Endocrinology Hypoglycemia Medicine Physiotherapy

Pathophysiology of Hypoglycemia

In this article we will discuss 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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