Case XIII-2
A 75-year-old woman had documented reactive hypoglycemia; her blood glucose declined to 45 mg percent during a prior glucose tolerance test. She presented in September 1986 with recurrent conjunctivitis over the past 1-1/2 years. Three ophthalmologists prescribed local antibiotics without benefit.
This patient had been consuming large amounts of pudding and other products containing aspartame. The FBS was now 143 mg percent. The hemoglobin A, C concentration (an indicator of sustained blood glucose elevations) was 14.3 (normal 4-6). After stopping aspartame, her FBS progressively dropped to 119 mg percent within one month. Concomitantly, the hemoglobin A, C decreased to 6.1.
Case XIII-3
A 78-year-old man had been treated since 1958 for reactive hypoglycemia associated with a prior gastrectomy. He had developed an unexplained arthoropathy involving the right elbow that was not gout. (The uric acid concentration was normal.) This attack subsided within several days of conservative therapy. His FBS was found to be repeatedly elevated - 156 mg percent on 8/3/87, and 16 mg percent on 8/10/87. A midafternoon blood glucose concentration on 8/10/87, however, was only 65 mg percent. When asked about aspartame use, he stated that he recently had been consuming large amounts of diet root beer and diet cola. These were discontinued and replaced by his customary interval snacks. A repeat FBS one week later was 118 mg percent.
Case XIII-4
A 62-year-old beautician began drinking aspartame soft drinks and pre-sweetened tea to lose weight. She subsequently experienced severe abdominal pain "under the rib cage on the left side." It became so intense that she pressed both fists against the abdominal wall seeking relief. Bicarbonate of soda afforded no benefit. There also was intense nausea, severe abdominal bloat, and blood in the stools.
Two months after the onset of aspartame use, a physician found her FBS to be 435 mg percent. It had been normal (100 mg percent) one year previously. She craved sweet cider while consuming aspartame.
A diagnosis of pancreatitis was made. The patient continued to suffer these symptoms while receiving cimetidine ("Tagamet") and an antacid in the hospital. She then deduced that her problems might be related to aspartame in her "diabetic diet," and demanded it be discontinued. Thereafter, "my hurting left and my sugar was regulated."
This patient had a history of asthma, hypoglycemia attacks, and allergy to penicillin. Her children also were aspartame reactors - a daughter suffering abdominal distention and eye-ear problems, and her son aspartame-induced headaches.
B. LOSS OF DIABETES CONTROL WHILE ON INSULIN THERAPY
Twenty-three diabetic patients among the first 551 aspartame reactors had been controlled for considerable periods on diet and one or several doses of insulin daily. Subsequently, they were found to have a persistent increase of the blood glucose concentration (by home glucose monitoring) in the absence of intercurrent infection or other problems conducive to loss of control. Inquiries about aspartame revealed a moderate or large intake of diet sodas and foods. Shortly after avoiding aspartame products, their glucose concentrations generally declined, enabling a reduction in dosage of insulin.
The vicious cycle of poor diabetic control with superimposed aspartame-associated infection and resistance to insulin was described in Chapter IX-H.
The experience of couples in whom both spouses were diabetic proved impressive. Cases XIII-16 and XIII-17 illustrate such an "aspartame diet."
Comparable problems in controlling diabetes surfaced in the form of questions sent syndicated medical columnists. For example, a diabetic asked Dr. Neil Solomon if there was a relationship between starting to drink diet soft drinks and difficulty in controlling his blood sugar (The Miami Herald October 8, 1986, p. D-2).
Insulin-dependent diabetic patients may have another superimposed problem of biotechnology: the increase of side effects from genetically-engineered recombinant human insulin. They include arthritic complaints, weight gain, and reduced hypoglycemia awareness.
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