Pathophysiology of Hypoglycemia

In this article, we will discuss the Pathophysiology of Hypoglycemia. So, let’s get started.


Counter-regulatory mechanisms: In response to a falling blood sugar, there is normally increased secretion of counter-regulatory hormones which antagonize the blood-glucose lowering effects of insulin. Glucagon, cortisol, GH and adrenaline are the counter-regulatory hormones which fail over time;hypoglycaemia-induced secretion of glucagon becomes impaired within 5 years of developing type 1 diabetes. Similarly after several years, the adrenaline response to hypoglycaemia also becomes defective; so that if hypoglycaemia develops, glucose recovery may be seriously compromised. Autonomic neuropathy may also contribute to defective adrenaline response. Those who develop deficient counter-regulatory responses may also have impaired central activation of neuroendocrine secretion. Failure of counter-regulatory mechanisms with impaired awareness of hypoglycaemia alter the glycaemic threshold for the onset of hormone secretion and symptoms in the affected patients, i.e. blood glucose has to fall to a critical lower level to trigger these responses.

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