My understanding is that diabetics have a pancreas that does not produce insulin or the body has stopped reacting to insulin, which mean they can get really high blood sugar because nothing metabolizes is.
But why does that cause diabetic people to also get low blood sugar more often than non-diabetics? If I eat a cake, my body produces a bunch of insulin to metabolize, then I go work out for an hour, my blood sugar won’t be as low as a diabetic who did the same.
In: 24
I’ll do my best to throw my 2 cents in since nobody has mentioned glucagon yet!
To start, when we talk about blood sugar, we’re specifically referring to the sugar known as glucose. This is the sugar that is readily available for energy production in cells in the energy producing pathway known as glycolysis which converts it to pyruvate, which is then further broken down in the citric acid cycle (Krebs cycle) to produce energy. When patients with diabetes check their blood sugar, they are using a meter to check glucose levels specifically.
In the body, you’ll often find more than one hormone responsible for functions that can help balance each other out to maintain homeostasis (the body’s ability to keep things approximately even despite ever changing conditions). In the case of glucose metabolism, you have insulin which helps to store glucose in the form of glycogen (short term storage) and fat (long term storage). The opposing hormone is glucagon, which helps to mobilize these energy stores by breaking down glycogen stores in the liver, mobilizing fat stores and releasing fatty acids, and stimulating gluconeogenesis (the production of glucose from certain non-sugar substrates). Glucagon is naturally released from the pancreas in response to stimuli such as low blood glucose, exercise, or fasting conditions. This makes sense, because these are all good times to want to make more energy stores available to the body.
In healthy individuals, the pancreas is able to produce these two hormones at appropriate times in response to blood glucose levels and other hormonal factors to keep glucose in a tightly controlled range. Too little glucose and you could experience sweating, hunger, fatigue, or end up losing consciousness. On the other hand, too much glucose leads to chemical reactions that produce inflammation that can damage the body and lead to nerve pain or loss of sensation, increased risk of heart disease, and problems with the kidneys, among other things. Patients with diabetes either aren’t producing insulin at all anymore (Type 1) or are effectively not producing enough insulin to keep up with the body’s glucose levels (Type 2, AKA insulin resistance).
To combat this loss of insulin effect, patients with diabetes can use medications to increase the amount of insulin released, inject extra insulin to meet their bodies demands, or other various mechanisms to reduce blood glucose. The problem comes from the inability to control exactly how much insulin is present and active at any given time. If you have too much insulin, it will lower blood glucose too quickly and not give the body enough time to produce glucagon and counteract the effects. In a healthy individual, this wouldn’t occur due to hormonal feedback loops that prevent dumping insulin all at once; the pancreas is able to release the right amount at the right time and just lower it enough. One medication that can be used to treat low blood sugar though is… Glucagon! While this used to be available only as an injection kit that needed to be mixed and injected, more recent devices have been made that allow for administration either with an auto-injector (now you don’t need to mix it first) or through a nasal spray (fast and easy administration).
Modern diabetes medications generally have a lower risk of causing hypoglycemia (low blood sugar) due to the different pathways involved (some medications cause you to pee out glucose for instance) and due to improved ability to monitor sugars and accurately dose insulin. In fact, closed loop monitoring systems that detect your blood sugar and release the appropriate amount of insulin are available and can help to prevent hypoglycemic episodes from happening as often.
The root problem at the heart of your question is ultimately because the medications prescribed for patients produce a relatively static response whereas your body is a dynamic and ever changing system. If the dose given at any particular time is more than what your body needed, well… Now your blood glucose is going to be too low.
TL;DR
The pancreas isn’t working properly, so you’re manually trying to correct for something that’s dynamic and always changing. Sometimes you mess up and overdo it. Then you get low blood sugar.
> ELI5: How do non-diabetics keep their blood sugar from going low?
To better understand that we’ll have to understand how the body handles energy.
When you eat something your body starts a process to break it down into energy. It cycles around the blood stream for a bit getting used by the organs as needed and any excess gets put into storage.
When a person does something they use up their immediate reserve, mostly just the nutrients currently cycling in the blood stream. This process is faster than the body can break down food, or maybe it has no food to break down in the first place. So the body starts breaking down the stored energy as well.
Insulin is a chemical required by the body to move this energy – aka sugar – into the muscles, organs, and fat (storage). So high insulin should mean low amounts of sugar in the blood because it’s quickly being moved into other spaces. And low insulin should mean high amounts of sugar in the blood because it’s stuck in there.
If you’re with me so far, you already have your answer. __Everyone’s bodies__ tries to keep their blood sugar from going low by pulling it out of the food or storage as needed.
But for more information. Diabetics have problems with their bodies producing insulin. Because of this they have to manually take a supplement amount, often blindly guessing at just how much they really need.
As a result, the excessive insulin demands the body to dump sugar into cells as fast as it can, dropping the amount of sugar in the blood. And other organs, like the brain, may not receive enough due to the body picking to much of it up. Which means those organs stop operating like they should.
This also happens the other way. Not enough insulin makes the sugar sit in the blood stream instead of entering the organs it needs to. Since the body can’t move into the cells to supply sugar for energy, the body thinks it needs to start breaking storage down. – Producing another source of energy collectively called ketones which are highly acidic. – but that’s not actually what the body needs right now. So it just creates more problems.
So like Goldielocks, we need just the right amount of insulin (and sugar) in our system to function. Too hot or to cold is just a different kind of problem.
> ELI5: How do non-diabetics keep their blood sugar from going low?
To better understand that we’ll have to understand how the body handles energy.
When you eat something your body starts a process to break it down into energy. It cycles around the blood stream for a bit getting used by the organs as needed and any excess gets put into storage.
When a person does something they use up their immediate reserve, mostly just the nutrients currently cycling in the blood stream. This process is faster than the body can break down food, or maybe it has no food to break down in the first place. So the body starts breaking down the stored energy as well.
Insulin is a chemical required by the body to move this energy – aka sugar – into the muscles, organs, and fat (storage). So high insulin should mean low amounts of sugar in the blood because it’s quickly being moved into other spaces. And low insulin should mean high amounts of sugar in the blood because it’s stuck in there.
If you’re with me so far, you already have your answer. __Everyone’s bodies__ tries to keep their blood sugar from going low by pulling it out of the food or storage as needed.
But for more information. Diabetics have problems with their bodies producing insulin. Because of this they have to manually take a supplement amount, often blindly guessing at just how much they really need.
As a result, the excessive insulin demands the body to dump sugar into cells as fast as it can, dropping the amount of sugar in the blood. And other organs, like the brain, may not receive enough due to the body picking to much of it up. Which means those organs stop operating like they should.
This also happens the other way. Not enough insulin makes the sugar sit in the blood stream instead of entering the organs it needs to. Since the body can’t move into the cells to supply sugar for energy, the body thinks it needs to start breaking storage down. – Producing another source of energy collectively called ketones which are highly acidic. – but that’s not actually what the body needs right now. So it just creates more problems.
So like Goldielocks, we need just the right amount of insulin (and sugar) in our system to function. Too hot or to cold is just a different kind of problem.
I’ll do my best to throw my 2 cents in since nobody has mentioned glucagon yet!
To start, when we talk about blood sugar, we’re specifically referring to the sugar known as glucose. This is the sugar that is readily available for energy production in cells in the energy producing pathway known as glycolysis which converts it to pyruvate, which is then further broken down in the citric acid cycle (Krebs cycle) to produce energy. When patients with diabetes check their blood sugar, they are using a meter to check glucose levels specifically.
In the body, you’ll often find more than one hormone responsible for functions that can help balance each other out to maintain homeostasis (the body’s ability to keep things approximately even despite ever changing conditions). In the case of glucose metabolism, you have insulin which helps to store glucose in the form of glycogen (short term storage) and fat (long term storage). The opposing hormone is glucagon, which helps to mobilize these energy stores by breaking down glycogen stores in the liver, mobilizing fat stores and releasing fatty acids, and stimulating gluconeogenesis (the production of glucose from certain non-sugar substrates). Glucagon is naturally released from the pancreas in response to stimuli such as low blood glucose, exercise, or fasting conditions. This makes sense, because these are all good times to want to make more energy stores available to the body.
In healthy individuals, the pancreas is able to produce these two hormones at appropriate times in response to blood glucose levels and other hormonal factors to keep glucose in a tightly controlled range. Too little glucose and you could experience sweating, hunger, fatigue, or end up losing consciousness. On the other hand, too much glucose leads to chemical reactions that produce inflammation that can damage the body and lead to nerve pain or loss of sensation, increased risk of heart disease, and problems with the kidneys, among other things. Patients with diabetes either aren’t producing insulin at all anymore (Type 1) or are effectively not producing enough insulin to keep up with the body’s glucose levels (Type 2, AKA insulin resistance).
To combat this loss of insulin effect, patients with diabetes can use medications to increase the amount of insulin released, inject extra insulin to meet their bodies demands, or other various mechanisms to reduce blood glucose. The problem comes from the inability to control exactly how much insulin is present and active at any given time. If you have too much insulin, it will lower blood glucose too quickly and not give the body enough time to produce glucagon and counteract the effects. In a healthy individual, this wouldn’t occur due to hormonal feedback loops that prevent dumping insulin all at once; the pancreas is able to release the right amount at the right time and just lower it enough. One medication that can be used to treat low blood sugar though is… Glucagon! While this used to be available only as an injection kit that needed to be mixed and injected, more recent devices have been made that allow for administration either with an auto-injector (now you don’t need to mix it first) or through a nasal spray (fast and easy administration).
Modern diabetes medications generally have a lower risk of causing hypoglycemia (low blood sugar) due to the different pathways involved (some medications cause you to pee out glucose for instance) and due to improved ability to monitor sugars and accurately dose insulin. In fact, closed loop monitoring systems that detect your blood sugar and release the appropriate amount of insulin are available and can help to prevent hypoglycemic episodes from happening as often.
The root problem at the heart of your question is ultimately because the medications prescribed for patients produce a relatively static response whereas your body is a dynamic and ever changing system. If the dose given at any particular time is more than what your body needed, well… Now your blood glucose is going to be too low.
TL;DR
The pancreas isn’t working properly, so you’re manually trying to correct for something that’s dynamic and always changing. Sometimes you mess up and overdo it. Then you get low blood sugar.
I’ll do my best to throw my 2 cents in since nobody has mentioned glucagon yet!
To start, when we talk about blood sugar, we’re specifically referring to the sugar known as glucose. This is the sugar that is readily available for energy production in cells in the energy producing pathway known as glycolysis which converts it to pyruvate, which is then further broken down in the citric acid cycle (Krebs cycle) to produce energy. When patients with diabetes check their blood sugar, they are using a meter to check glucose levels specifically.
In the body, you’ll often find more than one hormone responsible for functions that can help balance each other out to maintain homeostasis (the body’s ability to keep things approximately even despite ever changing conditions). In the case of glucose metabolism, you have insulin which helps to store glucose in the form of glycogen (short term storage) and fat (long term storage). The opposing hormone is glucagon, which helps to mobilize these energy stores by breaking down glycogen stores in the liver, mobilizing fat stores and releasing fatty acids, and stimulating gluconeogenesis (the production of glucose from certain non-sugar substrates). Glucagon is naturally released from the pancreas in response to stimuli such as low blood glucose, exercise, or fasting conditions. This makes sense, because these are all good times to want to make more energy stores available to the body.
In healthy individuals, the pancreas is able to produce these two hormones at appropriate times in response to blood glucose levels and other hormonal factors to keep glucose in a tightly controlled range. Too little glucose and you could experience sweating, hunger, fatigue, or end up losing consciousness. On the other hand, too much glucose leads to chemical reactions that produce inflammation that can damage the body and lead to nerve pain or loss of sensation, increased risk of heart disease, and problems with the kidneys, among other things. Patients with diabetes either aren’t producing insulin at all anymore (Type 1) or are effectively not producing enough insulin to keep up with the body’s glucose levels (Type 2, AKA insulin resistance).
To combat this loss of insulin effect, patients with diabetes can use medications to increase the amount of insulin released, inject extra insulin to meet their bodies demands, or other various mechanisms to reduce blood glucose. The problem comes from the inability to control exactly how much insulin is present and active at any given time. If you have too much insulin, it will lower blood glucose too quickly and not give the body enough time to produce glucagon and counteract the effects. In a healthy individual, this wouldn’t occur due to hormonal feedback loops that prevent dumping insulin all at once; the pancreas is able to release the right amount at the right time and just lower it enough. One medication that can be used to treat low blood sugar though is… Glucagon! While this used to be available only as an injection kit that needed to be mixed and injected, more recent devices have been made that allow for administration either with an auto-injector (now you don’t need to mix it first) or through a nasal spray (fast and easy administration).
Modern diabetes medications generally have a lower risk of causing hypoglycemia (low blood sugar) due to the different pathways involved (some medications cause you to pee out glucose for instance) and due to improved ability to monitor sugars and accurately dose insulin. In fact, closed loop monitoring systems that detect your blood sugar and release the appropriate amount of insulin are available and can help to prevent hypoglycemic episodes from happening as often.
The root problem at the heart of your question is ultimately because the medications prescribed for patients produce a relatively static response whereas your body is a dynamic and ever changing system. If the dose given at any particular time is more than what your body needed, well… Now your blood glucose is going to be too low.
TL;DR
The pancreas isn’t working properly, so you’re manually trying to correct for something that’s dynamic and always changing. Sometimes you mess up and overdo it. Then you get low blood sugar.
If your pancreas makes insulin, it makes a version of insulin that only persists in the body for a short time (like a few minutes). As soon as there’s no need to lower blood sugar, the pancreas stops making insulin and the signal goes away. It can overshoot slightly and give you an uncomfortable sugar crash, but a functioning pancreas can respond fast enough that it won’t push your blood sugar dangerously low.
Injecting precisely calculated doses of insulin every 5 minutes isn’t feasible for diabetics, so pharmaceutical companies developed chemically modified insulins that stick around for longer. The problem with that is that the modified insulins will persist in the body and keep lowering blood sugar after that’s no longer needed.
If your pancreas makes insulin, it makes a version of insulin that only persists in the body for a short time (like a few minutes). As soon as there’s no need to lower blood sugar, the pancreas stops making insulin and the signal goes away. It can overshoot slightly and give you an uncomfortable sugar crash, but a functioning pancreas can respond fast enough that it won’t push your blood sugar dangerously low.
Injecting precisely calculated doses of insulin every 5 minutes isn’t feasible for diabetics, so pharmaceutical companies developed chemically modified insulins that stick around for longer. The problem with that is that the modified insulins will persist in the body and keep lowering blood sugar after that’s no longer needed.
If your pancreas makes insulin, it makes a version of insulin that only persists in the body for a short time (like a few minutes). As soon as there’s no need to lower blood sugar, the pancreas stops making insulin and the signal goes away. It can overshoot slightly and give you an uncomfortable sugar crash, but a functioning pancreas can respond fast enough that it won’t push your blood sugar dangerously low.
Injecting precisely calculated doses of insulin every 5 minutes isn’t feasible for diabetics, so pharmaceutical companies developed chemically modified insulins that stick around for longer. The problem with that is that the modified insulins will persist in the body and keep lowering blood sugar after that’s no longer needed.
Diabetes is a disease that keeps the blood sugar too high for too long. It cannot go too low by itself. The medicinal treatment for diabetes is to add artificial insulin. The problem is we usually take the same prescribed quantity of artificial insulin. But the body’s requirement for insulin changes from day to day and meal to meal, which means the artificial insulin dosage is sometimes higher or sometimes lower. Also, generally people who have diabetes tend to be people who consume a lot of sugar. So doctors who monitor/adjust dosage tend to prescribe a bit higher than perfect. This mismatch of the body’s requirement, vs standardized dosage and erroring on the side of low blood sugar than high blood sugar, diabetics who are taking insulin can have a lot of situations with low blood sugar.
To your example, the reason why a diabetic can have a significantly lower blood sugar after excercise is that your body can stop the insulin production at anytime; but for the diabetic it cannot stop the insulin at any time. Whatever is put in will keep reducing the blood sugar until the insulin is removed, so they end up with lower blood sugar.
There is a role for the reverse glycogen process but it’s slow compared to the insulin part and that’s why insulin’s effect is more prominent. If diabetics can stay alive/sane for sometime during their low blood sugar period, they should come back to normal levels by itself, but this can be extremely dangerous
Diabetes is a disease that keeps the blood sugar too high for too long. It cannot go too low by itself. The medicinal treatment for diabetes is to add artificial insulin. The problem is we usually take the same prescribed quantity of artificial insulin. But the body’s requirement for insulin changes from day to day and meal to meal, which means the artificial insulin dosage is sometimes higher or sometimes lower. Also, generally people who have diabetes tend to be people who consume a lot of sugar. So doctors who monitor/adjust dosage tend to prescribe a bit higher than perfect. This mismatch of the body’s requirement, vs standardized dosage and erroring on the side of low blood sugar than high blood sugar, diabetics who are taking insulin can have a lot of situations with low blood sugar.
To your example, the reason why a diabetic can have a significantly lower blood sugar after excercise is that your body can stop the insulin production at anytime; but for the diabetic it cannot stop the insulin at any time. Whatever is put in will keep reducing the blood sugar until the insulin is removed, so they end up with lower blood sugar.
There is a role for the reverse glycogen process but it’s slow compared to the insulin part and that’s why insulin’s effect is more prominent. If diabetics can stay alive/sane for sometime during their low blood sugar period, they should come back to normal levels by itself, but this can be extremely dangerous
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