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In 1927, Sakel, who had recently qualified as a medical doctor in Vienna and was working in a psychiatric clinic in Berlin, began to use low (sub-coma) doses of insulin to treat drug addicts and psychopaths, and when one of the patients experienced improved mental clarity after having slipped into an accidental coma, Sakel reasoned the treatment might work for mentally ill patients. [3]
When individuals take insulin without needing it, to purposefully induce hypoglycemia, this is referred to as surreptitious insulin use or factitious hypoglycemia. [ 3 ] [ 2 ] [ 24 ] Some people may use insulin to induce weight loss, whereas for others this may be due to malingering or factitious disorder , which is a psychiatric disorder . [ 24 ]
Glucagon is a hormone that rapidly counters the metabolic effects of insulin in the liver, causing glycogenolysis and release of glucose into the blood. It can raise the glucose by 30–100 mg/dL within minutes in any form of hypoglycemia caused by insulin excess (including all types of diabetic hypoglycemia).
Reactive hypoglycemia, postprandial hypoglycemia, or sugar crash is a term describing recurrent episodes of symptomatic hypoglycemia occurring within four hours [1] after a high carbohydrate meal in people with and without diabetes. [2]
Insulin can be injected by several methods, including a hypodermic needle, jet injector, or insulin pump. There is also inhaled insulin that can be used in adults with diabetes. [33] There are several types of insulin that are commonly used in medical practice, with varying times of onset and duration of action. [32]
Insulin self-injected for treatment of diabetes (i.e., diabetic hypoglycemia) Insulin self-injected surreptitiously (e.g., Munchausen syndrome) Insulin self-injected in a suicide attempt or fatality; Various forms of diagnostic challenge or "tolerance tests" Insulin tolerance test for pituitary or adrenergic response assessment; Protein challenge
In insulin-deficient diabetes (exogenous) insulin levels do not decrease as glucose levels fall, and the combination of deficient glucagon and epinephrine responses causes defective glucose counterregulation. Furthermore, reduced sympathoadrenal responses can cause hypoglycemia unawareness.
[6] [7] At Mayo, she oversaw multiple ventures including establishment of the Mayo Clinic Care Network and the Mall of America project. [8] Simultaneously she was a member of the Mayo Clinic Board of Trustees and served as secretary for the Mayo Clinic Board of Governors. [4] Weis retired from the post of CAO at Mayo in November 2013.