Hypoglycaemia Habituation Flashcards
What does IAH stand for?
Impaired awareness of hypoglycemia
What is iatrogenic hypoglycemia?
Low blood sugar that is caused by medical treatment, most commonly due to taking too much insulin or other diabetes medications, leading to a drop in blood glucose levels
Why are T1D at risk of severe hypoglycaemic?
Their bodies lack the ability to produce insulin naturally
So they rely on external insulin injections which can easily lead to blood sugar dropping too low if not carefully managed
Their bodies also often have impaired counterregulatory hormone responses (like glucagon release) that normally help raise blood sugar when it drops too low, leaving them with limited defenses against hypoglycemia.
Repeated episodes of hypoglycemia can lead to “hypoglycemia unawareness,” where a person doesn’t experience the typical warning signs of low blood sugar, making it harder to recognize and treat.
What is the hemoglobin A1c (HbA1c) test?
Measures the amount of blood sugar (glucose) attached to your hemoglobin
What is the trade off in intensive insulin therapy?
The therapy delays onset and slows progression of diabetic retinopathy
BUT increase their rate of getting severe hypoglycaemia
What other side effects did intense insulin therapy have?
Decrease in adrenaline response
Feeling low
What response does hypoglycaemia impair?
Neuroendocrine response (CCR) to subsequent hypoglycaemia
What happens in IAH?
Threshold (glucose level) for eliciting CRR is lowered in impaired awareness of hypoglycemia = increasing risk of severe hypoglycaemia
This means that the body only senses low glucose when it is exceptionally low
Glucose sensing cells within hypothalamus become “unaware” of falling glucose levels
Why does impaired awareness of hypoglycaemia come about?
Due to repeated exposure to hypoglycaemia the body becomes habituated and no longer responds with CRR
Define habituation
Given that a particular stimulus elicits a response, repeated applictations of that stimulus result in a decreased response
As shown in hypoglycaemia
Define sponatneous recovery
If the stimulus is withheld, the response tends to recover over time
If T1D doesn’t go hypoglycaemic for many months = may be able to restore ability to detect glucose
When does habituaiton becomes more rapid?
After repeated series of habituation training and spontaneous recovery
What happens when the frequency of stimulation is increased?
More rapid and more pronounced habituation occurs
What effect does having a stong and weak stimulus do in habituation?
Weaker stimulus = more rapid and pronounced habituation
Strong stimuli may yield no significant habituation
What may strong stimuli yield no significant habituation?***
