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Q: Hypoglycemia
I seem to be opposite to the norm regarding blood glucose problems on protease inhibitors. I am on a combination of Fortovase, Viramune and Combivir and my past two blood glucose tests were 20 and 30, respectively, well below normal. Have you seen other patients on HAART therapy who are becoming hypoglycemic as well? I seem to be the only one my doctor is aware of. Can you offer suggestions for combating the hypoglycemia? I have tried to start eating every 2-3 hours in smaller quantities, eliminated simple sugars, started protein shakes...do I need to cut back on complex carbs? What else can I do? My symptoms are shakiness, irritability, insomnia, fatigue, vision problems when sugar is low, and it is affecting my work performance. Please help.
A: Barbara J. Scott, MPH, RD responds:
We haven't seen any hypoglycemia at my clinic so far, but it sounds like you are on the right tract. However, I'd suggest that you eat even more often than every 2-3 hours; perhaps even every hour since blood sugars that low are really serious. I would also suggest that you work with your doctor to see about borrowing a home glucose monitoring machine to see how low your sugars are going. With the ability to monitor in real time, you can see how you respond to different types of foods; how often you need to eat; how you respond to exercise and other activities.
(Administrator's Note: For some basic information on sugar metabolism, see the Q&A on Sugar Metabolism.)
