulin dosing when he was an engineer.

Dr. Bernstein is Director Emeritus of the Peripheral Vascular Disease Clinic of the Albert Einstein College of Medicine in Bronx, NY. His private medical practice in Mamaroneck NY specializes in treating diabetes and obesity.

He is a physician, research scientist, thriving type 1 for 67 years, and best-selling author of nine diabetes books including Diabetes Solution, The Diabetes Diet and several e-books. This link diabetes-book.com will give you more information about his publications. To sign up for his free monthly tele-seminars, visit askdrbernstein.net

Click Here To View Or Post Comments

Categories: Autonomic Neuropathy, Colonoscopy, Down Regulation, Epinephrine, Epinephrine Receptors, Hypoglycemic Unawareness


Take the Diabetes Health Pump Survey
See What's Inside
Read this FREE issue now
For healthcare professionals only

You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View

See if you qualify for our free healthcare professional magazines. Click here to start your application for Pre-Diabetes Health, Diabetes Health Pharmacist and Diabetes Health Professional.

Learn More About the Professional Subscription

Free Diabetes Health e-Newsletter

Latest
Popular
Top Rated

Latest Epinephrine Receptors Articles

Print | Email | Share | Comments (0)

You May Also Be Interested In...


Click Here To View Or Post Comments

Comments 0 comments - Oct 7, 2013

©1991-2014 Diabetes Health | Home | Privacy | Press | Advertising | Help | Contact Us | Donate | Sitemap

Diabetes Health Medical Disclaimer

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. Opinions expressed here are the opinions of writers, contributors, and commentators, and are not necessarily those of Diabetes Health. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website.