Hypoglycemia, or Hyper glycemia, which do I have

[Manderzacc]

When I was 17, I had to take a glucose Tolerance test, and I was told from the results I went from and extreme high to an extreme low.  The doctor told me it was Hypoglycemia, and that as long as I limited my sugar I was okay, he was right, but looking at the descriptions of Hyperglycemia, I'm not sure if I heard him right.  I was just wondering which I could possibly have and since I'm 25 if I could possibly not have to deal with it in the future.  Of course I know my chances are high, because my grandmother has type 1 diabetese, and my dad has low blood sugar.  And if I get pregnant, and become diabetic through pregnancy, is there a chance I'll keep it afterwards?

[JDRF-Team-sgg]

I wonder if you have your terms mixed up. Hypoglycemia is LOW blood sugar, and many people suffer from hypoglycemic episodes after eating foods with high carbohydrate contents because the body responds too the rising glucose levels which are normal after eating foods with lots of carbs by over-producing insulin. Hyperglycemia, on the other hand, is glucose which is too high and remains too high. So it would seem by your description that you suffer from hypoglycemia instead of hyperglycemia, which, untreated, is diabetes.

Now, you are writing about the chance that you will develop diabetes if you get pregnant, and also whether you would be likely to remain diabetic afterwards. What we DO know from your glucose tolerance test, is that your pancreas tends to over-react to stimulus. This is what usually causes hypoglycemia, and hormones can make this problem worse, too. Some people who suffer from hypoglycemia seem to eventually become diabetic. Some do not. The best way to protect yourself is to watch your diet carefully, avoiding food that has a high glycemic index, in other words, food that will overly stimulate the production of insulin.

By doing this, you also protect yourself as much as is possible from the onset of diabetes. No one can predict the future. Your history of hypoglycemia would seem to indicate a greater risk of either hypoglycemia or gestational diabetes if you do get pregnant, but no one knows how your body will react. I have a sister-in-law who suffers from severe symptoms of hypoglycemia. She can react so strongly to eating one chocolate chip cookie that she can almost pass out, and she had an uneventful pregnancy with no noticeable problems of any sort. Of course, she was very careful to avoid problem foods while pregnant, so some of what happens is really up to you and what you do to protect yourself by watching diet, weight gain, and maintaining an active lifestyle in pregnancy.

I am not a physician, but am a volunteer with the Juvenile Diabetes Research Foundation (JDRF). In my contacts with many type 1 diabetics through JDRF, I have run into a few type 1 women who contracted gestational diabetes while pregnant and who remained diabetic after pregnancy. So I cannot tell you that this is not a possibility. But this situation is not the most common scenario. Most women who develop gestational diabetes do not stay diabetic after pregnancy, for the hormones that are present during pregnancy create the insulin resistance that is the root of this diabetes, and those hormones are not as plentiful after the pregnancy is over.

Gestational diabetes has much more in common with type 2 diabetes than with type 1 diabetes because both are rooted in insulin resistance. There is a good web page which explains gestational diabetes very well:
http://www.clevelandclinic.org/health/health-info/docs/2300/2354.asp?index=9012

Your grandmother may be one of those diabetics who is called a type 1 diabetic because she takes insulin, but she is msy not be a true type 1 diabetic (whose root cause is an autoimmune disorder that destroys the insulin-producing cells in the pancreas). If a patient's root problem is insulin resistance (type 2 diabetes), and oral medications do not help, the patient is then put on insulin. So then this type 2 diabetic is frequently labelled a type 1 diabetic by the physician even though this label is not really accurate. Since your father has problems with hypoglycemia, I woud venture to guess that type 2 is the family danger, for this is much more genetically passed down in famiies than type 1, which tends to spring up in apparent random situations and does not seem to be as often traced through a family tree. If this is true, then the articles about type 2 diabetes may apply to your situation.

My best advice to you is to watch your diet very carefully, and make sure that you stay in your ideal weight. Fat cells are insulin-resistant, and so carrying any extra weight increases the risk of your pancreas having to work too hard. This coud mean more hypoglycemia or eventually, type 2 diabetes. Pregnancy could make the problem temporarily worse, but the situation is really under your control since what you eat truly determines what your pancreas does in response.