“Falling asleep causes 1 in 5 auto crashes,” The Washington Post story headlined in 2014. The finding was based on research of 14,268 crashes from 2009-2013 in which one vehicle was towed from the scene. The reason this caught my attention is that I could relate. In years past – before I changed the foods I ate – I almost killed myself (and sometimes others) on numerous occasions – too numerous to recount – by nodding off behind the wheel.
The reason, however, was not “fatigue” or lack of sleep in the usual sense; it was low blood sugar (NOT hypoglycemia). I have been a diagnosed Type 2 diabetic for 33 years, which means I have probably been a Type 2 for 40 years or longer (since I was in my 30s). This also means I was undoubtedly a Prediabetic for years before that, going back to my 20s. Why is this relevant? I will cite a source for the “history” of the development of Type 2 diabetes later in this post, but first I’ll cite some examples of common behavior that everyone can relate to.
We’re now entering the holiday season. In our house, some adults eat almost as many Christmas cookies (and other baked goods full of sugar and butter) as the children. We give ourselves “a pass” a few times a year to indulge in the goodies we would normally pass on. We also have fresh in our memories Thanksgivings and Christmases past when we ate loads of starchy vegetables and stuffing and gravies passed “family style” around the table. It’s a wonderful tradition. And it’s equally a tradition for some overstuffed family members to “feel sleepy” after a “big meal.” Others go for a walk in the cold air to increase their peripheral circulation and stave off that sleepy feeling.
Now we all know that we (most of us, except the cooks!) are not suffering from a lack of sleep, or even a few stressful days leading up to the big meal. We are suffering from a lack of blood in the arms and legs and brain while the blood concentrates in the truncal area to process, digest and absorb all the “energy” we ate. The extremities and the brain get short shrift, as they should. The body does this autonomically. It’s natural. Animals like big cats take a long nap after devouring enough of their catch to carry them days until they are fortunate enough to make another kill.
But the “big meal” syndrome is only part of the picture. People who have, or almost imperceptibly are beginning to have, a compromised glucose metabolism – like I was in my late 20s and early 30s – are simultaneously experiencing a different physiological phenomenon. Our blood sugar routinely becomes elevated above the normal +/- 140mg/dl after a meal. People with a healthy glucose metabolism never have a blood sugar above 140mg/dl, even after a big meal. But people with a compromised glucose metabolism, who eat a lot of carbs, always go higher.
This is partly the result of the loss of the 1st insulin response in which the pancreas produces a spurt of insulin in anticipation of and at the onset of eating and partly the beginning of insulin resistance in which the destination cells for the glucose circulating in our blood – muscles, etc., – have developed resistance to the insulin that is transporting the glucose. The result is that the glucose is not “taken up” as quickly. It continues to circulate and we have “high blood sugar.” So, to help out, the pancreas makes and sends more insulin. Then, eventually, slowly, for the prediabetic or Type 2, (but not the untreated Type 2), the elevated blood sugar lowers. In fact, it crashes, and you “feel tired.”
If you’re interested, the mechanism of how someone who is genetically predisposed to having a dysfunctional glucose metabolism, and who eats the Standard American Diet (SAD) – which is very high (60%+) in carbohydrates, especially processed carbs – is explained by Ralph DeFronzo, MD, the 2008 American Diabetes Association convention keynote speaker and Banting Award winner. It is also described in my Retrospective #99, “Natural History of Type 2 Diabetes.”But for the less technically inclined, just know this: If you’ve gained weight while eating the diet recommended by the USDA’s Dietary Guidelines, and the medical establishment (AMA/AHA/ACC/ADA), and their members who have no medical school training in nutrition, then consider that it may be that your glucose metabolism is starting to unravel (become disregulated and dysfunctional). If you “feel sleepy” after a big meal, it may be more than just all your blood rushing to the stomach to deal with your excesses. It may be a sign that you need to cut back on sugars and processed starches, i.e. on all processed dietary carbohydrates. The life you save may be your own, or your family’s.
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