Hypoglycemia and Syncope?

[BuddyLeesWife]

Could low blood sugar and an increased sensitivity to insulin be causing episodes of syncope?

The only time my husband was actually passed out with medical personnel present his blood sugar was extremely low. I thought this was somewhat of a fluke because it was following oral surgery and he had a reaction to the narcotics given for pain. Plus, following this he had extensive cardio and neurological testing and was eventually diagnosed with NCS. Add to that the many tests his identical twin has had over the past three years to try and determine why he passes out.

This past week my husband experienced pre-syncope twice and in both cases he had not eaten for a long time - he did stay hydrated with water. After drinking some juice and eating he felt much better. So today, I did a search on hypoglycemia and syncope and the following research article on Vasovagal Syncope (aka NCS) came up.

The article was difficult to decipher - I copied the conclusion below. Do you think they could have overlooked increased insulin sensitivity during all the testing? Following are the symptoms of hypoglycemia:

Sweating

Hunger

Trembling

Anxiety

Confusion

Blurred Vision

Glucose testing is also done in emergency settings to determine if low or high glucose is contributing to symptoms such as fainting and unconsciousness.

Acute Ischemic Heart Disease

Insulin Sensitivity in Young Women With Vasovagal Syncope

from American Heart Journal

Posted 06/23/2003

Conclusion

Young women with vasovagal episodes and HUT+ show a greater sensitivity to insulin than control subjects, as assessed by the OGTT. Moreover, a propensity to reproduce the symptoms during the OGTT is also observed. Such metabolic hypersensitivity may be related to a greater susceptibility to the vasodilation effects of insulin and thus may be one of the predisposing constitutional factors leading to vasovagal episodes in response to specific stimuli.

http://www.medscape.com/viewarticle/456228?src=search

[MightyMouse]

Yes, potentially, that could be a cause. They would test via glucose tolerance testing, yes? You should probably check with your doctor.

Nina

[Michelle Sawicki]

I met with a doctor who specializes in hyperinsulinemia to discuss this article a while back. He said you would have to take at least a 3-5 hour glucose tolerance test. According to him, the standard two hour test would not show hyperinsulinemia.

I have my notes from the meeting with him typed up. If you want them I can email them to you. I was going to include them in a newsletter article, but there were a few things that weren't clear (on my tape recording), and I never did clarification when I email this doc. Most of it was clear and understandable, though.

Michelle

[Gwem]

this is going to sound like i'm a porphyria advocate, but seriously speaking...has your husband been tested for porphyria...it is extreamly difficult to diagnose, however there is a relation to blood sugar and carbohydrates...i suggest you read up on it a bit because the symptoms you listed are a lot like those of AIP (Acute Intermittent porphyria) as well. also look at the general discussion under Porphyria for the other links.

i hope this is helpful.

also, look up the medication your husband reacted too and check to see if it's on one of th "unsafes" for those with porphyria.

i know this is just a far shot but it would be helpful to rule it in or out of his diagnosis.

www.americanporphyriafoundation.com

[migraine]

Ooo, I had the glucose tolerance test and had a grandmal seizure. This was when I was undiagnosed with POTs and they were checking to see if I was hyplogycemic, epileptic, or diabetic. Niether disease won and to this day no one has a clue what the heck happend. I still have sugar in my urine at any given time for no reason. Here's a catch phrase for ya..."Unknown Etiology." It means they don't have a clue what it is or where it came from...but apparently it sounds more professional. Maybe I'll check out this Porphyria! Good luck, but be careful with this testing and be ready for anything.

[MomtoGiuliana]

This conversation is very interesting. Good lord, migraine, a grand mal seizure. That's frightening. More so that there was no explanation for it.

Just to add my experience, when I was hospitalized with my cornucopia of symptoms over a year ago, they did a 4-hour glucose tolerance test, among other things. It was awful and I felt awful, but nothing unusual happened and they found nothing unusual with my blood sugar during the test. I had had seizure-like episodes as well as hypoglycemic-like episodes that seemed like they could be related to blood sugar levels, but this test didn't show that in my case.

My endocrinologist explained to me later that many people with POTS have hypoglycemic-like episodes, and believe they are hypoglycemic, but it is actually believed that POTS patients have a lower tolerance for blood sugar changes. I am pretty sure that's what he said. So, in other words, your blood sugar goes down (not too low) but enough that the adrenalin response kicks in inappropriately, thus causing sweating, trembling, anxiety, etc.

However, I would not be surprised if there are all variants of POTS and that some POTS patients do actually have problems with inappropriately low blood sugar.