Individuals who take insulin, which includes all people with Type 1 (insulin-dependent) diabetes and some people with Type 2 (non-insulin-dependent) diabetes, are prone to hypoglycemia. Common symptoms of hypoglycemia include weakness, drowsiness, confusion, hunger, dizziness, paleness, headache, irritability, trembling, sweating, rapid heartbeat, and a cold, clammy feeling. Most people with diabetes can recognize these symptoms and treat them by quickly eating or drinking something with sugar, such as candy, juice, or a regular (not diet) soft drink, or by taking special glucose tablets or gel, available over the counter in pharmacies.
If a person with diabetes does not recognize and treat hypoglycemia by eating something, he may require a glucagon injection (which must be given by another person). People with diabetes can reduce or prevent episodes of hypoglycemia by monitoring their blood sugar levels frequently and learning to recognize the symptoms of low blood sugar and the situations that can trigger it.
Disclaimer Statements: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The Future of Pumping Henry Anhalt, DO, CDE Director, Pediatric Endocrinology and Diabetes Saint Barnabas Medical Center Livingston, NJ. Excessive 24-Hour Glucose Fluctuations in Type 1 Patients with Mean A1C of 6.7% Levetan C, et al. WTR 49% WTR 42% WTR 45% ATR 33% BTR 18% ATR 46% BTR 12% ATR 41% BTR 14% Brewer KW, Chase PH, Owen S, Garg SK.
Schematics of the Autosensor & Biographer Mask Hydrogel Pads Ionto Sensor Electrode Assembly Electronic Components Garg et al. Near Infrared Ray (NIR) Large desk-like apparatus Skin temperature and hydration Calibration is too cumbersome Patient intervention required Real Need!
Trials clinici fondamentali Intensive blood-glucose control with sulphonlureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33).
Iperglicemia a digiuno Fisiopatologia diabete Fisiopatologia diabete Legata soprattutto ad aumento produzione epatica di glucosio glucosio insulina Iperglicemia postprandiale glucosio Legata ad alterata soppressione Insulino-mediata) della produzione Epatica glucosio+ ridotta utilizzazione (insulinostimolata) del glucosio da Parte del muscolo.

Diabete mellito di tipo 2: fase precoce della secrezione insulinica nel soggetto sano e nel paziente diabetico Ward WK, et al. GLINIDI Farmaci di seconda linea in aggiunta alla metformina quando non si raggiunge lobiettivo di HbA1c Prevalente iperglicemia postprand.
Trials clinici fondamentali Trials clinici fondamentali Effect of intensive blood-glucose control with metformin on complication in overweight patients with type 2 diabetes (UKPDS 34).
Long-Term Problems (contd) Rates of eye and kidney disease based on glucose variability (using CGM) in Type-2 Diabetes Source: Liu et al, American Diabetes Association 71 st Scientific Sessions 2011, Abstract 2205-PO.
Glycemic Index All carbs (except fiber) convert to blood glucose eventuallyAll carbs (except fiber) convert to blood glucose eventually G.I. Meal Sequences Eat veggies before starch when having mixed meals Eat veggies before starch when having mixed meals Make lunch the higher carb meal (less at breakast & dinner) Make lunch the higher carb meal (less at breakast & dinner) Presented at the American Diabetes Associaion Scientific Sessions, 2012, symposium on minimizing glucose variability.
People with Type 2 diabetes who take sulfonylureas are also vulnerable to episodes of low blood sugar. In severe cases, hypoglycemia can cause a person to lose consciousness or even lapse into a coma. However, some people with long-standing diabetes develop a condition known as hypoglycemia unawareness or hypoglycemia without warning, in which they no longer develop the usual symptoms that herald the onset of hypoglycemia.
Glucagon, a hormone, quickly eases the symptoms of hypoglycemia by converting liver stores of glucose into a usable form and releasing it into the bloodstream. They should consult their health-care providers for advice about the best way to treat low blood sugar. Limited availability of reliable continuous glucose monitoring Lack of alternate routes of insulin delivery. The Average HbA1c is not the most complete expression of the degree of glycemia and the risk of complications may be more highly dependent on the excursions or influenced by counterregulatory hormonal responses to hypoglycemia.

Trials clinici fondamentali Intensive blood-glucose control with sulphonlureas or insulin compared with conventional treatment.
Effects of meals with different glycaemic index on postprandial blood glucose response in patients with Type 1 diabetes treated with continuous subcutaneous insulin infusion. Insulin taken with meal Insulin taken 15-30 min Pre-Meal (if >150) Duran-Valdez, et al (U of New Mexico). Hypoglycemia can occur when a person takes too much medicine, skips or delays a meal, eats too little food for the amount of insulin he injected, exercises too strenuously, or drinks too much alcohol. This condition can be reversed by maintaining higher blood sugar levels for a short period of time (about two weeks) and scrupulously avoiding low blood sugar. A person who does not respond immediately to treatment for hypoglycemia may need to be admitted to the hospital so that blood sugar can be stabilized. Friends and relatives should be informed about the symptoms of hypoglycemia and know how to treat it, if necessary.
Consult appropriate health-care professionals before taking action based on this information. Reflects the magnitude of blood glucose rise for the first 2 hours following ingestion G.I. CryerFrom the Division of Endocrinology, Diabetes and Metabolism, and the General Clinical Research Center and the Diabetes Research and Training Center, Washington University School of Medicine, St.
Number is % or rise relative to pure glucose (100% of glucose is in bloodstream within 2 hours)G.I.

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