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    Picking Dr. G's brain one last time, fluctuating glucose levels and bipolar symptom onset
    reneegigliotti posted:
    Hi Dr. G

    I apologize for yet another question. We researchers can't help ourselves. My Dr. G and I have been theorizing where the rapid cycling phase has come from since it was new. At first we thought it might have been triggered by possibly me being menopausal. A hormone panel showed I'm not even peri-menopausal yet. I have been, however, experiencing severe episodes of glucometer documented hypoglycemia ( a common side effect to Gastric bypass surgery). Since my glucose levels fluctuate wildly , lows in the mid 30s to highs in the low 180s and this is new for me, as of roughly a year ago, I asked the question of Dr G and my surgeon, are my fluctuating glucose levels exacerbating my bipolar symptoms. My surgeon thought it was a possibility. Dr G wasn't sure. So, I did a literature search to see if there was any clinical data showing a correlation between glucose level fluctuation and bipolar symptom exacerbation. The results of the studies I reviewed were inconclusive. I find this very unsatisfying as both a researcher and a patient. I have a burning desire to be able to nail down the variable that has cost me 2 hospitalizations and work time this past year. My Dr. G is rather Zen about it. He thinks we just may not know and the best we can do is treat the episodes as they happen. I'd like a little more prophylactic control than that but he may be right. My question for you, in your research circles have you found there to be a correlation between unstable glucose readings and bipolar symptom onset? My Dr G said I should pose the research question to Western Psychiatric Institute and Clinic here in Pittsburgh. He likes the question and given how many people have untreated type ii diabetes may be a relevant one well beyond my selfish interest. Just thought I'd ask.
    Joseph F Goldberg, MD responded:
    Dear Renee,

    I'm inclined to agree with your Dr G...I know of no substantive data linking recurrent affective episodes with poor glucose control. I assume by rapid cycling you are referring to true distinct frequent episodes, and not to the concept of mood lability that is often misconstrued as rapid cycling in nontechnical circles. Moment-to-moment moodiness may well be influenced at least in part by wide sugar fluctuations, but that's different than rapid cycling.

    Dr. G.
    reneegigliotti replied to Joseph F Goldberg, MD's response:
    Yes, 3 completely different episodes within an 8 month period. Two psychotic and manic, one depressive. There were periods of resolution between each (or as he likes to call it, "normal time") Two episodes required admission one did not. OK. I just thought I'd ask. I'm collecting opinions wherever I can. I know several PIs at WPIC and I plan to ask the question of them. I'll spare you any more questions. I can be like a dog with a bone. We'll see where my query leads.
    reneegigliotti replied to reneegigliotti's response:
    As an addendum, (I had to rush to a meeting at shul), I want to thank you for your informative insights as well as your patience. I don't tend to like to post on sites designed for bipolar disorder. I find I'm not often in sync with others who share my diagnosis. Being able to post and dialogue with someone who has similar interests to mine was a treat. I'll give all your responses to my Dr G. He's accustomed to me bringing in PubMed abstracts and journal articles when we are wrestling with a topic. You've contributed to our body of knowledge. They will spark further discussion between he and I. I wish you future success in your work.


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