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From Gainesville, Florida, USA:

I am a 39 year old diabetic male. I have had diabetes for 18 years. Based on my A1c's and my eye exams I am in excellent control with no signs of complications. My question refers to rebounding and your bodies ability to produce sugar to offset hypoglycemia.

Most of the time when I am low I have no signs of hypoglycemia. My body seems to rebound and the low blood sugar episode goes undetected. I am making this assumption because I have tested myself and found my blood sugar to be 45 and had no symptoms of low blood sugar.

My question is: If a body was to go through this rebounding process often is there any adverse affect on one's organs with having to produce or convert stored fat into sugar? Also, after rebounding blood sugar levels typically go higher; are these high blood sugars as dangerous as high blood sugars you get after eating? It seems that when I am running high after rebounding that my blood sugar goes down quicker than when my blood sugar is high after overeating.


To begin with, it would appear that you have a condition known as hypoglycemic unawareness or asymptomatic hypoglycemia. It seems to occur most often in Type I diabetics and at night. However since you have had this problem in diabetes control for nearly 20 years without any ill effects, it promises no adverse reactions in the future.

The central nervous system and to a much lesser extent the peripheral nervous system is the only organ susceptible to both transient and long term damage from hypoglycemia. The reason for this is thought to be that in the brain glucose is essentially the only major substrate for energy production unlike the liver the kidneys or the heart. Certainly in children asymptomatic hypoglycemia has been well documented as a cause of developmental delay. In adults an impact on day to day functioning is less well established; but unquestionably hypoglycemia can cause severe temporary and lasting CNS damage.

The answer to this is to maintain a profile of blood sugar at all hours including an occasional one in the early morning hours. This will indicate if there are times of the day when you might be vulnerable to hypoglycemia: and in turn give you an opportunity to modify insulin dose or diet or exercise to correct the problem.

In terms of liability to long term complications, what matters is the duration as well as the peak height of the blood sugar levels. High blood sugars that are the result of a rebound response to a transient excess of short acting insulin are likely to be less than those that are due to the sustained absorption of complex carbohydrate.


Original posting 8 May 1999
Posted to Hypoglycemia


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Last Updated: Tuesday April 06, 2010 15:09:02
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