Disorders of Blood Sugar

Roberto Victor Illa, M.D.



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Several endocrine conditions (not just hypothyroidism) will cause you to gain weight or not be able to lose.

Brief periods (approximately a minute) of hypoglycemia will trigger increased appetite and not be sensed by you. 50% of these occur during sleep. More than 70% of these episodes can be recorded using the Dexcom continuous glucose meter. (see dexcom.com website). You do not have to have "diabetes" to suffer these episodes.

These generally fall into three categories:

1. Hypothalamic (called "spontaneous" in Europe) Hypoglycemia.

2. Nesidioblastosis (bursts of high insulin released from the pancreas followed by periods of normal insulin release. First described in 1938.)

3. Solid tumors of the pancreas or retroperitoneum. The most common is "insulinoma", which is not a cancer. This group is very rare.

These conditions are confused with "diabetes" or "pre-diabetes" by practitioners who are unfamiliar with them. Patients are routinely placed on metformin, insulin or sulfonylurea drugs which do not help their condition and are associated with many side effects; most prominently fatigue, weight gain, memory loss and rarely seizures and death. (See 2008 New England Journal of Medicine ACCORD trial results,my textbook and YouTube presentations). Additionally pancreatic cancer (associated with weight loss) will first cause depression and abnormalities in blood sugar homeostasis on the Dexcom continuous glucose meter, before any other signs and symptoms appear. The Dexcom continuous glucose meter is, therefore, a great screening and monitoring tool in a variety of conditions besides Type 1 and Type 2 diabetes.