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Diabetes

Sleepy after eating good breakfast

01/15/2008

Question:

I just read your response about one person with this. I get up and feel fine, but about 1 hour after I eat, I get overwhelming fatigue and sleepiness that I have to lie down. I eat a meal of frosted mini shredded wheat every morning. What am I doing wrong? I have a family history of diabetes, and my fasting BS is almost always exactly 120. It does run higher when not fasting. I also have RA and fibromyalgia, but this is more sleepiness than fibromyalgia fatigue. Thank YOU so much.

Answer:

I talked your situation over with one of my colleagues who is very knowledgeable about hormones from the intestine and how they interact in the regulation of blood sugar control, and we did not know of any such mechanisms like those that could explain what you describe in terms of sleepiness in relation to meals.  Certainly, that can be a fairly common phenomenon - so really what we are saying is that we just can't provide a very good or satisfying explanation for it.

We both however separately reached the same conclusion that the numbers you describe represent a significant risk that you either might have diabetes now or might be at risk for developing it in the future.  There is a classification for fasting glucose results with respect to diabetes:  Normal is 100 mg/dl or less, diabetes is 126 mg/dl or greater and any value in between fits into the category of impaired fasting glucose, which represents a high risk for developing diabetes.  The blood sugar 2 hours after drinking a standard amount of glucose (oral glucose tolerance test) is normal if 140 mg/dl or less, diabetes if 200 or more and impaired glucose tolerance at any value in between.  These are based on laboratory glucoses.  Fingerstick glucoses are not precise enough to use for making a diagnosis of diabetes.  The results mentioned are close enough that perhaps this more formal testing should be done.  There are some advantages to a person knowing they have diabetes if that is the case in that they can be directed into treatment.  There are some disadvantages include that being labelled with the diagnosis of diabetes can limit some options.  Therefore, sometimes I advise people that are close to the borderline to regard themselves as if they have diabetes and make the lifestyle changes they would make if they have diabetes whether in fact they undergo the testing to prove it one way or not.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati