What are the real dangers of hypoglycemia?

Hi FirstClass,

I did put this in the type 1 board but will post it here as well, everything you need to know about hypoglycaemia.

http://www.iddtinternational.org/health ... caemia.htm

Thanks Catherine, there's more......

Here is a link to a website which clearly explains Hypoglycaemia in all it's aspects. Have a read.
http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/

An extract:
Hypoglycemia can happen suddenly. It is usually mild and can be treated quickly and easily by eating or drinking a small amount of glucose-rich food. If left untreated, hypoglycemia can get worse and cause confusion, clumsiness, or fainting. Severe hypoglycemia can lead to seizures, coma, and even death.

It is the Pancreas that either doesn't work at all or doesn't work properly in a Diabetic, not the
Liver. The Pancreas doesn't produce Insulin to decrease the level of glucose in the blood. Hence a Type 1 and a Type 2 can both 'liver dump' which boosts Glucose levels when required. So long as your liver is healthy it will continue to do this. It only does this when you are dropping into the hypoglycaemic zone.

The body uses all three macro-nutrients (carbohydrates, proteins, and fats) to store energy.

The most easily used is the storage medium of carbohydrates, called glycogen. Glycogen is made from glucose, and is stored in the liver and muscles. Since it is basically nothing more than a complex matrix of glucose, it is easy for the body to store and use, something the body does all day long. The technical term for the act of creating and storing glycogen is glycogenesis. When the body calls for the conversion of glycogen back to glucose it is called glycogenolysis.

Another macro-nutrient that is available to be converted to glucose is protein. Most of us think of our protein as being stored in muscle, but the body has protective mechanisms to make muscle wasting its last choice. One of the most useful and readily available sources of protein storage is in blood components, i.e., albumin (plasma). The body uses a process performed in the liver to convert amino acids, the building blocks of proteins, into glucose. The name for this process is gluconeogenesis, literally "the creation of new glucose".

Hi I have had diabetes T1 for 26 years and have never really thought about the dangers of hypos (low sugars) up until recently, you read all about the dangers that high sugars can cause. When my husband was speaking to my diabetic nurse on the phone a couple of weeks ago and she told him that it has been known that hypo's (low sugars) can cause altzimmers disease (excuse spelling not sure how its spelt) when you are older this is the first time i have ever heard this i don't know about anyone else. Apparentley because when the brain is starved of glucose during a hypo it kills off brain cells (scarey)

I too have read that some people think that hypos can destry brain cells, but I haven't seen any evidence. My suspicion is that it would take more than just an ordinary hypo to do this;perhaps a HUGE overdose of insulin, which is used to murder people in detective stories, but I can't find many verified accounts of its actually happening.
I have been researching this question and so far all the information I've found points to High BG being a much more serious long term danger than Hypos.
Hana

I've had hundreds of mild to moderate hypos and I've still got all my marbles (I think, I'm not sure) :lol:

It would seem that bg advice is changing though as I too was told by a pump dsn that a bg of 4 or below is now classed as hypo and that too many hypos can starve the brain of oxygen. Whether this is really true or not, I don't know. If this is the case, then I should have been advised on this years ago. Instead nothing was ever said to me when a consultant read my bg diary and saw some of my bg levels were below 3. I actually had to bring the low bg levels up myself. The consultant's response was that my levels were not that bad as I wouldn't be able to write the details down in my diary if I was really hypo. I could see his point so I just got on living with the odd hypo feeling and dealing with them as I saw fit.

It seems that the internet advice of having bg levels between 4-7 before meals and being no higher than 8 two hours later is now going to be contradicted by new advice (as given by my dsn - bg levels to be between 5-10 before meals). My hba1c is currently on 6.7% and have been told that this is too tight. The 5% club is definately out now I think.

iHs
as long as I can, I shall stick with the 5% club. If I CAN get into the 4s, I shall. If diabetic complications are caused by High blood glucose, I plan to stay as close as I can manage to the non-diabetic values. To avoid frequent hypos, I shall resist using medications which cause them. I have to keep on top of things, because my T1 insulin using husband needs me to be there and alert if I'm to rescue him a couple of times per week.
I've been told by many people that my low blood glucose( latest HbA1c 5.3%) and my low carb diet are bad for me. I wish those peddlars of doom and gloom would explain to me why then I am so fit and well.
I have yet to see any evidence that Bernstein's method doesn't work or is harmful.
Hana

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First Class said
I've learned that liver is the organ that provides glucagon to blood when your blood sugar is low but why doesn't it work properly on a diabetic? Isn't diabet all about pancreas?

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The cells responsible for making and releasing glucagon are also in the pancreas... the alpha cells.

Glucagon responses to hypoglycemia have been known to be blunted in type 1 diabetes of long duration, and this may be a result of a loss of alpha- and beta-cell communication secondary to insulin deficiency.[7,8] Glucagon responses to hypoglycemia in type 2 diabetes are thought to remain intact

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http://www.medscape.com/viewarticle/452112

I've also found this article written by the author of a recent book on hypoglycemia. It gives some answers though is written in 'medical' language
http://diabetesmanager.pbworks.com/Hypoglycemia-During-Therapy-of-Diabetes-

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Tracy 167 said
she told him that it has been known that hypo's (low sugars) can cause altzimmers disease (excuse spelling not sure how its spelt) when you are older this is the first time i have ever heard this i don't know about anyone else. Apparentley because when the brain is starved of glucose during a hypo it kills off brain cells (scarey)

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from the same article, you could chase up the references, I think that at present they feel that there may well be a problem with severe hypos on the developing brain and possibly on the ageing one as well.

Follow-up of the DCCT patients suggests that recurrent iatrogenic hypoglycemia does not result in cognitive impairments [246]; however, that did not include very young patients with T1DM or elderly patients with T2DM [247][248]. There is evidence of hypoglycemia-associated impairment of cognitive function in the former [249] and of hypoglycemia-associated dementia in the latter in some [250], but not other [251], studies. Older patients are at increased risk of morbidity from hypoglycemic episodes such as fracture and perhaps arrhythmia, stroke and myocardial infarction [252].

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hanadr said:

I too have read that some people think that hypos can destry brain cells,

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I do hope thats not true because I don't have too many as it is :lol:

Happy Christmas, Sid
I expect it's like so many of the scientific breakthroughs we read about all the time
Hana

Despite DUK's dire warnings of brain malfunction by carb reduction (no mention of hypos), I've never had a reading below 4. I did suffer symptoms long before diabetes similar to hypo, from exertion & working beyond lunch by a slave driving wife

Even now, I am in demand as an occasional maths teacher - using what I learned at school.

I 'm very well acquainted too with matters mathematical,
I understand equations, both the simple and quadratical,
About binomial theorem I'm teeming with a lot o' news ­
With many cheerful facts about the square of the hypotenuse.
.....
I'm very good at integral and differential calculus,
I know the scientific names of beings animalculous;
...

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Ian
Next time we meet, you can help me with my calculus.
Hana

iHs said:

It seems that the internet advice of having bg levels between 4-7 before meals and being no higher than 8 two hours later is now going to be contradicted by new advice (as given by my dsn - bg levels to be between 5-10 before meals). My hba1c is currently on 6.7% and have been told that this is too tight. The 5% club is definately out now I think.

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6.7% is cool if it works for you though? I was told that running my hba1c at below 6 was too 'tight' for me and I had to agree as I was dealing with horrible hypo's so I've made a real effort to up it and now it's just over 6 and I haven't had any bad hypo's for several months now it was hard to move away from the 'rules' but even by cranking those numbers up a smidge, my life has become less traumatic for me and those close to me who have to pick up the hypo pieces

Hi

Yes I agree with you. I also don't plan to go below 6%. I did have a a1c of 6.4% at one time but had a load of 2's and 3's throughout the week. I was able to deal with most of them though so didn't see them as a big deal but then I've had diabetes coming up for 45yrs now.

At the moment I'm getting used to getting my target at 6 so have got to use a different insulin to carb ratio. It's not working out too well at the moment as I am trying to eat just 3 meals a day instead of little and often.

Like yourself, I'm trying for a pump so here's hoping with any luck.