By in Nutrition

Case Study: Diabetes and Insomnia

Dawn (not her real name) is a 52-year old lady who first came to see me four weeks ago. She is overweight, has been on blood pressure lowering medication for years and was diagnosed with type 2 diabetes 18 months ago. It is unusual for clients to start nutritional therapy or a weight loss programme before Christmas – it is not the easiest time to change the diet – but Dawn was stressed, tired and fed up and determined to make changes right now.

She decided to do a 1:1 zest4life Weight Loss Programme with me as the next group programme was not due to start until early in 2017. It consists of a 90-minute initial consultation, followed by a 30-minute appointment every week for six weeks. During the first session, we discussed Dawn’s goals: long-term, for the next six weeks, and for the first week. Among her long-term goals was the hope to reduce her blood sugar back to pre-diabetic levels and to get more than four hours uninterrupted sleep within six months as well as to get her neuropathy under control within three months.

When asked how often she had less than four hours sleep per night, Dawn replied: “I never get more than that, but sometimes less. Last night, for instance, I slept for only one hour.” It had been like that for at least ten years. Dawn has a full-time job, working in an office environment. It is difficult to imagine how she functioned, and of course she was struggling. She described her working day as very stressful. Dawn was tired, found it hard to concentrate and had to work long hours. No surprise then, that she felt little inclination to prepare a healthy dinner in the evenings. Instead, she would just pick at snacky foods, which she described as “rubbish”. She rarely prepared packed lunches either, relying instead of shop-bought sandwiches or salads.

I offer zest4life Weight Loss Programmes, which are based on Patrick Holford’s Low-GL Diet. zest4life Programmes are a combination of step-by-step nutrition education and health coaching, supporting clients all the way for as long as they need to get used to eating the low-GL way and to adopt it as their new way of life (rather than ‘a diet’ that has an end). Following a low-GL diet means to just monitor the quality and quantity of carbohydrate foods consumed. There is no calorie counting and no real restriction of proteins and good fats. Clients don’t feel hungry and the meals are tasty, which makes it easy to follow.

Type 2 diabetes is a metabolic condition caused by insulin resistance: The hormone insulin opens the door for sugar (glucose) from the blood stream to enter our body cells. Insulin also converts any excess sugar into fat and stores it away for a rainy day. Insulin resistance means that the cells have become ‘deaf’ to insulin. Blood glucose levels rise, and the patient will eventually be diagnosed as diabetic. Diabetes is a serious chronic disease; sufferers are at a much greater risk of heart disease and likely to experience problems such as eye, nerve and kidney damage. Indeed, Dawn already had nerve damage (neuropathy) in her feet, making them feel numb. People with neuropathy are unable to feel injury to the feet, and even a small wound can become a big problem as another effect of diabetes is poor wound healing. Most leg amputations are related to diabetes, this is how serious neuropathy can get, and Dawn was very worried.

The low-GL diet is ideal for diabetics as insulin levels rise only in response to carbohydrates. Sugar is broken down into glucose and fructose, whereas the non-sweet complex carbohydrates, e. g. from bread, pasta, rice, or potatoes are made up of chains of glucose. As they get digested, blood glucose levels rise, triggering the release of insulin. Restricting carbohydrates and choosing only those that release their glucose slowly helps keeping blood sugar levels even and limiting the release of insulin to a minimum. Over time, the cells’ insulin sensitivity can be improved that way.

During the first session of any programme, I explain how the low-GL diet works, which foods can be eaten in abundance and which should be limited or avoided. Dawn left the clinic with a list of foods she needed to get – and others to get rid off. The next morning, I received an email from her:

After I left your office I went to the supermarket and purchased a trolley full of healthy food. I have wraps and salad and almond butter for lunch. I ate healthy last night and … I slept! I had about 6 hours uninterrupted sleep. Can’t tell you how happy I am.

When Dawn first said that she was hoping to sleep for more than four hours per night within six months, I knew that it would not take that long. Balancing blood sugar usually brings results in a very short time, but even I didn’t expect an improvement this fast. Now, four weeks into the programme, I am happy to report that Dawn has slept through the night ever since that day. Her energy levels have gone up, she is able to concentrate at work, which has increased her efficiency so that she no longer needs to stay late. Dawn gets her work done during regular office hours and now has the time and energy to prepare dinner and a packed lunch every day.

Like many diabetic patients, Dawn monitors her blood sugar levels on a daily basis, and they have been in the normal range ever since she started working with me, except for one time at Christmas where she indulged in a couple of mince pies. Her blood sugar levels rose up high again then, and the neuropathy – which had been gone – came back. Now equipped with the knowledge she needed to get her blood sugar levels back under control, Dawn was back to her new healthy way of life the next day.

Dawn’s programme is still ongoing but, with her chronic insomnia resolved, she is highly motivated and embracing the low-GL diet and exercise programme wholeheartedly.

Note: Insomnia can have a multitude of possible underlying reasons: sleep hygiene issues, stress, hormonal imbalance, to name but a few, but sometimes it can be as simple as balancing blood sugar.

For more advice on insomnia and diabetes, please call The Body Matters on 01702 714968 to book an appointment with our nutritional therapist.

Make an enquiry

Melanie
Latest posts by Melanie (see all)