Achalasia and Diabetes

[Guest guest]

Does anyone else deal with achalasia and disbetes at the same time? I have been

having a very difficult time keeping blood sugers under control. Let me know any

advice would be helpful. I go in on Friday the 4th for my surgery. I'll let

everyone know how it goes.

[Guest guest]

Tough place to be in! I'm not, but I used to be very pre-diabetic. Atkins

saved ma butt. I'm VERY carb allergic, and 10g a day is usually about all I can

handle. I live on eggs and chicken mostly. Gave up the crackers a month after

the Heller. Have been wheat free for about two months, and that helps too.

Fasting blood sugar is down from 110 a couple of years ago to 94 last week, so I

don't do testing.

This is a good resource,

http://blog.trackyourplaque.com/2008/04/low-carb-eating-for-diabetes.html as is

this: http://www.wheatbellyblog.com/2012/01/diabeti-illuminati/ -- Same doctor,

two different hats, lol! He's a cardiologist who noticed that the things he was

recommending for his heart patients were working for those who were also

diabetic. . . .

Good journey.

>

> Does anyone else deal with achalasia and disbetes at the same time? I have

been having a very difficult time keeping blood sugers under control. Let me

know any advice would be helpful. I go in on Friday the 4th for my surgery. I'll

let everyone know how it goes.

>

[Guest guest]

wrote:

>

> Does anyone else deal with achalasia and disbetes at the same time? I

> have been having a very difficult time keeping blood sugers under

> control. ...

>

There isn't much in the literature about the combination or relation of

diabetes and achalasia. There are some things though. Achalasia can be

secondary to diabetes due to diabetic neuropathy of the nerves

controlling the LES. Type 1 diabetes is, according to one study, over 5

times as common among people with achalasia than the general population.

Because diabetes can cause more frequent urination it can lead to

problems staying hydrated. High blood sugar is toxic to nerves so the

combination of diabetes and whatever destroys nerves in primary

achalasia may be a double attack on the esophageal nerves. Diabetic

neuropathy can complicate achalasia in other ways. It can cause

gastroparesis, slow emptying of the stomach, and dysfunction of the

sphincter between the stomach and the intestines, among other GI problems.

With achalasia, and even worse when combined with other GI problems from

diabetes, food does not move at the expected rate or even a consistent

rate. It could differ considerably from one meal to another. Even

sleeping or reclining could add to the time food takes to be digested.

That means you don't know when the blood glucose peak is going to happen

or how fast it will progress once it starts, broad or sharp. If you eat

in the evening and the food does not make it to the stomach before going

to sleep, it may stay there until morning and then create higher than

expected glucose readings. That can also be a problem for the 12 hr

fasting test. In that case the A1C is going to be more reliable. Also,

if you take insulin in expectation of a glucose rise after eating and

the the food stays in the esophagus the insulin may cause a glucose low.

Because achalasia and gastroparesis can be better or worse from day to

day or even meal to meal it is hard to learn what the pattern is.

The only advise I have is to take a lot of notes of how the achalasia

and other problems seem to be before and during a meal and what effect

the meal had on glucose. Unlike others with diabetes who may get enough

information from just the meal, or meal and activity level, you may need

to keep a record of the state of the achalasia and other problems to

combine with the other data to adjust your doses from meal to meal.

Good luck. I would be interested in knowing if you find something that

helps.

notan