Hypo and aggression???

[kyrani99]

Hi to all,
I've been reading some research papers that claim type 2 diabetes hypos are tied to aggression. I fully appreciate that someone can be irritable and may even lose their temper in a hypo but I find it hard to believe that someone experiencing a hypo can be aggressive. After all to be aggressive you'd need at least normal if not high blood sugars. What do other people think?
kyrani

 

[Dillinger]

When your blood sugar drops you release adrenaline; hence the shaking, sweating and aggression associated with hypos.

The hypo/adrenaline release causes the aggression not the other way around by the way.

Type 2 hypos would normally self correct unless you are taking insulin as your pancreas although impaired would still respond.

Best

Dillinger

 

[Charles Robin]

About 12 years ago I had a big hypo, and believed we were in the middle of a nuclear war. I also believed my mother was not helping me to escape. I started screaming at her that if she did not save me I would trash the house and smash everything in sight. So hypos definitely can cause aggression!

 

[Flowerpot]

From my experience aggression occurs at very low blood glucose levels. Adrenalin, the fight or flight hormone ,is released by the body when blood sugar drops below normal levels and causes the symptoms of hypoglycaemia such as sweating, shaking etc.

If the brain continues to be starved of fuel due to glucose dropping to very low levels then confusion, aggression and violence can be symptoms accompanied by no recollection of your actions. It certainly isn't a conscious decision to become aggressive when experiencing a severe hypo and it is frightening to hear how your behaviour has changed in this situation.

 

[Nicko2K]

I am type 1 but found that before i was diagnosed, when my BG levels were running really high, i had an uncontrollable temper, would even say rage, got to the point where i was arguing with random people on the street :-( Thought i had a mental problem until later when i got my levels under control, it all then corrected. Also find when i run low for extended periods i can become a little snappy at times. But nothing like pre-diagnosis.

Type 1 Diabetic: (Novorapid/Levemir) Diagnosed 2014: Extremely handsome: Always smiling

 

[Spiker]

The researcher doing these hypo/aggression papers is an idiot, who should receive a Statement of the Obvious award. The link between hypos and aggression has been known for the best part of a hundred years, and now one guy is making a cottage industry out of it. Making some quite tenuous claims about it and seemingly ignoring the well known basis in the adrenalin response. Some scientists should just go get a proper job instead.

 

[Jaylee]

Yep, they can put out exceptional bursts of energy during hypoglycaemia..

I was attacked by one once.. He was sweating, lilting, shaking & moaning like an American TV evangelist.
Then he changed, jumped the counter & grabbed my throat..
I fought the guy off. He came back a while later, humbled & apologised for his actions..

 

[Robinredbreast]

I'm not aggressive with a hypo, just feel a little irritable and fed up or can go the other way and start blubbering. Had other experiences ,where I freaked out doing the weekly shop, after work in Morrisons with my then 8 year old, ( I felt so bad afterwards) but we got through it Does it happen more in males than females, as I did hear or read about a man who had to restrained because he was attacking violently ?

 

[Jaylee]

I'm actually quite passive during a hypo. & can usually get away with treating without the other party even knowing...

I passed a testing on one only the other night while my wife & I were sorting out time away corresponding our diaries..
Date checking was like astrophysics & my ipad diary layout looked like a bright white rectangle.
While I was drawing the conclusion I was having a low, my wife gave me the obligatory "your not interested are you?!!"..
The usual "fighting talk" from the book of female marriage guidance was quashed simply by a clearly visible led meter reading of 2.1!

No harsh words were retaliated from my quarter.. Too busy stuffing my face..

But then I have always been an articulate fellow..!!

 

[kyrani99]

Hi everyone and thanks for all your information.
I still have some problems in understanding this. In a hypo there is low blood sugar and to become aggressive as to bash someone up it takes a lot of energy which means there has to be glucose there to have enough energy to become physical.

I can understand if the person has a sudden rage and uses up their blood sugars too rapidly that they would end up with a hypo. But I can't see how having a hypo causes aggression and even if adrenalin is involved because it still does not account for the low blood glucose. Adrenalin alone is not enough to be able to engage is strong physical activity. The person has to have energy so they need enough blood glucose.

The dawn phenomenon has adrenalin involvement but there we see high blood glucose. Adrenalin stimulates the liver to dump sugar. I can understand that high level of insulin may be involved but even then the aggression / rage has to come first not the hypo.

Does anyone know if any continuous glucose monitoring has been done at the time a hypo was experienced?
Kyrani.

 

[Jaylee]

The agression comes to some hypoglycaemic suffers due to the minds confusion during the sugar low... "Rashionality" flies out the window.
If there is a paranoiac tendancy or maybe an underlying stress factor? Then this could be the catalyst for hypoglycaemic violence..

I have trained myself as a child to control my actions through my thoughts when hypo, partly due to the desire not to be singled out as "special case" in social circumstances....

Let's face it. Tantrums don't look good.!

I use the same application when drunk too..

 

[Flowerpot]

Adrenalin brings about a survival response. Blood is diverted to the limbs and muscles to enable us to escape the perceived danger we are in but obviously with hardly any glucose present this reaction is a last ditch attempt to save ourselves.

The type of aggression/rage I have suffered from during severe hypos is more lashing out with my arms and legs in uncontrolled movements. It doesn't involve going ten rounds with someone which would require a lot of energy. Although your glucose level is abnormally low you still have some present to fuel your muscles into managing involuntarily thrashing around, often just before going unconscious. It is surprising to see how strong someone can be under these conditions.

If your blood glucose is normal then yes you could cause a hypo by using energy for physical aggression. Aggression during a hypo is caused by adrenalin being released as a result of hypoglycaemia triggering the fight or flight response combined with irrational behaviour due to the brain being starved of glucose. Two very different things. The first we can choose to do , the second is an involuntary situation caused by hormonal responses to hypoglycaemia.

 

[Jaylee]

Does anyone know if any continuous glucose monitoring has been done at the time a hypo was experienced?
Kyrani.

Yes, but unfortunately all the equipment & the data collated was destroyed...

 

[Nicko2K]

I think when experiencing a hypo, just because your BG is low, doesnt mean your limbs are going to stop moving, your muscles run on their own fuel storage, separate from your immediate BG. Lows for me dont last that long so dont notice a difference in muscle control. Any shaking i get i believe is a symptom of my brain being starved of glucose, and also believe my brain suffers the most from immediate low BG. I also think my brain would cease to function faster than my muscle. :-/

Type 1 Diabetic: (Novorapid/Levemir) Diagnosed 2014: Extremely handsome: Always smiling

 

[kyrani99]

Yes, but unfortunately all the equipment & the data collated was destroyed...

Interesting! why was that done?

 

[kyrani99]

Yes there is a store -glycogen in the muscles, and it can be used to perform some actions, moving hands and feet around etc., and even that would tax their glucose supplies. The papers I read seem to be trying to suggest that diabetes could be a violent menace to the public owing to hypos and that is outrageous. They are trying to say if you go hungry then you get aggro so if the body goes hungry, i.e., a hypo then the body gets aggro. It is still not equal aggression.

The adrenalin/ fight or flight response does not automatically translate to violence. Panic attacks, anxiety attacks both, with normal blood glucose don't translate to violence. And furthermore I can't go with the "man is a machine" paradigm of the medicos. I strongly suspect that were a humane person commits violence there has to have been a reason, provocation, threat, violation of themselves or their property. The idea that it is just a machine malfunction is IMO garbage.

I can understand a hypo in the case of T1 because they have to carefully monitor their insulin levels and if they suffer some stress the insulin would quickly get used up but that doesn't make them violent monsters. In T2 also there has to have been a reason for the depletion, possibly the liver supply low so it is not being replenished in the blood fast enough. And some drugs do cause problems. I found that both worry and depression also cause insulin resistance and maybe even the production of insulin reduced a bit. But low insulin means hyper not hypo.

 

[Jaylee]

Interesting! why was that done?

I believe the data was corrupted by too much gamma radiation & the equipment destroyed when the participant expressed an unwillingness to continue with the experiment...

 

[catherinecherub]

Yes there is a store -glycogen in the muscles, and it can be used to perform some actions, moving hands and feet around etc., and even that would tax their glucose supplies. The papers I read seem to be trying to suggest that diabetes could be a violent menace to the public owing to hypos and that is outrageous. They are trying to say if you go hungry then you get aggro so if the body goes hungry, i.e., a hypo then the body gets aggro. It is still not equal aggression.

The adrenalin/ fight or flight response does not automatically translate to violence. Panic attacks, anxiety attacks both, with normal blood glucose don't translate to violence. And furthermore I can't go with the "man is a machine" paradigm of the medicos. I strongly suspect that were a humane person commits violence there has to have been a reason, provocation, threat, violation of themselves or their property. The idea that it is just a machine malfunction is IMO garbage.

I can understand a hypo in the case of T1 because they have to carefully monitor their insulin levels and if they suffer some stress the insulin would quickly get used up but that doesn't make them violent monsters. In T2 also there has to have been a reason for the depletion, possibly the liver supply low so it is not being replenished in the blood fast enough. And some drugs do cause problems. I found that both worry and depression also cause insulin resistance and maybe even the production of insulin reduced a bit. But low insulin means hyper not hypo.

Can you give us some links to the articles?

 

[phoenix]

Emily Deans (a psychiatrist) has a blog post about low glucose and aggressiveness. She mentions the release of hormones as others have done ( she mentions catecholamines and glucocorticoids, growth hormone, and glucagon) She suggests that 'If the blood glucose falls low enough that the brain is impaired, certainly very bizarre behavior (such as psychosis) can be observed'
http://evolutionarypsychiatry.blogspot.fr/2011/08/can-carbs-make-you-crazy-more-about.html

However she also discusses some evidence of associations between aggression and people who suffer low glucose levels (not necessarily clinically hypoglycaemic ) .
Here's one of the abstracts (dates from 1988)

'68 male habitually violent offenders and 20 male controls from the psychiatric personnel were studied by means of the glucose tolerance test. Those with an intermittent explosive disorder had much the same kind of abnormal curve as the antisocial personality group, but the return from reactive hypoglycemia to the original basal values was very rapid. It was also found that in the whole group of habitually violent offenders, the slow recovery from hypoglycemia was connected with those features which are usually considered typical of the antisocial personality'

There is also the more recent 'voodoo doll' paper ' http://news.sciencemag.org/brain-behavior/2014/04/unhappy-marriages-due-low-blood-sugar (personally I find this study slightly odd and not very convincing)

Personally, when hypo, I withdraw into myself and don't want to talk to anyone or want anyone to interfere. This is (I think) because my brain can only cope with a limited amount of input (ie there is channel overload at a lower than normal level) Trying to respond to others is too much. I don't want to speak so I will be terse, I may seem rude . I still have self constraint though and as much as possible I just want to get away from others. I can't imagine being physically violent, that's not part of my nature at any time.

I remember once seeing a man in a KFC, his friend had obviously called the ambulance service because he was hypo. They were very loud asking him questions about his insulin and when he had eaten etc. He appeared to be acting aggressively but I think he was just trying to push them away .

 

[Jaylee]

I can understand a hypo in the case of T1 because they have to carefully monitor their insulin levels and if they suffer some stress the insulin would quickly get used up but that doesn't make them violent monsters.

Nope. It's the blood sugar levels that need to be constantly monitored with blood testing.
The insulin dose is adjusted in the case of a T1 to keep sugar levels at a healthy parameter & avoid the inevitable complications associated with prolonged high BG.
Insulin is calculated in a balancing act involving carb intake to insulin ratio & forecasting exercise ,physical exertion or the respective lack of....
One can also include climate change & insulin integrity too..
Because unfortunately, though we might be able to think like a pancreas. We can't act as fast as one.

In terms of the "man is a machine"..? If the blood sugars swing either way.. For instance regarding this topic a hypoglycaemic episode..
It's safe to put this down in short to "driver error".!