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There is a certain type of hypoglycemia, or low blood sugar, that accompanies many cases of FMS and CMP. This is not the same as the fasting hypoglycemia that shows up on the glucose tolerance test. Reactive hypoglycemia usually occurs two to three hours after a high carbohydrate meal, overstimulating insulin release, which triggers an adrenalin response. This can cause symptoms such as tremors, rapid heart rate and sweating. Anxiety also stimulates adrenalin, as does caffeine and nicotine. Reactive hypoglycemia may lead to IR. After your body has turned the food you eat into glucose, and the glucose has moved though the walls of your gastrointestinal system, it can travel freely to some areas, but others are restricted. Your body needs an agent to take the glucose to the mitochondria so it can be turned into energy, just like a visitor to a power plant needs an escort. Insulin receptors open the doors of the mitochondria and allow the glucose to enter and be processed into ATP. ATP is the fuel that runs your body. When you have insulin resistance, the mitochondria no longer recognize the security pass, and the glucose is denied entrance. This could be due to changes in the shape of the insulin receptor, or to changes in the way your cells respond to insulin itself.

Insulin is also the agent that causes excess glucose to deposit as belly fat. Obesity can be one sign of insulin resistance, but thin people can have IR too. Insulin resistance may not show up on glucose tolerance tests, but you can test for serum insulin response to an oral glucose load. This will pick up IR. Insulin also controls salt and water retention, and IR may be involved in a combination of rising blood pressure and galloping cholesterol. People with IR often display clinical abnormalities other than impaired glucose tolerance, including central obesity, hypertension and abnormal coagulation (Sowers and Draznin, 1998). Reactive hypoglycemia and IR not only can perpetuate FMS and CMP, they can institute a metabolic cascade on their own, leading to, among other things, type II diabetes. These conditions, until fairly recently, were not taken as seriously as they should be by some in the medical community. This is changing. The research on these conditions is vigorous.

Hypoglycemia can produce a highly significant deterioration in performance on all of the visual information processing tasks (McCrimmon, Deary, Huntly et al. 1996). That means it can add to fibrofog. Cognitive, perceptual, and motor deficits are part of the constellation of symptoms found in various hypoglycemic conditions (Piotrowski 1997). It is logical to check people with chronic pain for signs of insulin resistance, since sleep disturbances may adversely affect glucose tolerance (Scheen, Byrne, Plat et al.1996). Even moderate exercise is associated with improved insulin sensitivity in healthy individuals (Mayer-Davis, d’Augostino Jr., Karter, 1998).

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