Hypoglycemia due to Type 1 diabetes is iatrogenic hypoglycemia as it is induced inadvertently by medical treatment by the interplay of therapeutic hyperinsulinemia and compromised defense which results in hypoglycemia associated autonomic failure.
Hypoglycemia that is low blood sugar occurs in a patient with Type 1st diabetes occurs when there is too much insulin and not enough sugar in the blood.
Many factors contribute to hypoglycemia in people with type 1st diabetes includes taking too much insulin and other diabetic medications and another reason behind hypoglycemia is skipping a meal and exercising harder than usual.
It is demonstrated by Diabetes Control and complications Trials that patients with intensive insulin therapy will help you to reduce the risk of long- term microvascular complications.
However, you will get an increase in the risk of severe glycemia with strict glycemic control. In the case of recurrent episodes of hypoglycemia, it will lead to hypoglycemia unawareness and it exerts adverse effects on neurocognitive function and it may cause significant emotional morbidity in the child and parents.
Hypoglycemic episodes during the night also known as Nocturnal hypoglycemia account for about half of all severe episodes and it is particularly dangerous because of warning symptoms are absent or blunted during sleep.
In a healthy person who is with perfect counter-regulatory defense mechanism, in case of hypoglycemia, the body generates autonomic symptoms and it alerts the individuals.
Then the body of healthy subjects responds by suppressing insulin release and it stimulates glucagon release from islet cells of the pancreas and it protects the brain from glucose deprivation.
But in case of a patient suffering from Type 1 diabetes, blood insulin level depends on exogenous administration and this makes insulin suppression response impossible.
The glucagon response is also diminished partly or entirely by Type 1st diabetic patient with time. With time, there is blunting of autonomic processes and it leads to hypoglycaemic unawareness. This will further increase the risk of subsequent severe hypoglycaemic episodes.
In diabetes therapy, the introduction of new insulin analogs and also the use of continuous subcutaneous insulin infusion are improving hope for the solution of this problem, but this modality is not associated with the expected decrease in hypoglycemia episodes.
The best suggestion which can prevent the hypoglycemia in Type 1st diabetes patient lies in biologically controlled insulin secretion as in case of islet transplantation or another way is developing an autonomous closed-loop system that efficiently mimics the action of pancreatic β cells and it will help in maintaining blood glucose levels within the desired range.
You need to pay attention to all early warning signs and it will help you treat low blood sugar promptly. The treatment of hypoglycemia involves short term solutions like taking glucose tablets and by drinking juice and these will raise blood sugar into a normal range.
In case of lack of treatment of hypoglycemia induced by an overdose of insulin in type 1st diabetic patient lead to seizures and loss of consciousness and it can be considered as a medical emergency. Sometime it may be fatal.
You can also read this Treatment of Diabetes associated Hypoglycemia
Causes
Hypoglycemia is common among many people who take insulin. But it can also occur in patients who are taking oral diabetic medications. Most common causes of diabetes associated hypoglycemia include:
- Overdose of insulin and diabetic medication.
- Meal skipping is another cause of hypoglycemia.
- Increased exercise and physical activity without eating sufficient and without adjusting medicines.
- Drinking alcohol is another cause of hypoglycemia.
Pathophysiology
In type 1st diabetes, there is hypoglycemia because of the combination of an absolute or relative excess of insulin and impaired physiological defense against fall in blood glucose.
The physiological defense mechanism, glucose counter-regulation which prevents and restores balance in case of hypoglycemia is impaired in Type 1st diabetic patients. Due to compromised glucose counterregulatory responses, in case of excess of administered insulin, the body will not be able to decrease insulin in the blood and increase glucagon secretion, and it leads to hypoglycemia.
Symptoms of Hypoglycaemia in Type 1st diabetes. Early warning signs and symptoms:
- You may feel shakiness.
- You will also feel dizziness.
- You will also feel symptoms of sweating.
- There will be increased hunger in diabetic patients.
- You will also face irritable or moodiness.
- There will be anxiety and nervousness.
- You will also face a headache.
Nighttime symptoms:
- Half of the diabetic hypoglycemia occurs while you sleep. Signs and symptoms include:
- Damp sheets and bedclothes because of perspiration.
- You will also face nightmares.
- You will also face symptoms like irritability, tiredness, and confusion upon waking.
Severe symptoms
- In case of lack of treatment of hypoglycemia because of type 1st diabetes, signs and symptoms include:
- There will be clumsiness and jerky movement.
- You will also face muscle weakness.
- There may be symptoms of difficulty in speaking or slurred speech.
- You may also face the problem of blurry a double vision.
- There may be drowsiness.
- There may be seizures and convulsions.
- The patient may go unconscious.
- Sometime it may lead to death.
Conclusion
So these are all symptoms and causes of Type 1st associated hypoglycemia.
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