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Type 1 Diabetes
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<blockquote data-quote="MarkMunday" data-source="post: 2282853" data-attributes="member: 525839"><p>No one disagrees with that. However, it is helpful to understand what happens during hypos so we know what risk may be involved should a hypo not be promptly treated. </p><p></p><p>The unpleasant and scary hypo symptoms we all have experienced are not actually caused by the brain being starved of glucose. They are part of the stress response that, if given time, pumps glucose into the bloodstream. The paranoid thoughts, anxiety and sweating are caused by stress hormones - cortisol and epinephrine. These same hormones promote glycogenolysis : the conversion of liver glycogen to glucose that is released into the bloodstream. </p><p></p><p>Passing out is a defense mechanism for conserving scare blood glucose, a situation that rectifies itself by utilising stored glycogen. The stress response starts well before glycogenolysis gets underway, which is why hypos are often over-treated. Hypo driven anxiety prompts excessive consumption of carbs which, together with liver glucose, causes blood glucose to go very high. AKA the 'rebound effect'. When you sleep through a low and have high blood glucose in the morning, it is called the 'Somogyi effect'. Sound familiar? Yes, hypos can cause seizures. They can also cause accidents if they happen during the day. So precautions should be taken to avoid them. </p><p></p><p>Neuroglycopenia (glucose starvation of the brain) occurs when blood glucose is 1.1 mmol/l. You ever seen such low blood glucose? Stress hormones from it would wake the deepest sleeper. Most people treat their hypos well before this level is reached because of stress response symptoms. </p><p></p><p>We are advised to not let blood glucose fall below 3.5. The reason for it is that lower blood glucose down-regulates the hypo stress response, making hypos harder to recognise and treat promptly. It has nothing to do with the brain being starved of glucose. </p><p></p><p>I have 'hypo unawareness' from too many hypos as well as age. I am able to function comfortably below 2.5. The brain gets enough glucose and there is no stress response. It is a precarious situation to be in, especially if lots of carb is consumed and bolus insulin used. I have not been able to regain hypo awareness and my solution is to eat very low carb. That way blood glucose never changes fast and testing every 2 hours is adequate. </p><p></p><p>Yes, we should take precautions, be responsible, be vigilant and act promptly when blood glucose goes out of the target range. I have been working at this for 43 years. Sometimes life gets in the way, though, so don't be too concerned if for whatever reason a hypo isn't treated.</p></blockquote><p></p>
[QUOTE="MarkMunday, post: 2282853, member: 525839"] No one disagrees with that. However, it is helpful to understand what happens during hypos so we know what risk may be involved should a hypo not be promptly treated. The unpleasant and scary hypo symptoms we all have experienced are not actually caused by the brain being starved of glucose. They are part of the stress response that, if given time, pumps glucose into the bloodstream. The paranoid thoughts, anxiety and sweating are caused by stress hormones - cortisol and epinephrine. These same hormones promote glycogenolysis : the conversion of liver glycogen to glucose that is released into the bloodstream. Passing out is a defense mechanism for conserving scare blood glucose, a situation that rectifies itself by utilising stored glycogen. The stress response starts well before glycogenolysis gets underway, which is why hypos are often over-treated. Hypo driven anxiety prompts excessive consumption of carbs which, together with liver glucose, causes blood glucose to go very high. AKA the 'rebound effect'. When you sleep through a low and have high blood glucose in the morning, it is called the 'Somogyi effect'. Sound familiar? Yes, hypos can cause seizures. They can also cause accidents if they happen during the day. So precautions should be taken to avoid them. Neuroglycopenia (glucose starvation of the brain) occurs when blood glucose is 1.1 mmol/l. You ever seen such low blood glucose? Stress hormones from it would wake the deepest sleeper. Most people treat their hypos well before this level is reached because of stress response symptoms. We are advised to not let blood glucose fall below 3.5. The reason for it is that lower blood glucose down-regulates the hypo stress response, making hypos harder to recognise and treat promptly. It has nothing to do with the brain being starved of glucose. I have 'hypo unawareness' from too many hypos as well as age. I am able to function comfortably below 2.5. The brain gets enough glucose and there is no stress response. It is a precarious situation to be in, especially if lots of carb is consumed and bolus insulin used. I have not been able to regain hypo awareness and my solution is to eat very low carb. That way blood glucose never changes fast and testing every 2 hours is adequate. Yes, we should take precautions, be responsible, be vigilant and act promptly when blood glucose goes out of the target range. I have been working at this for 43 years. Sometimes life gets in the way, though, so don't be too concerned if for whatever reason a hypo isn't treated. [/QUOTE]
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