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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).
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]
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]
In order for blood glucose to be kept stable, modifications to insulin, glucagon, epinephrine and cortisol are made. Each of these hormones has a different responsibility to keep blood glucose regulated; when blood sugar is too high, insulin tells muscles to take up excess glucose for storage in the form of glycogen. Glucagon responds to too ...
Management of the dawn phenomenon varies by patient and thus should be done with regular assistance from a patient's physician. Some treatment options include, but are not limited to, dietary modifications, increased exercise before breakfast and during the evening, and oral anti-hyperglycemic medications if a patient's HbA1c is > 7%.
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Insulin is usually taken several times per day in patients who require it to control their diabetes. [32] Often patients usually take long acting insulin once a day and then take insulin before meals. The time of onset of the insulin determines how far in advance patients should take the insulin before they eat. [32]
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