Thursday, July 30, 2009

Hypoglycemia unawareness- Drowning with the anchor

We had a guest over at our home few days back, we were having a nice time, had tea together with some buscuits , As our friend is a Diabetic obviously the tea was without sugar and light diet buscuits with lot of fibres only accompanied, our friend refused to have dinner he said he was having some stomach problem since the morning , wasn't feeling like eating at all and had very light lunch as well because of the same reason.... Well knowing him well we did'nt press too much. As the time went by we noticed he started behaving strangely.. Started speaking ( we thought opening secrets') about some common friends, talking in a manner utterly uncompatible with himself- we've known since years as one of the most humble and respectable persons.. I could sense something was wrong. Then to our utter surprise he put his legs on the table and started angrily shouting about a politician..I knew now for sure something was gravely wrong! Either this was hypoglycemia or he was undergoing a stroke, we immdiately checked his capillary glucose it showed 30 by glucometer. This gentleman was still talking, sitting moving about..Had we not known him for so long we would have accepted him just as an angry man.
Even after giving 300 gms of glucose by mouth his capillary levels did not rise beyond 60, we finally gave him intravenous glucose and he was back to his normal self just in 15 min, Utterly surprised to the surroundings of a hospital emergency- he was absolutely unaware of whatever had happened, even though outwardly he'd been conscious all the time.

Very often this is what is felt by friends and family members of Diabetics who have been having uncontrolled diabetes for a long time, rarely this may end in a tragedy , because of coma or accidents.
Glucose is the principal form of energy required by brain, it cannot function without glucose which it must derive from blood as it does not have any sources of its own. If the level of glucose starts falling down below a critical level, the glucose counter regulatory system comes into action which releases blood glucose from stores in the body like liver, kidney muscles, causes outward manifestations like hunger, palpitations, sweating, headache which make the seek food and help.
These systems and their manifestations are controlled by the autonomic Nervous system, which is adversely affected by the continued damage of high blood glucose and other changes which happen in longstanding Diabetes. Since the person whose sugar levels are falling pricipitously doesn't get any warning signals he doesn't act and blood glucose keeps dropping like an anchor, this is termed as Hypoglycemia Unawareness. All the systems which ahve been put in place by nature to counter this simply do not activate.
click here to read more about Diabetic Neuropathy, theres a lot to it than just Hypoglycemia unawareness.