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As a child, I was diagnosed with hypoglycemia. I had the typical symptoms; I was tired, shaky, irritable, and would have brain fog. My parents were told to keep me away from sweets and for years, I didn’t have candy. I remember even having pancakes with syrup would cause severe nausea and I’d have to lay down. I never really understood that if I had low blood sugar (hypoglycemia), why would putting sugar in the system bother me? It would seem that would be the way to fix it.

As usual, the answer to this is much more nuanced as it is the human body. It’s not just a simple input/output machine. Part of the answer is due to homeostasis, and the other part has to do with the endocrine system.

I’ll give an analogy for the way homeostasis works. Imagine driving on a highway on a cold night, and you hit a patch of black ice. You start to fishtail out of control and then overcorrect the steering wheel to now fishtail in the opposite direction, but to a lesser extent. You tug the wheel back and forth until you finally straighten back out. This is how our bodies react to rapid swings in blood chemistry.

When you eat a meal high in carbs, the endocrine system reacts by overcorrecting, for individuals that are carb sensitive. Insulin is secreted by the pancreas and wipes out the sugar by ushering it into muscle cells and the liver. Now the body is in a hypoglycemic state.

The traditional medical answer is usually to add more sugar back into the system, but that is addressing the symptom rather than the root cause. Why not just stop eating high carb meals? The carbs are causing the spike in insulin and subsequent drop in blood sugar. Carbs are non-essential to the human diet. We are able to produce glucose in our bodies via the liver in a process called gluconeogenesis.

One of the issues that arises in type 2 diabetics is insulin resistance. All cells have receptors for insulin, and when someone has a diet of high carbs over long periods of time, the receptors for insulin become resistant, and the cells don’t allow glucose in. Insulin has many functions, one of which is to suppress gluconeogenesis. So when the liver becomes insulin resistant, gluconeogenesis is not suppressed (Hatting et al., 2017). So now the liver is producing glucose, and more glucose is flooding the body through the diet. Now we are in a hyperglycemic state, and this is where much of the damage of sugars occur, furthering the disease process of diabetes.

Glucagon is another player in this situation. It has the opposite effect of insulin; it draws sugars out of cells back into the bloodstream. Why not increase glucagon in the diet when we are in a hypoglycemic state? Turns out that eating a moderate amount of protein can stimulate glucagon secretion (Schmid et al., 1989).

In short, a diet low in carbs and high in proteins and fats will keep blood sugars at normoglycemic levels, and can prevent the development of metabolic dysfunction.

References:

Hatting, M., Tavares, C. D., Sharabi, K., Rines, A. K., & Puigserver, P. (2017). Insulin regulation of gluconeogenesis. Annals of the New York Academy of Sciences, 1411(1), 21-35. doi:10.1111/nyas.13435

Schmid, R., Schusdziarra, V., Schulte-Frohlinde, E., Maier, V., & Classen, M. (1989). Role of amino acids in stimulation of POSTPRANDIAL INSULIN, Glucagon, and Pancreatic POLYPEPTIDE in humans. Pancreas, 4(3), 305-314. doi:10.1097/00006676-198906000-00006

Why People with Hypoglycemia Should Eat a Low Carb Diet