What happens to Type II diabetics who eat a ton of sugar?

I keep finding citations that explain that eating a lot of sugar doesn’t cause diabetes, but I can’t find anything that addresses any issues in people who already have diabetes. What if a type II diabetic binges on, say, candy bars? Or eats 1/2 a birthday cake. Are there health concerns for that person that are different from any other person? Is there a greater chance of going into hypoglycemic shock, for instance? Inquiring minds want to know. (And this is the place to find out.)

Hypoglycemic shock is caused by a lack of sugar, not by too much.

A person with diabetes who eats a huge load of sugar will likely have his/her blood sugar level go very high. As a result, they will probably start to pee a lot because of what’s called osmotic diuresis, i.e. when peed out, the sugar pulls water out of the body with it.

If enough sugar is peed out (but probably not from one binge), the person can get dehydrated and feel awfully thirsty and even lightheaded. But, for a one-time binge, there’s very little chance of any danger (so long as the person re-hydrates him/herself, i.e. pays attention to and sates the thirst that results).

The damage from high blood glucose happens slowly. A single binge probably won’t cause lasting damage, but allowing your glucose level to stay high causes incremental damage. Typical points of failure include eyes, kidneys, and feet. Uncontrolled diabetics are also at a higher risk for heart disease and IIRC stroke.

Interestingly, there’s not that much of a difference in the risk of heart disease between being frankly diabetic and just ‘pre-diabetic’ (or whatever you want to call it).

Sort of along the same lines, although controlling sugar levels in diabetics reduces eye disease and kidney disease, that does not seem to be the case for heart disease.

I saw an interview with a British woman who was around 50 and had had diabetes type 2 for a long time. She didn’t really control her glucose levels very well, which didn’t lead to problems initially. But at the time of the interview, she had lost both legs and an arm from infections that wouldn’t heal because of bad circulation caused by blood vessel damage from the years of high blood sugar levels. And now she had an infection in her remaining arm.

I know, but I thought that hypoglycemic shock is brought about by an overproduction of insulin as a response to a heavy sugar load. Maybe in “pre-diabetics” and those who are “frankly” diabetic (I love those terms) insulin is, by definition, not going to be produced in abundance?

But if they’re resistant to insulin, you’d suppose that even high levels won’t lower their sugar. At least not to the hypoglycemic range.

(that said, so-called reactive hypoglycemia has been reported in ‘prediabetics’, but it’s uncommon)

Thanks, doc.

Sugar doesn’t directly cause type II diabetes, but it can play a role in causing it.

You have cells in your pancreas that produce insulin. The insulin travels through your body and binds to insulin receptors in your cells. If you are overweight (maybe because you’ve eaten a lot of sugary things and haven’t watched your total calorie intake) then the fat can clog up the insulin receptors. Now the cells in your pancreas have to work harder to regulate your blood sugar, and eventually some of them die off from being overworked. These cells aren’t regenerated. Once they die off, they are gone for good. Lose too many of them, and they won’t be able to regulate your blood sugar properly any more. Now you have type II diabetes. I’m oversimplifying a bit, but that’s the basic idea.

So, what happens if you go nuts and eat half a birthday cake? Your body can’t regulate its sugar levels properly any more, so the amount of sugar in your blood rises and stays high for several hours. Eat too much sugar and you’ll start to pee it out. You might faint or get dehydrated. Nothing super-bad is going to happen though.

So, eating half of a birthday cake as a one-time thing, no biggie.

Consistently eating too much sugar though (or carbs that get converted directly into sugar) will cause a LOT of problems. The cells in your pancreas are already damaged, and continuing to strain and overwork them will kill off even more of them. Eventually, even losing weight and watching what you eat won’t be enough. There will be so much damage to your pancreas that you’ll need to take insulin to regulate your blood sugar.

The high sugar levels also cause damage to various parts of your body. It attacks your nerve cells. You can lose feeling in your feet and are at risk for injuring yourself and not realizing it. Your circulatory system doesn’t regulate itself properly (your blood vessels normally expand and contract to handle temperature changes, but those rely on signals from your nerves and don’t work properly when those nerves are damaged). You end up with poor circulation, which is bad in a whole bunch of ways. Wounds take a long time to heal. You can go blind. Lots of bad stuff.

What if you have hypoglycemia? I’ve always had sugar crashes but they’re much worse now that I’m older. If I have a huge English breakfast (eggs, toast, bagel, ham, potatoes.beans,juice, tea) and it fills me up for a long time and I don’t get sleepy. If I have a breakfast sandwich with peanut butter crackers on the side I’m seriously tired in 15-30 minutes.

I’m 70, and have had Type 2 for about 25 years. I suffer from chronic heart damage, peripheral vascular disease, diabetic neuropathy, and my eyesight is precarious. I have to inject myself with two types of insulin, three times a day.

If I suddenly ate half a cake . . . I shudder at the thought of even attempting this. I have to wonder how many pieces of cake I ate in the past, that exacerbated my condition. I once mentioned to my endocrinologist that just one piece of cake won’t kill me. He replied that, worse, it’ll maim me.

It’s scary, how a hypothetical future eventually becomes reality.

Reported.

Those two are very different in both size and composition. The English breakfast has a TON of proteins and the carbs are relatively slow compared with those of the itty bitty version, which also has a load of fat and maaaaaybe one protein which managed to sneak in (yeah, I’m exaggerating, but not by much). Quick carbs satiate quickly but for a short time.

Try a breakfast that’s mostly protein but not huge, it should hold you up a lot better than the sandwich and crackers.

My cousin is 55 and a nurse. She knew she has type 2 diabetes and continued to drink Coca Cola like she always had in the past (several a day). She now is on kidney dialysis and is losing her eyesight. Many family members are unsympathetic to her condition (behind her back) because as a nurse she should have known better that to drink high fructose corn syrup like she was still a teenager.

Maillard reaction
Role of the Maillard reaction in diabetes mellitus and diseases of aging.

So is the hemoglobin A1C testing as good as anything to monitor the levels of sugar to insure that damage doesn’t ensue?

A1C measures that there has been high sugar for a long time.

The usual “stick” measurements are for values in a given moment in time. They can show high sugar, low sugar, in-between sugar…

My doctor wants me to monitor my blood sugar two ways. First is through regular testing with a glucose meter. This is the one where you get to stab yourself and put the test strip in the machine. You want to measure your blood sugar an hour or two after eating to insure that your sugar levels are dropping back to normal like they should.

The second is periodic A1C tests. This is more of a long term measurement. If your blood sugar is consistently high, it will show up on an A1C test.

If your glucose meter tests are all where they should be (somewhere close to 95 mg/dl two hours after eating) then it’s a safe bet that your A1C is going to come back normal as well.

A description of Type II that I heard was that your body floats in sugar so long, your body - fat cells? - stop “listening” to the insulin and forget how to process sugar properly.

This was an interview with some scientists who were working on diabetes prevention with the 30-second workout. The interview was fairly serious, but the “30-second workout” tag line was used for a bit of humor. The theory was by having the subject exercise full blast on a stationary bike for 30 seconds, they would exhaust the ATP and glucose in the thighs (largest muscles in the body). The muscles would need a re-charge, and by ensuring that the process happens regularly - once or twice a week - this would prevent the body’s processes from “forgetting” how to process glucose.