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Beta cells are sensitive to blood sugar levels so that they secrete insulin into the blood in response to high level of glucose, and inhibit secretion of insulin when glucose levels are low. [10] Insulin production is also regulated by glucose: high glucose promotes insulin production while low glucose levels lead to lower production. [11]
This is because the presence of a small quantity of insulin suppresses the release of counterregulatory hormones and limits the production of ketones. [10] Multiple factors can trigger HHS, including infection, myocardial infarction , and trauma, [ 13 ] [ 17 ] [ 15 ] as well as infections in the respiratory, digestive, and urinary systems.
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).
This leads to excessive urination (more specifically an osmotic diuresis), which, in turn, leads to volume depletion and hemoconcentration that causes a further increase in blood glucose level. Ketosis is absent because the presence of some insulin inhibits hormone-sensitive lipase-mediated fat tissue breakdown. [citation needed]
Antibodies can be formed against insulin, leading to autoimmune hypoglycemia. [3] [33] Antibodies are immune cells produced by the body, that normally attack bacteria and viruses, but sometimes can attack normal human cells, leading to an autoimmune disorder. [34] In autoimmune hypoglycemia, there are two possible mechanisms.
Glucagon should be injected intramuscularly or intravenously, or dextrose can be infused intravenously to raise the blood glucose. Oral administration of glucose can worsen the outcome, as more insulin is eventually produced. Most people recover fully even from severe hypoglycemia after the blood glucose is restored to normal.
This leads to elevated free fatty acids in the blood plasma and can further worsen insulin resistance. [38] [39] [40] Since insulin is the primary hormonal signal for energy storage into fat cells, which tend to retain their sensitivity in the face of hepatic and skeletal muscle resistance, insulin resistance stimulates the formation of new ...
The main goal of diabetes management is to keep blood glucose (BG) levels as normal as possible. [1] If diabetes is not well controlled, further challenges to health may occur. [1] People with diabetes can measure blood sugar by various methods, such as with a BG meter or a continuous glucose monitor, which monitors over several days. [2]