Free Hypoglycemia Alert
Hypoglycemia? My heart goes out to people who depend on insulin because they walk a tightrope when their blood sugar levels fluctuate between extremes of high and low levels. Most stay out of trouble with just one hypoglycemic coma every six years, despite showing abnormal blood sugar values.
The trouble is there are a few whose lives have been disrupted by more than their share of hypoglycemia and ketoacidosis. Although most people call this brittle diabetes, some diabetologists do not agree.
Diabetologists? What is that? You heard me right. They are experts in the management of diabetes. Some of these think that patients whose blood glucose are stable in the hospital and only unstable outside should be excluded from brittle diabetes.
They believe that it is more helpful to use the term brittle to refer to the few whose lives are regularly disrupted by hypoglycemia or hyperglycemia . They found in their practice that the problem is either repeated hypoglycemia or recurrent ketoacidosis and hardly ever both.
Even the doctors find these cases exasperating to say the least. They also do not agree how often the episode should be before considering the condition as pathological. It depends on the treatment goals set and the tools the patients are given.
Let’s put this in a historical perspective. Hypoglycemia was thought to be the result of multiple insulin injections. This was done in the hope the urine will be free of sugar. Those who did best at this avoided complications and had just one coma each year. Of course, we do not accept this as good enough.
The doctors also found out that recurrent hypoglycemia does not favor sex, age and the length of the episode. It could happen to either male or female, young or old with the duration of the disease in varying length.
Lately though, interest has been shown in patients exhibiting no symptoms to warn them of the impending episode. They get no warning whatsoever so they have no defense against what is coming.
At least those who have warning signs can try to increase their glucose production in order to counteract the situation. They can try to compensate for the ongoing hyperinsulinemia. The trouble is there are situations that could complicate the matter.
What, another problem? When will this ever end? Well, of course there will be challenges along the way. And we have to know all this information in order to face the challenge head on. So, take a deep breath and get ready for more, shall we?
Here we go!
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