Polyphagia during diabetes

POLYPHAGIA is a condition characterised by excessive hunger or an increase in your appetite, and while the causes vary, Dr Samantha Nicholson, medical internist at Imani Medical Centre, Papine Plaza, says there is a strong link between polyphagia and diabetes.

“Polyphagia is a symptom of diabetes, which literally means an increased appetite or excessive hunger. The condition is usually triggered by the body’s inability to use the insulin even when the levels are high, and in response it does the next best thing, which is to demand food continuously in the hope that it will find a source it can get energy from,” Dr Nicholson said.

She explained that what happens is that in diabetic patients, who in most instances have recurrent episodes of low blood sugar, even though it may not have been low enough to cause them to faint, it sends the body urgent messages that it needs food to bring the levels up, whether the person is type one, in which case they have absolutely no insulin at all; or type two, where they have plenty of insulin but the body’s tissues do not respond to the insulin.

When this happens, Dr Nicholson says that you cannot use sugar or carbohydrates at all which are the primary sources of energy, which is needed for pretty much anything that your body wants to do. As a result, this forces the body to find alternative sources of energy.

“If you don’t have the energy to fuel all the processes that the body has to carry out, then the body will need to find an alternate source. So it will use fats and proteins in the body. What this means is that your body will break down all available fats and proteins to try to form sugar. The breakdown of these, however, will result in the loss of a lot of weight in the case of fat and the loss of muscle mass in the case of protein,” Dr Nicholson shared.

She notes that the problem doesn’t end there, as even with all the conversions done by the body, it still won’t be able to use the sugar, and so you fuel this state where you are constantly eating because your body is trying desperately to get sources. So the cycle of overeating will continue, but because you have no insulin you can’t use it.

To combat polyphagia, Dr Nicholson said that simply satisfying the hunger will not fix the issue; in fact, she notes that once there is an unexplained increase in appetite, the first thing that you must do is to consult your doctor. Polyphagia is a common symptom of uncontrolled diabetes, but she notes that it is also closely associated with hyperthyroidism, which is the medical term used to describe an overactive thyroid.

“If the results are that you are diabetic, then treatment will be determined by your type. If you are type one, it’s definitely insulin, but for type two it may be insulin, pills or both, depending on what your doctor believes that you will need. In the case of patients who are going low, the doctor would have to decrease their medication and/or use ones that give more steady control,” Dr Nicholson advised.

There are also non-medical ways in which people with diabetes can stave off polyphagia; for example, Dr Nicholson says that if it’s a case where they’re going low all the time, then they need to improve intake of complex carbs. She says this may come as a surprise to many diabetics since they tend to think that they should stop eating carbs and sugar. She says this could not be farther from the truth as they, in fact, need carbs just like everyone else, and the bulk of their calories should come from carbs.

“When choosing carbs, choose complex carbs since they are better. So sweet potato instead of white rice, yam instead of pasta, and green banana instead of bread, for example. If they just do fish and vegetables they’re going to have a problem,” Dr Nicholson advised.

In addition to carbs, she says that some supplements lower blood sugar such as cinnamon, chromium and to some extent moringa, but you should get clearance from your doctor before using these.

“In general, if the problem is type-one diabetes, it just needs to be better managed with regular blood glucose monitoring at home, and this also helps your doctor to make decisions concerning therapy, and allows the patient to actively participate,” Dr Nicholson advised.