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Hypo treatments

Brunneria said:
Haha! Brilliant!

They say there is nothing new under the sun... :D
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This was the summer of 1976. Back in the days of pee testing & big glass syringes. The T1 character "Peter" in the book was always getting into jolly scrapes. (as opposed to his female counterpart who was a "model diabetic.)

This one "misadventure". "Peter had run out to play without eating his lunch.?" He then came over "feeling a little queer.."
"He told his mum & she gave him some milk!"

In reality? "Little J" would sort it out for himself.. Not wanting to cause a fuss.
The last of the milk got polished.. I had no ranting cat to blame... ;)

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kokhongw said:
Ah what most do not recognized is that
1) most T2D are still able to produce plenty of phase 2 insulin...10s of times higher then usual, in an effort to remove the carbs/glucose from the system. So at 2 hour mark, glucose reading is > 12 mmols, but with the massive amount of phase 2 insulin kicks in, and suddenly all the glucose have disappeared from the circulatory system. This can also be accelerated by strong tea... 10.3 mmol at 10:00pm to 3.7 mmol by 11:51pm (The Accuchek Performa date/time stamp was not in sync.)
12507324_1705186389725820_1599253818743099292_n.jpg


2) There can be insulin resistance in the brain as being noted by the development of dementia. So the brain would now require higher level of glucose to feel normal or be adequatedly fueled. A relatively normal 4.5 mmol now is being sensed as a low and the brain starts to react in a hypo manner. It does not even need to go down to the 3 mmol range...

But if a T2D has been on a low carb, ketogenic diet, then there will be sufficient circulating ketone bodies to provide the brain with alternative fuel...and even if glucose is measure in the lower 4mmols or upper 3 mmols, There is no sense of hypo...
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In answer to your point 2 though. Isn't that just the brain's tolerance to high levels of BS for prolonged periods of time & then going "cold turkey" when the levels come down into a safe range..
Think of an alcoholic going on the wagon? I've seen a detoxing drug addict quite literally look & act like she was having a hypo.. ;)
 
Jaylee said:
In answer to your point 2 though. Isn't that just the brain's tolerance to high levels of BS for prolonged periods of time & then going "cold turkey" when the levels come down into a safe range..
Think of an alcoholic going on the wagon? I've seen a detoxing drug addict quite literally look & act like she was having a hypo.. ;)
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That is what I used to think too...until I came across more papers discussing dementia and Alzheimer's disease...
However, growing evidence supports the concept that AD is fundamentally a metabolic disease with substantial and progressive derangements in brain glucose utilization and responsiveness to insulin and insulin-like growth factor [IGF] stimulation.
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Brain insulin resistance and deficiency as therapeutic targets in Alzheimer's disease.
https://www.ncbi.nlm.nih.gov/pubmed/22329651

And this
young adults with mild insulin resistance or with a maternal family history of AD. (iii) Regional brain glucose uptake is impaired in AD and mild cognitive impairment (MCI), but brain uptake of ketones (beta-hydroxybutyrate and acetoacetate), remains the same in AD and MCI as in cognitively healthy age-matched controls. These observations point to a brain fuel deficit which appears to be specific to glucose, precedes cognitive decline associated with AD, and becomes more severe as MCI progresses toward AD
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Can Ketones Help Rescue Brain Fuel Supply in Later Life? Implications for Cognitive Health during Aging and the Treatment of Alzheimer’s Disease
http://dx.doi.org/10.3389/fnmol.2016.00053

So the dots begins to connect...
 
I apologise and if I'm out of order please ignore my post.

However, there are many hypoglycaemia patients not only RH!
And most of them, wouldn't know or it is a natural extension of the bodies function.
Most hypos in non T1s is caused after a meal and in response to too much insulin in the first and second insulin response. It is more likely to occur after the second response.
Other conditions such as insulinoma and hyperinsulinaemia as well as more serious conditions such as pancreatitis and pancreatic cancer can also have serious hypos.
Also I agree with Brun (as always) and @kokhongw, hypos do drastically effect future brain function. Ketones are known to help with the mental health of those effected.
There are many ideas at what causes severe brain problems in not only the elderly, but doing low carb certainly helps.

Oh yeah, as I haven't had a hypo in nearly three years now, last one as part of an OGTT in hospital. It was a cuppa, black no sugar and a plain biscuit that brought my bloods back up into normal levels without the rebound effect of a hyper then a repeat hypo!
My body definitely would prefer to stay in ketosis, then worry about Hypoglycaemia.
The reason, I'm really fit and healthy!
It I'm weird and we're all different.
 
@Lamont D ,
Alway cool to have your input... :cool:
I've mentioned this before regarding RH.
I had a school friend tell me he had symptoms in his youth.. & my wife's old house mate (male nurse?)would quite often keel over with syptoms & fix it with something sweet to eat.. He wasn't a diabetic.
 
Jaylee said:
@Lamont D ,
Alway cool to have your input... :cool:
I've mentioned this before regarding RH.
I had a school friend tell me he had symptoms in his youth.. & my wife's old house mate (male nurse?)would quite often keel over with syptoms & fix it with something sweet to eat.. He wasn't a diabetic.
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I've just thought of how many tests I've had to determine my diagnosis and all of them were to dismiss other potential conditions. All designed to make me hypo!
I've also had food tolerances and allergy tests, to see how I 'react' to certain foods.
Also my testing and experimental period to see how much of the 'baddies' I could get away with! (Not many at all!)
The biggest lesson I believe I learned, was that the potential threat to my health was supposed to be healthy food! The basic foodstuff that gave us the vitamins, minerals and the energy to live our lives!
Who would have believed I was eating myself to death! Insulin was killing me!
How many times have you read that on a diabetic forum?

Also avoid hypos, cos, they are not nice at all!
 
catapillar said:
If you don't take insulin or any other drug, what makes you think you are ever anywhere near a danger zone from a hypo? Going hypo close to a meal time when taking no medication could be called being hungry.
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If you are diabetic, T2, then you know what a hypo feels like. Exercise can cause one.... not just drugs. Some alternative methods that lower blood glucose can contribute to one.
 
Tophat1900 said:
If you are diabetic, T2, then you know what a hypo feels like
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I'm a bit confused by this. Being diabetic doesn't cause or create a risk of hypoglycaemia more than anyone else in the general population. If anything being type two diabetic (a condition of high blood sugar) would make your risk of low blood sugar even less likely than the general population.

It's the drugs used to treat diabetes that can cause hypoglycaemia. If you aren't on any drugs where does the "danger zone" from low blood sugar come from? Your body will just survive with low blood sugar and take you back to where it wants your blood sugar to be by internal correction processes because there aren't any drug stopping that. Your body's just telling you to eat cos it's hungry.

Exercise might cause low blood sugar in a diet controlled type two diabetic. But is calling it a hypo medicalising something unnecessarily? Most marathon runners take glucose gels out with them as standard.

Sorry I guess it's one of the comments that really irritate me when people find out I'm diabetic the "oh I get low blood sugar" response. I do have to bite my tongue to stop from pointing out that would be the opposite of diabetes and that their low blood sugar, if they don't eat often enough, isn't quite the same as a low blood sugar caused by too much insulin. Maybe it's just because I've been woken up a 3am by an alarm to tell me I'm hypo though so probably I can be reasonably ignored.
 
Given the increased understanding/interest in ketone bodies and brain glucose uptake impairment, it is not inconceivable that a few years down the road, exogenous ketones/MCT/VCO may be the preferred treatment for hypos.
 
catapillar said:
I'm a bit confused by this. Being diabetic doesn't cause or create a risk of hypoglycaemia more than anyone else in the general population. If anything being type two diabetic (a condition of high blood sugar) would make your risk of low blood sugar even less likely than the general population.

It's the drugs used to treat diabetes that can cause hypoglycaemia. If you aren't on any drugs where does the "danger zone" from low blood sugar come from? Your body will just survive with low blood sugar and take you back to where it wants your blood sugar to be by internal correction processes because there aren't any drug stopping that. Your body's just telling you to eat cos it's hungry.

Exercise might cause low blood sugar in a diet controlled type two diabetic. But is calling it a hypo medicalising something unnecessarily? Most marathon runners take glucose gels out with them as standard.

Sorry I guess it's one of the comments that really irritate me when people find out I'm diabetic the "oh I get low blood sugar" response. I do have to bite my tongue to stop from pointing out that would be the opposite of diabetes and that their low blood sugar, if they don't eat often enough, isn't quite the same as a low blood sugar caused by too much insulin. Maybe it's just because I've been woken up a 3am by an alarm to tell me I'm hypo though so probably I can be reasonably ignored.
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I've been t2 for 10 yrs. When diagnosed, I started on insulin and experienced the hypos associated with that. The experience is exactly the same without it (They are rare, I should point out), but it's still the same frightening experience. If you don't understand what someone is experiencing and trying to convey, then you don't understand. No big deal.
 
kokhongw said:
Given the increased understanding/interest in ketone bodies and brain glucose uptake impairment, it is not inconceivable that a few years down the road, exogenous ketones/MCT/VCO may be the preferred treatment for hypos.
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Exogenous ketones will not work with T1. Yes, it might mean the brain functions with no issues (and believe me I understand how the brain functions whilst ketogenic and hypo having been down incredibly low, having my nervous system stop communicating with my legs properly, but having my brain fully aware the entire time, and not losing consciousness), but when exogenous insulin is involved, especially a lot of it, rarely does the body have the ability to counter the insulin, and it has to get to a very low blood glucose level to even start that. So while signalling may play an important part in managing hypos in non-medicated types of diabetes, while there are exogenous agents in play, I'd be surprised if that's all it took.
 
tim2000s said:
Exogenous ketones will not work with T1. Yes, it might mean the brain functions with no issues (and believe me I understand how the brain functions whilst ketogenic and hypo having been down incredibly low, having my nervous system stop communicating with my legs properly, but having my brain fully aware the entire time, and not losing consciousness), but when exogenous insulin is involved, especially a lot of it, rarely does the body have the ability to counter the insulin, and it has to get to a very low blood glucose level to even start that. So while signalling may play an important part in managing hypos in non-medicated types of diabetes, while there are exogenous agents in play, I'd be surprised if that's all it took.
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Perhaps when lots of insulin is in used, get the right level of anything is a challenge because so many other factors are involved.

But it is interesting to note that there are researchers looking into exactly the same direction, though the study has been on T1D mice only...so the idea does not appear to be too far fetch...
Medium-Chain Fatty Acids Improve Cognitive Function in Intensively Treated Type 1 Diabetic Patients and Support In Vitro Synaptic Transmission During Acute Hypoglycemia

CONCLUSIONS Medium-chain triglyceride ingestion improves cognition without adversely affecting adrenergic or symptomatic responses to hypoglycemia in intensively treated type 1 diabetic subjects. Medium-chain triglycerides offer the therapeutic advantage of preserving brain function under hypoglycemic conditions without causing deleterious hyperglycemia.
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http://diabetes.diabetesjournals.org/content/58/5/1237
 
@kokhongw - I think you are reiterating the point I was making. Cognitively, when low on a ketogenic diet, I am (and many others that follow a ketogenic diet are) aware that brain function is retained, and that's what this research is looking at.

Sure, the brain is better protected if ketones are the predominant fuel, but the brain still requires some glucose (not a lot at all, but still some), even when it has switched over to a ketogenic fuel source, so when your glucose levels become very low (i.e. sub 1.5 mmol/l) there are still issues, and ketones alone will not enable recovery.
 
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