Driving a Wedge . . .

[diamondnostril]

Hi all . . .

I just wondered what are forum members' responses to the following published medical case?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2495396/

There was a link to it from this Blog post regarding Ketosis, on Peter Attia's Eating Academy site:

http://eatingacademy.com/nutrition/ketosis-advantaged-or-misunderstood-state-part-i

What caught my eye in this case was this:
Blood glucose concentrations around 30 mg/100 ml [1.7mmol/l] were recorded consistently during the last 8 months, although the patient was ambulant and attending as an out-patient.

One interpretation of this case is that our concept of the "normal" blood-sugar level is not correct, and that non-Diabetic humans who do not eat the modern carb- and protein- loaded diet may naturally have levels that are lower.

Another interpretation is that this non-Diabetic patient is suffering from a form of Hypo Unawareness, because his levels (presumably due to some other problem in his biology) have been running too low.

I've been thinking about this case in relation to the DVLA regulations in the UK.

If you side with the first interpretation, it seems somehow unfair that the DVLA and Doctors are making judgements on peoples' fitness to drive, based on an inaccurate understanding of what is a "normal" blood-sugar level for humans.

If you side with the second interpetation, it seems somehow unfair that a Diabetic suffering from Hypo Unawareness must forfeit his/her driving licence, whereas a non-Diabetic suffering the exact same problem is permitted to keep their licence.

Or are neither of my interpretations correct? Would welcome the views of other members.

Regards
Antony

 

[smidge]

My consultant told me in December that a true hypo is considered anything below 2.2mmol (he might have said 2.1 actually but i can't quite remember). Anyway, the figure of 4mmol was only given to diabetics as a margin to keep them safe. As the insulins have become better and testing equipment is more readily-available, that safe margin has been reduced and 3.5mmol is now the level most diabetics are told (i.e. on DAFNE courses). Either way, the figures used by DVLA are completely unrelated to any medical evidence of 'safe' limits for driving - all non-diabetics will be driving with their BGs lower than we are allowed to. 1.7mmol is definitely a medically-defined hypo though.

Smidge

 

[tim2000s]

This raises the same question that has been aired, but questioned a few times. If you are fully keto-adapted, are you truly "hypo" in the sense that your brain and body function incorrectly when your glucose level is below 3.5 mmol/l? Or at this level do you still function normally? Have there been any tests to disprove this hypothesis?

 

[noblehead]

Probably many of us have functioned normally when below 3.5mmol but does it make us safe on the roads? Personally the thought of anyone driving on the roads in the 1's, 2's and even 3's sends a shiver down my spine.

 

[jack412]

I would shiver the same for a t2 in the 20's having a false hypo at 6

 

[CollieBoy]

Lets run this thread on a"what if ? basis"rather than a "knee jerk basis"

 

[diamondnostril]

This raises the same question that has been aired, but questioned a few times. If you are fully keto-adapted, are you truly "hypo" in the sense that your brain and body function incorrectly when your glucose level is below 3.5 mmol/l? Or at this level do you still function normally? Have there been any tests to disprove this hypothesis?

Here are 4 studies that I know of. The first involves mice, the second and third and fourth involve human participants . . .

http://www.ncbi.nlm.nih.gov/pubmed/720768
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC332976/pdf/jcinvest00637-0253.pdf
http://www.coconutketones.com/pdfs/CahillGF_CerebMetab_1980_p234-242[1].pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC332976/

Maybe there are more that I did not find yet . . .

Regards,
Antony

(edited to add 1 extra study that I discovered)