This is how I have come to understand the workings of blood sugar. Please point out where I’m going wrong.
Glucose (sugar) comes from food. Insulin is a hormone that turns glucose into glycogen (fat) in the liver. The hormone glucagon turns glycogen back into glucose. Diabetics produce too little insulin, so their body can’t properly turn glucose into glycogen. So, if they don’t take their insulin with a meal, their blood sugar becomes too high. So far so good.
But how does this lead to low blood sugar? Their glucagon is working fine, so they should be able to turn glycogen into glucose when they need it. Right? Does this only occur when a diabetic accidentally takes too much insulin?
There are tons of different sources on this topic, but they’re either too confusing or they contradict each other. It doesn’t help that there are two types of diabetes. If anyone can explain, I’d appreciate it a lot!
In: Biology
Taking too much insulin is a common cause, but there are many things that can lower glucose levels. Exercise/physical activity lowers glucose levels, so when diabetics know they’re going to be active they often take less insulin. Heat can also lower glucose. Even prolonged rest (sleeping, when the body naturally slows down all basal metabolic processes so the body ends up requiring less insulin.) Sickness can impact glucose also. Those are a few of the most common examples, but there are many others. The difficult part for diabetics is timing, planning, and dosing their insulin requirements to account for this.
For example, some diabetics will have their glucose levels drop within 10 minutes of exercise, while others won’t see the impact until hours later. If you know you’re going hiking in hot weather in the afternoon, and so take less insulin that morning, but then someone offers a delicious chocolate trail mix while hiking, do you give a standard insulin dose for that chocolate, or less, given you’ve already reduced your dosage earlier in the day. Do you dose your insulin for the snack right away, or wait an hour? If the weather cools down 30 minutes into the hike, but you already dosed insulin assuming high heat all day, how does that change the plan? It’s a constant calibration and calculation balancing act – in my hiking example, the diabetic will probably bounce back and forth throughout the rest of the day between slightly high and slightly low glucose (hopefully avoiding any serious swings!)
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