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Question:

From Wrentham, Massachusetts, USA:

Please explain to me why is it that a person with type 1 diabetes can have a rebound from a low during the night as opposed to having a seizure. I do not at all understand the mechanism behind this. Although I do know that the liver puts out glucose in the instance of rebound, why then does this not happen with all lows? Why wouldn't the liver kick in each and every time a low occurs? How long would it take for the liver to replenish its stores?

Answer:

You assume that everything works perfectly all the time. Probably when one has diabetes, there are some subtle abnormalities of the autonomic nervous system. This controls a lot of things including the body response to hypoglycemia. We suspect that this "thermostat" mechanisms is faulty, and the body either does not recognize or is not able to respond appropriately with hypoglycemia stress. So, sometimes there are symptoms and sometimes none at all. Sometimes seizures and sometimes just shakiness.

Remember also that the blood glucose level is not exactly the same as the brain glucose levels, only an approximation of each. It is possible that brain hypoglycemia is lower than what can be measured at home or even through a vein blood glucose level but the subtle differences may also explain differences in symptoms and response. The best way to prevent severe episodes of hypoglycemia is to know what causes them, do things to minimize their occurrence and do lots of blood glucose testing to recognize when they are happening.

SB

DTQ-20030406213833
Original posting 25 Apr 2003
Posted to Hypoglycemia

  
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Last Updated: Tuesday April 06, 2010 15:09:46
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