Guest guest Posted March 24, 2008 Report Share Posted March 24, 2008 Other than Orbit gum which was sold years ago and I haven't seen for a long time, does anybody else know of a type of gum sweetened with xyletol? Interesting article Pat. Ruth Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 24, 2008 Report Share Posted March 24, 2008 Ruth, they do still sell Orbitz gum, thankfully. I love the stuff! They actually have a new flavor, or at least new to me, Hawaiian Melon Mint or something like that. I can't imagine they aren't selling it up there. If nothing else, I saw it at Wal-Mart in like a 12-pack of three different flavors. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 16, 2008 Report Share Posted April 16, 2008 Alligator Blood May Help Diabetic Wounds Heal Despite their reputation for deadly attacks on humans and pets, alligators are wiggling their way toward a new role as potential lifesavers in medicine. Biochemists described how proteins in gator blood may provide a source of powerful new antibiotics to help fight infections associated with diabetic ulcers, severe burns, and �superbugs� that are resistant to conventional medication. Their study, described as the first to explore the antimicrobial activity of alligator blood in detail, found a range of other promising uses for the gator’s antibiotic proteins. Among them: combating Candida albicans yeast infections, which are a serious problem in AIDS patients and transplant recipients, who have weakened immune systems, the scientists say. “We’re very excited about the potential of these alligator blood proteins as both antibacterial and antifungal agents,†says study co-author Mark Merchant, Ph.D., a biochemist at McNeese State University in Lake , La. “There’s a real possibility that you could be treated with an alligator blood product one day.†Previous studies by Merchant showed that alligators have an unusually strong immune system that is very different from that of humans. Unlike people, alligators can fight microorganisms such as fungi, viruses, and bacteria without having prior exposure to them. Scientists believe that this is an evolutionary adaptation to promote quick wound healing, as alligators are often injured during fierce territorial battles. After collecting blood samples from American alligators. They then isolated disease-fighting white blood cells (leucocytes) and extracted the active proteins from those cells. In laboratory tests, tiny amounts of these protein extracts killed a wide range of bacteria, including MRSA (methicillin-resistant Staphylococcus aureus), the deadly bacteria that are moving out of health care settings and into the community. These “superbugs†are increasingly resistant to multiple antibiotics and cause thousands of deaths each year. The proteins also killed six out of eight different strains of Candida albicans, the researchers say. Their previous research also suggests that blood proteins may help fight HIV, the virus that causes AIDS. The scientists are working to identify the exact chemical structures of the antimicrobial proteins and determine which proteins are most effective at killing different microbes. The gator blood extract may contain at least four promising substances, they estimate. With the chemical structures in hand, scientists can begin developing them into antibacterial or antifungal drugs, including pills and creams, for fighting infections. These drugs show particular promise as topical ointments, Merchant says. Gator-blood creams could conceivably be rubbed onto the foot ulcers of patients with diabetes to help prevent the type of uncontrolled infections that lead to amputations, he says. The creams could also be applied to the skin of burn patients to keep infections at bay until damaged skin can heal, the researcher adds. Merchant suggests that the proteins might be called “alligacin.†If studies continue to show promise, the drugs could land on pharmacy shelves in another seven to ten years, he estimates. Until then, don’t try to create your own home-remedies using alligator blood, as raw, unprocessed blood could make you sick or even kill you if injected, the researcher cautions. 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Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 Great article. Yesterday after exercising I tested to find my blood sugar at 1.9 mmol/L, or 34 mg/dl. I can usually pick up symptoms when I'm not that low, but while exercising they are almost impossible to pick up on. The symptoms I get are mild and easy to miss if I don't keep the " do I feel low " body scan going in the back of my mind pretty much constantly. Jen article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 Great article. Yesterday after exercising I tested to find my blood sugar at 1.9 mmol/L, or 34 mg/dl. I can usually pick up symptoms when I'm not that low, but while exercising they are almost impossible to pick up on. The symptoms I get are mild and easy to miss if I don't keep the " do I feel low " body scan going in the back of my mind pretty much constantly. Jen article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 Great article. Yesterday after exercising I tested to find my blood sugar at 1.9 mmol/L, or 34 mg/dl. I can usually pick up symptoms when I'm not that low, but while exercising they are almost impossible to pick up on. The symptoms I get are mild and easy to miss if I don't keep the " do I feel low " body scan going in the back of my mind pretty much constantly. Jen article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 I agree Jen, Most of the time when I feel low, I can tell, but occasionally it will sneak up on me and I find the paramedics looming over me because I have missed that feeling. That happened to me last 4th of July. I have a long term diabetic friend who has total diabetic unawareness and has passed out at work and just walking down the street with her dog. article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 I agree Jen, Most of the time when I feel low, I can tell, but occasionally it will sneak up on me and I find the paramedics looming over me because I have missed that feeling. That happened to me last 4th of July. I have a long term diabetic friend who has total diabetic unawareness and has passed out at work and just walking down the street with her dog. article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 I agree Jen, Most of the time when I feel low, I can tell, but occasionally it will sneak up on me and I find the paramedics looming over me because I have missed that feeling. That happened to me last 4th of July. I have a long term diabetic friend who has total diabetic unawareness and has passed out at work and just walking down the street with her dog. article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 I find this one very interesting. I do wonder what they mean by a drop in your A1C causing a problem with hypoglycemia? Does this mean like if your A1C was say 13 and then you bring it down to say 6 or 7? I have felt some of these symptoms before, but when checking my sugar it was fine. What would happen if your sugar level dropped to low when you were sleeping? They talk a lot about type one's, but can a type 2 as my self have a problem with ether one of these things the artical talks of? I've always heard that a type 2 can skip a meal and get away with it, but a type 1 has to eat especially right after taking a shot. It said that tight control or getting your A1C to low can cause you to have these hypoglycemia reactions. Some pretty scarey stuff to read if you ask me. I always knew diabetes isn't nothing to take lightly, but my eyes have been opened farther after my hart attack and reading articals as this one.But it's a grate one and I sent it to many different list I belong to for all the diabetics I know on them. If it helps just one diabetic it was worth the trouble. Thanks. article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 I find this one very interesting. I do wonder what they mean by a drop in your A1C causing a problem with hypoglycemia? Does this mean like if your A1C was say 13 and then you bring it down to say 6 or 7? I have felt some of these symptoms before, but when checking my sugar it was fine. What would happen if your sugar level dropped to low when you were sleeping? They talk a lot about type one's, but can a type 2 as my self have a problem with ether one of these things the artical talks of? I've always heard that a type 2 can skip a meal and get away with it, but a type 1 has to eat especially right after taking a shot. It said that tight control or getting your A1C to low can cause you to have these hypoglycemia reactions. Some pretty scarey stuff to read if you ask me. I always knew diabetes isn't nothing to take lightly, but my eyes have been opened farther after my hart attack and reading articals as this one.But it's a grate one and I sent it to many different list I belong to for all the diabetics I know on them. If it helps just one diabetic it was worth the trouble. Thanks. article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 I find this one very interesting. I do wonder what they mean by a drop in your A1C causing a problem with hypoglycemia? Does this mean like if your A1C was say 13 and then you bring it down to say 6 or 7? I have felt some of these symptoms before, but when checking my sugar it was fine. What would happen if your sugar level dropped to low when you were sleeping? They talk a lot about type one's, but can a type 2 as my self have a problem with ether one of these things the artical talks of? I've always heard that a type 2 can skip a meal and get away with it, but a type 1 has to eat especially right after taking a shot. It said that tight control or getting your A1C to low can cause you to have these hypoglycemia reactions. Some pretty scarey stuff to read if you ask me. I always knew diabetes isn't nothing to take lightly, but my eyes have been opened farther after my hart attack and reading articals as this one.But it's a grate one and I sent it to many different list I belong to for all the diabetics I know on them. If it helps just one diabetic it was worth the trouble. Thanks. article Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your Mind? King, Editor-in-Chief 1 May 2008 Recommend this Article: Average Rating: We originally wrote this article for our September 1994 issue. Now it is an " Archive Favorite " as it has not gone out of date, and is still very helpful. Not much has changed about hypoglycemia or its treatment in the last 14 years. Am I right or wrong? For me, Learning all I can about Lows makes it easier to recognize and manage them (before I go too Low). I've used this article to help understand what I am feeling so I can recognize a Low early on! Please use the Comment feature below to share your experiences of success, or tell us about your worst Low, what happened and what you learned. A word of caution about the values used below. This study was conducted using people without diabetes. Some people with diabetes experience symptoms at higher glucose levels than the study suggests. Other people with diabetes appear to function well with blood sugars in the 30's and 40's (mg/dl). Therefore, the values in the study should only be used as an approximation. This study also used plasma glucose levels. Your values done at home might be 20 percent lower or higher than these lab values. For example, epinephrine release in someone without diabetes would begin at about 63mg/dl with a home blood glucose meter. More caution: Many people with long-standing type 1 diabetes completely lose some of these responses. The glucose counter-regulation system becomes impaired sometime during the first few years of diabetes. This impairment is unusual in that it seems to be hypoglycemia-specific: the ability of glucagon and epinephrine to respond to other stimuli is basically unchanged, but is reduced or absent when dealing with hypoglycemia. The cause of this is not known, but it is closely linked with the lack of insulin production. SIDE BAR: HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: at 69 mg/dl Epinephrine is released into the bloodstream at 68 mg/dl Glucagon release begins at 67 mg/dl The brain conserves glucose by reducing glucose uptake at 66 mg/dl The body releases the growth hormone Somatotropin, which tells the body to reduce its use of glucose and burn fat instead at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen into glucose at 54 mg/dl Full-on hypoglycemic body symptoms may start including shaking, pounding heart, nervousness, sweating, tingling and hunger at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination and odd behavior *Many type 1s don't have all these responses. In this age of tight control, hypoglycemia has become a major concern for people with diabetes. How much do you really know about it? This article details symptoms, causes, and the body's responses to hypoglycemia. The more you know about hypoglycemia, its progression, and its causes, the more likely you will be to control or prevent it. " I'm drenched in sweat and everything is getting on my nerves. My face feels tight and my lips feel numb. I know I should check my blood sugar, but I can't think well enough to get it together. Finally I get my finger stuck, my blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 Dex4's and start to feel better in about 10 minutes. My health practitioner calls this hypoglycemia, but I call it pure hell. " I know many type 1's actually get used to this, and learn to feel, test and correct by eating very effectively. Others, like me, get the " Diabetic Werewolf Syndrome " where I have to keep eating everything in site until my blood glucose raises back up, usually about 20 or 30 minutes until we stop shaking. But of course every hypo can be different. I have friends that can get quit querulous when they are low. I have seen some skinny type 1's who, when low, may even " fight off " a husband who tries to get them to eat. Many of us have spent our whole lives AVOIDING Sweets, so their subconscious eschews sweet even when low. Everyone had heard of some Low diabetic doing something REALLY wacky. Like running out to the parking lot at work and urinating while standing on the bosses car. Can't you just hear him later, " Wow, I did that? Sorry Boss, I must have had a real bad Low! " At some level, hypoglycemia as the ability to let our unconscious thoughts come out. Kind of like being drunk and doing something embarrassing you don't remember later. Has anyone here ever woke-up with paramedic surrounding your bed asking you what day it is? Maybe yours was running naked our the front door one night mumbling something about the ice-cream man coming? This can happen to anyone as it is really very easy to et too much insulin. No one has to tell most people with diabetes that low blood sugar or hypoglycemia is one of the most common and potentially dangerous problems of diabetes. Mild hypoglycemia is annoying and embarrassing; severe episodes can lead to brain damage, seizure, coma, or, even death. Although the famous 1993 DCCT study showed conclusively that reducing blood glucose levels also reduces long-term diabetes complications, it also found that people who keep their blood sugars close to the normal range have a three times greater chance of hypoglycemia. Some of the 27 centers involved in the DCCT were able to achieve nearly normal average blood sugar readings with very little hypoglycemia. However, a significant risk remains when tight control is attempted. Hypoglycemia is dangerous because it impacts the brain or nerve center, which derives almost all of its energy from glucose. The brain depends on the bloodstream for a continuous supply of glucose because it can only store a few minutes' worth of energy as glycogen. Any change in blood glucose levels can quickly and seriously affect thinking and coordination. Hypoglycemia can usually be detected by the brain, but the brain relies heavily on warning signals generated by the central nervous system as the blood sugar drops. Signals like sweating and shaking are produced by the release of stress hormones in a process called glucose counter-regulation. This release starts the slow return of the blood sugar to the normal range. The liver, interestingly, is directly involved as well in sensing and correcting low blood sugars. Remember that some type 1s lose this response (the body's own ability to raise BG's) altogether over the years. Non-diabetics can count on the body's backup systems for raising a low blood sugar. In a research paper done by Dr. Philip Cryer at the Washington University School of Medicine, these recovery systems were outlined in non-diabetic volunteers. Physical responses that generate recovery are triggered at different glucose levels. The first response, which occurs at around 83 mg/dl, is a reduction of insulin production, while the second, the release of epinephrine into the bloodstream, begins at 69 mg/dl, but plays a minor role unless the supply of glucagon becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 mg/dl by a reduced glucose uptake into the brain. And at 66 mg/dl, the body releases the growth hormone somatotropin, which tells the body to reduce its use of glucose (so this defense mechanism is trying to keep us form going too Low). Somatotropin also tells the body to increase the use of fats as fuel. As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that promotes the conversion of glycogen into glucose, is released to assist in raising the body's glucose levels. For these test subjects, when the glucose level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 mg/dl thinking becomes impaired, as now the brain is low on glucose too. Long term type 1s who lack a good epinephrine and glucagon response, are 25 times more likely to experience severe hypoglycemia than those who respond normally. Two types of symptoms are associated with hypoglycemia: neurogenic (body) symptoms, which originate in the nervous system, affect the body, and are usually noticed by the person with diabetes himself; and neuroglycopenic (mind) symptoms, which affect the mind. The latter are a direct result of glucose deprivation in the brain, and are frequently noticed by others but not by the person with diabetes. In the controlled study of non-diabetics, the neurogenic symptoms occur at around 54 mg/dl and include shaking, pounding heart, nervousness, sweating, tingling, and hunger, while the neuroglycopenic symptoms which occur at 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, difficulty speaking, impaired coordination, and odd behavior (and, of course, coma, seizures, and death). Risk Factors for Hypoglycemia: 1-an excessive insulin in the blood (due to either high injected dosage or missed meals), 2-an increase in the use of insulin (as seen during exercise), 3-a decrease in glucose production (as occurs after drinking alcohol), or 4-an increase in insulin sensitivity (also seen during exercise). 5-a history of severe hypoglycemia, 6-having type 1 diabetes for over 9 to 12 years, 7-any lowering of HbA1c levels, and 8-an increase in your insulin dose. 9-Any hypoglycemia can impair the body's detection of hypoglycemia for up to 3 days. This means glucose levels must go even lower to produce hypoglycemic symptoms and activate glucose counter-response after any hypoglycemia. Hypoglycemia unawareness, the clinical condition in which people no longer experience the neurogenic symptoms of low blood sugars, affects many people with type I diabetes and a few with type 2. The glucose levels needed to trigger glucose counter-response are lower in people with hypoglycemia unawareness and the first symptoms they usually experience are neuroglycopenic, a sign of blood sugars of 49 mg/dl or less. Recent studies indicate that avoiding hypoglycemia for a period of time as short as a few weeks may reverse hypoglycemia unawareness. (See the Uncomplicating Column in the March, 1994, issue of Diabetes Health.) People who suffer from hypoglycemia unawareness should monitor their blood sugar levels very closely. Hypoglycemia unawareness itself increases the risk for hypoglycemia by seven times. Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps the most easily treated, but can also be the most immediately dangerous. Awareness of the signs, symptoms, and risks of hypoglycemia, and diligent monitoring of blood sugars allows hypoglycemia to be controlled and even avoided. This can be vital, because like many things about diabetes, hypoglycemia is a self-perpetuating problem. This article was refined from a review article called " Hypoglycemia " which appeared in the July, 1994 issue of Diabetes Care. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 Hi, I agree, when exercising testing is essential as I also can get very low with out knowing. When not exercising I can usually tell I am getting low when my blood sugars get around the mid 3's. Cheers, Brett. article > > Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your > Mind? > King, Editor-in-Chief > 1 May 2008 > > Recommend this Article: > Average Rating: > > We originally wrote this article for our September 1994 issue. Now it is > an " Archive Favorite " as it has not gone out of date, and is still very > helpful. > Not much has changed about hypoglycemia or its treatment in the last 14 > years. Am I right or wrong? For me, Learning all I can about Lows makes > it easier > to recognize and manage them (before I go too Low). I've used this > article to help understand what I am feeling so I can recognize a Low > early on! Please > use the Comment feature below to share your experiences of success, or > tell us about your worst Low, what happened and what you learned. > > A word of caution about the values used below. This study was conducted > using people without diabetes. Some people with diabetes experience > symptoms at > higher glucose levels than the study suggests. Other people with > diabetes appear to function well with blood sugars in the 30's and 40's > (mg/dl). Therefore, > the values in the study should only be used as an approximation. This > study also used plasma glucose levels. Your values done at home might be > 20 percent > lower or higher than these lab values. For example, epinephrine release > in someone without diabetes would begin at about 63mg/dl with a home > blood glucose > meter. > > More caution: Many people with long-standing type 1 diabetes completely > lose some of these responses. The glucose counter-regulation system > becomes impaired > sometime during the first few years of diabetes. This impairment is > unusual in that it seems to be hypoglycemia-specific: the ability of > glucagon and epinephrine > to respond to other stimuli is basically unchanged, but is reduced or > absent when dealing with hypoglycemia. The cause of this is not known, > but it is > closely linked with the lack of insulin production. > > SIDE BAR: > HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: > > at 69 mg/dl Epinephrine is released into the bloodstream > at 68 mg/dl Glucagon release begins > at 67 mg/dl The brain conserves glucose by reducing glucose uptake > at 66 mg/dl The body releases the growth hormone Somatotropin, which > tells the body to reduce its use of glucose and burn fat instead > at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen > into glucose > at 54 mg/dl Full-on hypoglycemic body symptoms may start including > shaking, pounding heart, nervousness, sweating, tingling and hunger > at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: > confusion, drowsiness, weakness, feeling too warm, difficulty speaking, > impaired coordination > and odd behavior > > *Many type 1s don't have all these responses. > > In this age of tight control, hypoglycemia has become a major concern > for people with diabetes. How much do you really know about it? This > article details > symptoms, causes, and the body's responses to hypoglycemia. The more you > know about hypoglycemia, its progression, and its causes, the more > likely you > will be to control or prevent it. > > " I'm drenched in sweat and everything is getting on my nerves. My face > feels tight and my lips feel numb. I know I should check my blood sugar, > but I can't > think well enough to get it together. Finally I get my finger stuck, my > blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 > Dex4's and > start to feel better in about 10 minutes. My health practitioner calls > this hypoglycemia, but I call it pure hell. " > > I know many type 1's actually get used to this, and learn to feel, test > and correct by eating very effectively. Others, like me, get the > " Diabetic Werewolf > Syndrome " where I have to keep eating everything in site until my blood > glucose raises back up, usually about 20 or 30 minutes until we stop > shaking. But > of course every hypo can be different. I have friends that can get quit > querulous when they are low. I have seen some skinny type 1's who, when > low, > may even " fight off " a husband who tries to get them to eat. Many of us > have spent our whole lives AVOIDING Sweets, so their subconscious > eschews sweet > even when low. Everyone had heard of some Low diabetic doing something > REALLY wacky. Like running out to the parking lot at work and urinating > while standing > on the bosses car. Can't you just hear him later, " Wow, I did that? > Sorry Boss, I must have had a real bad Low! " > > At some level, hypoglycemia as the ability to let our unconscious > thoughts come out. Kind of like being drunk and doing something > embarrassing you don't > remember later. Has anyone here ever woke-up with paramedic surrounding > your bed asking you what day it is? Maybe yours was running naked our > the front > door one night mumbling something about the ice-cream man coming? This > can happen to anyone as it is really very easy to et too much insulin. > > No one has to tell most people with diabetes that low blood sugar or > hypoglycemia is one of the most common and potentially dangerous > problems of diabetes. > Mild hypoglycemia is annoying and embarrassing; severe episodes can lead > to brain damage, seizure, coma, or, even death. > > Although the famous 1993 DCCT study showed conclusively that reducing > blood glucose levels also reduces long-term diabetes complications, it > also found > that people who keep their blood sugars close to the normal range have a > three times greater chance of hypoglycemia. Some of the 27 centers > involved in > the DCCT were able to achieve nearly normal average blood sugar readings > with very little hypoglycemia. However, a significant risk remains when > tight > control is attempted. > > Hypoglycemia is dangerous because it impacts the brain or nerve center, > which derives almost all of its energy from glucose. The brain depends > on the bloodstream > for a continuous supply of glucose because it can only store a few > minutes' worth of energy as glycogen. Any change in blood glucose levels > can quickly > and seriously affect thinking and coordination. > > Hypoglycemia can usually be detected by the brain, but the brain relies > heavily on warning signals generated by the central nervous system as > the blood > sugar drops. Signals like sweating and shaking are produced by the > release of stress hormones in a process called glucose > counter-regulation. This release > starts the slow return of the blood sugar to the normal range. The > liver, interestingly, is directly involved as well in sensing and > correcting low blood > sugars. Remember that some type 1s lose this response (the body's own > ability to raise BG's) altogether over the years. > > Non-diabetics can count on the body's backup systems for raising a low > blood sugar. In a research paper done by Dr. Philip Cryer at the > Washington University > School of Medicine, these recovery systems were outlined in non-diabetic > volunteers. Physical responses that generate recovery are triggered at > different > glucose levels. > > The first response, which occurs at around 83 mg/dl, is a reduction of > insulin production, while the second, the release of epinephrine into > the bloodstream, > begins at 69 mg/dl, but plays a minor role unless the supply of glucagon > becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 > mg/dl by > a reduced glucose uptake into the brain. And at 66 mg/dl, the body > releases the growth hormone somatotropin, which tells the body to reduce > its use of > glucose (so this defense mechanism is trying to keep us form going too > Low). Somatotropin also tells the body to increase the use of fats as > fuel. > > As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that > promotes the conversion of glycogen into glucose, is released to assist > in raising > the body's glucose levels. For these test subjects, when the glucose > level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 > mg/dl thinking > becomes impaired, as now the brain is low on glucose too. > > Long term type 1s who lack a good epinephrine and glucagon response, are > 25 times more likely to experience severe hypoglycemia than those who > respond > normally. > > Two types of symptoms are associated with hypoglycemia: neurogenic > (body) symptoms, which originate in the nervous system, affect the body, > and are usually > noticed by the person with diabetes himself; and neuroglycopenic (mind) > symptoms, which affect the mind. The latter are a direct result of > glucose deprivation > in the brain, and are frequently noticed by others but not by the person > with diabetes. > > In the controlled study of non-diabetics, the neurogenic symptoms occur > at around 54 mg/dl and include shaking, pounding heart, nervousness, > sweating, > tingling, and hunger, while the neuroglycopenic symptoms which occur at > 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, > difficulty speaking, > impaired coordination, and odd behavior (and, of course, coma, seizures, > and death). > > Risk Factors for Hypoglycemia: > > 1-an excessive insulin in the blood (due to either high injected dosage > or missed meals), > > 2-an increase in the use of insulin (as seen during exercise), > > 3-a decrease in glucose production (as occurs after drinking alcohol), > or > > 4-an increase in insulin sensitivity (also seen during exercise). > > 5-a history of severe hypoglycemia, > > 6-having type 1 diabetes for over 9 to 12 years, > > 7-any lowering of HbA1c levels, and > > 8-an increase in your insulin dose. > > 9-Any hypoglycemia can impair the body's detection of hypoglycemia for > up to 3 days. This means glucose levels must go even lower to produce > hypoglycemic > symptoms and activate glucose counter-response after any hypoglycemia. > > Hypoglycemia unawareness, the clinical condition in which people no > longer experience the neurogenic symptoms of low blood sugars, affects > many people > with type I diabetes and a few with type 2. The glucose levels needed to > trigger glucose counter-response are lower in people with hypoglycemia > unawareness > and the first symptoms they usually experience are neuroglycopenic, a > sign of blood sugars of 49 mg/dl or less. > > Recent studies indicate that avoiding hypoglycemia for a period of time > as short as a few weeks may reverse hypoglycemia unawareness. (See the > Uncomplicating > Column in the March, 1994, issue of Diabetes Health.) People who suffer > from hypoglycemia unawareness should monitor their blood sugar levels > very closely. > Hypoglycemia unawareness itself increases the risk for hypoglycemia by > seven times. > > Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps > the most easily treated, but can also be the most immediately dangerous. > Awareness > of the signs, symptoms, and risks of hypoglycemia, and diligent > monitoring of blood sugars allows hypoglycemia to be controlled and even > avoided. This > can be vital, because like many things about diabetes, hypoglycemia is a > self-perpetuating problem. > > This article was refined from a review article called " Hypoglycemia " > which appeared in the July, 1994 issue of Diabetes Care. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 Hi, I agree, when exercising testing is essential as I also can get very low with out knowing. When not exercising I can usually tell I am getting low when my blood sugars get around the mid 3's. Cheers, Brett. article > > Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your > Mind? > King, Editor-in-Chief > 1 May 2008 > > Recommend this Article: > Average Rating: > > We originally wrote this article for our September 1994 issue. Now it is > an " Archive Favorite " as it has not gone out of date, and is still very > helpful. > Not much has changed about hypoglycemia or its treatment in the last 14 > years. Am I right or wrong? For me, Learning all I can about Lows makes > it easier > to recognize and manage them (before I go too Low). I've used this > article to help understand what I am feeling so I can recognize a Low > early on! Please > use the Comment feature below to share your experiences of success, or > tell us about your worst Low, what happened and what you learned. > > A word of caution about the values used below. This study was conducted > using people without diabetes. Some people with diabetes experience > symptoms at > higher glucose levels than the study suggests. Other people with > diabetes appear to function well with blood sugars in the 30's and 40's > (mg/dl). Therefore, > the values in the study should only be used as an approximation. This > study also used plasma glucose levels. Your values done at home might be > 20 percent > lower or higher than these lab values. For example, epinephrine release > in someone without diabetes would begin at about 63mg/dl with a home > blood glucose > meter. > > More caution: Many people with long-standing type 1 diabetes completely > lose some of these responses. The glucose counter-regulation system > becomes impaired > sometime during the first few years of diabetes. This impairment is > unusual in that it seems to be hypoglycemia-specific: the ability of > glucagon and epinephrine > to respond to other stimuli is basically unchanged, but is reduced or > absent when dealing with hypoglycemia. The cause of this is not known, > but it is > closely linked with the lack of insulin production. > > SIDE BAR: > HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: > > at 69 mg/dl Epinephrine is released into the bloodstream > at 68 mg/dl Glucagon release begins > at 67 mg/dl The brain conserves glucose by reducing glucose uptake > at 66 mg/dl The body releases the growth hormone Somatotropin, which > tells the body to reduce its use of glucose and burn fat instead > at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen > into glucose > at 54 mg/dl Full-on hypoglycemic body symptoms may start including > shaking, pounding heart, nervousness, sweating, tingling and hunger > at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: > confusion, drowsiness, weakness, feeling too warm, difficulty speaking, > impaired coordination > and odd behavior > > *Many type 1s don't have all these responses. > > In this age of tight control, hypoglycemia has become a major concern > for people with diabetes. How much do you really know about it? This > article details > symptoms, causes, and the body's responses to hypoglycemia. The more you > know about hypoglycemia, its progression, and its causes, the more > likely you > will be to control or prevent it. > > " I'm drenched in sweat and everything is getting on my nerves. My face > feels tight and my lips feel numb. I know I should check my blood sugar, > but I can't > think well enough to get it together. Finally I get my finger stuck, my > blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 > Dex4's and > start to feel better in about 10 minutes. My health practitioner calls > this hypoglycemia, but I call it pure hell. " > > I know many type 1's actually get used to this, and learn to feel, test > and correct by eating very effectively. Others, like me, get the > " Diabetic Werewolf > Syndrome " where I have to keep eating everything in site until my blood > glucose raises back up, usually about 20 or 30 minutes until we stop > shaking. But > of course every hypo can be different. I have friends that can get quit > querulous when they are low. I have seen some skinny type 1's who, when > low, > may even " fight off " a husband who tries to get them to eat. Many of us > have spent our whole lives AVOIDING Sweets, so their subconscious > eschews sweet > even when low. Everyone had heard of some Low diabetic doing something > REALLY wacky. Like running out to the parking lot at work and urinating > while standing > on the bosses car. Can't you just hear him later, " Wow, I did that? > Sorry Boss, I must have had a real bad Low! " > > At some level, hypoglycemia as the ability to let our unconscious > thoughts come out. Kind of like being drunk and doing something > embarrassing you don't > remember later. Has anyone here ever woke-up with paramedic surrounding > your bed asking you what day it is? Maybe yours was running naked our > the front > door one night mumbling something about the ice-cream man coming? This > can happen to anyone as it is really very easy to et too much insulin. > > No one has to tell most people with diabetes that low blood sugar or > hypoglycemia is one of the most common and potentially dangerous > problems of diabetes. > Mild hypoglycemia is annoying and embarrassing; severe episodes can lead > to brain damage, seizure, coma, or, even death. > > Although the famous 1993 DCCT study showed conclusively that reducing > blood glucose levels also reduces long-term diabetes complications, it > also found > that people who keep their blood sugars close to the normal range have a > three times greater chance of hypoglycemia. Some of the 27 centers > involved in > the DCCT were able to achieve nearly normal average blood sugar readings > with very little hypoglycemia. However, a significant risk remains when > tight > control is attempted. > > Hypoglycemia is dangerous because it impacts the brain or nerve center, > which derives almost all of its energy from glucose. The brain depends > on the bloodstream > for a continuous supply of glucose because it can only store a few > minutes' worth of energy as glycogen. Any change in blood glucose levels > can quickly > and seriously affect thinking and coordination. > > Hypoglycemia can usually be detected by the brain, but the brain relies > heavily on warning signals generated by the central nervous system as > the blood > sugar drops. Signals like sweating and shaking are produced by the > release of stress hormones in a process called glucose > counter-regulation. This release > starts the slow return of the blood sugar to the normal range. The > liver, interestingly, is directly involved as well in sensing and > correcting low blood > sugars. Remember that some type 1s lose this response (the body's own > ability to raise BG's) altogether over the years. > > Non-diabetics can count on the body's backup systems for raising a low > blood sugar. In a research paper done by Dr. Philip Cryer at the > Washington University > School of Medicine, these recovery systems were outlined in non-diabetic > volunteers. Physical responses that generate recovery are triggered at > different > glucose levels. > > The first response, which occurs at around 83 mg/dl, is a reduction of > insulin production, while the second, the release of epinephrine into > the bloodstream, > begins at 69 mg/dl, but plays a minor role unless the supply of glucagon > becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 > mg/dl by > a reduced glucose uptake into the brain. And at 66 mg/dl, the body > releases the growth hormone somatotropin, which tells the body to reduce > its use of > glucose (so this defense mechanism is trying to keep us form going too > Low). Somatotropin also tells the body to increase the use of fats as > fuel. > > As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that > promotes the conversion of glycogen into glucose, is released to assist > in raising > the body's glucose levels. For these test subjects, when the glucose > level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 > mg/dl thinking > becomes impaired, as now the brain is low on glucose too. > > Long term type 1s who lack a good epinephrine and glucagon response, are > 25 times more likely to experience severe hypoglycemia than those who > respond > normally. > > Two types of symptoms are associated with hypoglycemia: neurogenic > (body) symptoms, which originate in the nervous system, affect the body, > and are usually > noticed by the person with diabetes himself; and neuroglycopenic (mind) > symptoms, which affect the mind. The latter are a direct result of > glucose deprivation > in the brain, and are frequently noticed by others but not by the person > with diabetes. > > In the controlled study of non-diabetics, the neurogenic symptoms occur > at around 54 mg/dl and include shaking, pounding heart, nervousness, > sweating, > tingling, and hunger, while the neuroglycopenic symptoms which occur at > 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, > difficulty speaking, > impaired coordination, and odd behavior (and, of course, coma, seizures, > and death). > > Risk Factors for Hypoglycemia: > > 1-an excessive insulin in the blood (due to either high injected dosage > or missed meals), > > 2-an increase in the use of insulin (as seen during exercise), > > 3-a decrease in glucose production (as occurs after drinking alcohol), > or > > 4-an increase in insulin sensitivity (also seen during exercise). > > 5-a history of severe hypoglycemia, > > 6-having type 1 diabetes for over 9 to 12 years, > > 7-any lowering of HbA1c levels, and > > 8-an increase in your insulin dose. > > 9-Any hypoglycemia can impair the body's detection of hypoglycemia for > up to 3 days. This means glucose levels must go even lower to produce > hypoglycemic > symptoms and activate glucose counter-response after any hypoglycemia. > > Hypoglycemia unawareness, the clinical condition in which people no > longer experience the neurogenic symptoms of low blood sugars, affects > many people > with type I diabetes and a few with type 2. The glucose levels needed to > trigger glucose counter-response are lower in people with hypoglycemia > unawareness > and the first symptoms they usually experience are neuroglycopenic, a > sign of blood sugars of 49 mg/dl or less. > > Recent studies indicate that avoiding hypoglycemia for a period of time > as short as a few weeks may reverse hypoglycemia unawareness. (See the > Uncomplicating > Column in the March, 1994, issue of Diabetes Health.) People who suffer > from hypoglycemia unawareness should monitor their blood sugar levels > very closely. > Hypoglycemia unawareness itself increases the risk for hypoglycemia by > seven times. > > Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps > the most easily treated, but can also be the most immediately dangerous. > Awareness > of the signs, symptoms, and risks of hypoglycemia, and diligent > monitoring of blood sugars allows hypoglycemia to be controlled and even > avoided. This > can be vital, because like many things about diabetes, hypoglycemia is a > self-perpetuating problem. > > This article was refined from a review article called " Hypoglycemia " > which appeared in the July, 1994 issue of Diabetes Care. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2008 Report Share Posted May 3, 2008 Hi, I agree, when exercising testing is essential as I also can get very low with out knowing. When not exercising I can usually tell I am getting low when my blood sugars get around the mid 3's. Cheers, Brett. article > > Hypoglycemia: What Do You Feel In Your Body? What Do You Feel In Your > Mind? > King, Editor-in-Chief > 1 May 2008 > > Recommend this Article: > Average Rating: > > We originally wrote this article for our September 1994 issue. Now it is > an " Archive Favorite " as it has not gone out of date, and is still very > helpful. > Not much has changed about hypoglycemia or its treatment in the last 14 > years. Am I right or wrong? For me, Learning all I can about Lows makes > it easier > to recognize and manage them (before I go too Low). I've used this > article to help understand what I am feeling so I can recognize a Low > early on! Please > use the Comment feature below to share your experiences of success, or > tell us about your worst Low, what happened and what you learned. > > A word of caution about the values used below. This study was conducted > using people without diabetes. Some people with diabetes experience > symptoms at > higher glucose levels than the study suggests. Other people with > diabetes appear to function well with blood sugars in the 30's and 40's > (mg/dl). Therefore, > the values in the study should only be used as an approximation. This > study also used plasma glucose levels. Your values done at home might be > 20 percent > lower or higher than these lab values. For example, epinephrine release > in someone without diabetes would begin at about 63mg/dl with a home > blood glucose > meter. > > More caution: Many people with long-standing type 1 diabetes completely > lose some of these responses. The glucose counter-regulation system > becomes impaired > sometime during the first few years of diabetes. This impairment is > unusual in that it seems to be hypoglycemia-specific: the ability of > glucagon and epinephrine > to respond to other stimuli is basically unchanged, but is reduced or > absent when dealing with hypoglycemia. The cause of this is not known, > but it is > closely linked with the lack of insulin production. > > SIDE BAR: > HYPOGLYCEMIA, What Happens As Your Blood Glucose Levels Fall*: > > at 69 mg/dl Epinephrine is released into the bloodstream > at 68 mg/dl Glucagon release begins > at 67 mg/dl The brain conserves glucose by reducing glucose uptake > at 66 mg/dl The body releases the growth hormone Somatotropin, which > tells the body to reduce its use of glucose and burn fat instead > at 58 mg/dl Cortisol, a steroid that promotes the conversion of glycogen > into glucose > at 54 mg/dl Full-on hypoglycemic body symptoms may start including > shaking, pounding heart, nervousness, sweating, tingling and hunger > at 49 mg/dl Thinking becomes impaired. The Mind symptoms start: > confusion, drowsiness, weakness, feeling too warm, difficulty speaking, > impaired coordination > and odd behavior > > *Many type 1s don't have all these responses. > > In this age of tight control, hypoglycemia has become a major concern > for people with diabetes. How much do you really know about it? This > article details > symptoms, causes, and the body's responses to hypoglycemia. The more you > know about hypoglycemia, its progression, and its causes, the more > likely you > will be to control or prevent it. > > " I'm drenched in sweat and everything is getting on my nerves. My face > feels tight and my lips feel numb. I know I should check my blood sugar, > but I can't > think well enough to get it together. Finally I get my finger stuck, my > blood drop on the strip, wait... Blood sugar reads 40mg/dl. I eat 4 > Dex4's and > start to feel better in about 10 minutes. My health practitioner calls > this hypoglycemia, but I call it pure hell. " > > I know many type 1's actually get used to this, and learn to feel, test > and correct by eating very effectively. Others, like me, get the > " Diabetic Werewolf > Syndrome " where I have to keep eating everything in site until my blood > glucose raises back up, usually about 20 or 30 minutes until we stop > shaking. But > of course every hypo can be different. I have friends that can get quit > querulous when they are low. I have seen some skinny type 1's who, when > low, > may even " fight off " a husband who tries to get them to eat. Many of us > have spent our whole lives AVOIDING Sweets, so their subconscious > eschews sweet > even when low. Everyone had heard of some Low diabetic doing something > REALLY wacky. Like running out to the parking lot at work and urinating > while standing > on the bosses car. Can't you just hear him later, " Wow, I did that? > Sorry Boss, I must have had a real bad Low! " > > At some level, hypoglycemia as the ability to let our unconscious > thoughts come out. Kind of like being drunk and doing something > embarrassing you don't > remember later. Has anyone here ever woke-up with paramedic surrounding > your bed asking you what day it is? Maybe yours was running naked our > the front > door one night mumbling something about the ice-cream man coming? This > can happen to anyone as it is really very easy to et too much insulin. > > No one has to tell most people with diabetes that low blood sugar or > hypoglycemia is one of the most common and potentially dangerous > problems of diabetes. > Mild hypoglycemia is annoying and embarrassing; severe episodes can lead > to brain damage, seizure, coma, or, even death. > > Although the famous 1993 DCCT study showed conclusively that reducing > blood glucose levels also reduces long-term diabetes complications, it > also found > that people who keep their blood sugars close to the normal range have a > three times greater chance of hypoglycemia. Some of the 27 centers > involved in > the DCCT were able to achieve nearly normal average blood sugar readings > with very little hypoglycemia. However, a significant risk remains when > tight > control is attempted. > > Hypoglycemia is dangerous because it impacts the brain or nerve center, > which derives almost all of its energy from glucose. The brain depends > on the bloodstream > for a continuous supply of glucose because it can only store a few > minutes' worth of energy as glycogen. Any change in blood glucose levels > can quickly > and seriously affect thinking and coordination. > > Hypoglycemia can usually be detected by the brain, but the brain relies > heavily on warning signals generated by the central nervous system as > the blood > sugar drops. Signals like sweating and shaking are produced by the > release of stress hormones in a process called glucose > counter-regulation. This release > starts the slow return of the blood sugar to the normal range. The > liver, interestingly, is directly involved as well in sensing and > correcting low blood > sugars. Remember that some type 1s lose this response (the body's own > ability to raise BG's) altogether over the years. > > Non-diabetics can count on the body's backup systems for raising a low > blood sugar. In a research paper done by Dr. Philip Cryer at the > Washington University > School of Medicine, these recovery systems were outlined in non-diabetic > volunteers. Physical responses that generate recovery are triggered at > different > glucose levels. > > The first response, which occurs at around 83 mg/dl, is a reduction of > insulin production, while the second, the release of epinephrine into > the bloodstream, > begins at 69 mg/dl, but plays a minor role unless the supply of glucagon > becomes deficient. Glucagon release begins at 68 mg/dl, followed at 67 > mg/dl by > a reduced glucose uptake into the brain. And at 66 mg/dl, the body > releases the growth hormone somatotropin, which tells the body to reduce > its use of > glucose (so this defense mechanism is trying to keep us form going too > Low). Somatotropin also tells the body to increase the use of fats as > fuel. > > As the blood glucose level reaches 58 mg/dl, cortisol, a steroid that > promotes the conversion of glycogen into glucose, is released to assist > in raising > the body's glucose levels. For these test subjects, when the glucose > level fell to 54 mg/dl, the body's hypoglycemic symptoms started. At 49 > mg/dl thinking > becomes impaired, as now the brain is low on glucose too. > > Long term type 1s who lack a good epinephrine and glucagon response, are > 25 times more likely to experience severe hypoglycemia than those who > respond > normally. > > Two types of symptoms are associated with hypoglycemia: neurogenic > (body) symptoms, which originate in the nervous system, affect the body, > and are usually > noticed by the person with diabetes himself; and neuroglycopenic (mind) > symptoms, which affect the mind. The latter are a direct result of > glucose deprivation > in the brain, and are frequently noticed by others but not by the person > with diabetes. > > In the controlled study of non-diabetics, the neurogenic symptoms occur > at around 54 mg/dl and include shaking, pounding heart, nervousness, > sweating, > tingling, and hunger, while the neuroglycopenic symptoms which occur at > 49 mg/dl are confusion, drowsiness, weakness, feeling too warm, > difficulty speaking, > impaired coordination, and odd behavior (and, of course, coma, seizures, > and death). > > Risk Factors for Hypoglycemia: > > 1-an excessive insulin in the blood (due to either high injected dosage > or missed meals), > > 2-an increase in the use of insulin (as seen during exercise), > > 3-a decrease in glucose production (as occurs after drinking alcohol), > or > > 4-an increase in insulin sensitivity (also seen during exercise). > > 5-a history of severe hypoglycemia, > > 6-having type 1 diabetes for over 9 to 12 years, > > 7-any lowering of HbA1c levels, and > > 8-an increase in your insulin dose. > > 9-Any hypoglycemia can impair the body's detection of hypoglycemia for > up to 3 days. This means glucose levels must go even lower to produce > hypoglycemic > symptoms and activate glucose counter-response after any hypoglycemia. > > Hypoglycemia unawareness, the clinical condition in which people no > longer experience the neurogenic symptoms of low blood sugars, affects > many people > with type I diabetes and a few with type 2. The glucose levels needed to > trigger glucose counter-response are lower in people with hypoglycemia > unawareness > and the first symptoms they usually experience are neuroglycopenic, a > sign of blood sugars of 49 mg/dl or less. > > Recent studies indicate that avoiding hypoglycemia for a period of time > as short as a few weeks may reverse hypoglycemia unawareness. (See the > Uncomplicating > Column in the March, 1994, issue of Diabetes Health.) People who suffer > from hypoglycemia unawareness should monitor their blood sugar levels > very closely. > Hypoglycemia unawareness itself increases the risk for hypoglycemia by > seven times. > > Hypoglycemia is dangerous. As a complication of diabetes, it is perhaps > the most easily treated, but can also be the most immediately dangerous. > Awareness > of the signs, symptoms, and risks of hypoglycemia, and diligent > monitoring of blood sugars allows hypoglycemia to be controlled and even > avoided. This > can be vital, because like many things about diabetes, hypoglycemia is a > self-perpetuating problem. > > This article was refined from a review article called " Hypoglycemia " > which appeared in the July, 1994 issue of Diabetes Care. > > > Quote Link to comment Share on other sites More sharing options...
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