2nd Edition-Sept 2005

Ask Nurse Lorna

In this article I shall try to explain what Diabetes & Hypoglycemia are:
and the differences between the conditions.
Nurse Lorna





What is Diabetes?

Diabetes is a number of diseases that involve problems with the
hormone insulin. Normally, the pancreas (an organ behind the stomach)
releases insulin to help your body store and use the sugar and fat from
the food you eat. Diabetes occurs:
When the pancreas does not produce any insulin, or
When the pancreas produces very little insulin, or
When the body does not respond appropriately to insulin, a condition
called “Insulin resistance”.

There are two main types of diabetes, they are:
Type 1 diabetes, also known as insulin dependent diabetes
Type 2 diabetes also known as non-insulin dependent diabetes.
Type 1 diabetes occurs because the insulin-producing cells of the
pancreas ( called beta cells) are destroyed by the immune system .
People with type 1 diabetes produce no insulin and must use Insulin
injections to control their blood glucose

Unlike people with type 1 diabetes, people with type 2 diabetes produce
insulin. However, the insulin their pancreas secretes is either not
enough, or the body is unable to recognise the insulin and use it
properly. When there is no insulin or the insulin is not used, as it should
be glucose can’t get into the body’s cells.


What is hypoglycemia?

Hypoglycemia or low blood glucose is a condition in which the level of
glucose (sugar) in the blood drops below a certain point (about 2.5
mmols/l or 45 mg/dl)

Hypoglycemic Episodes in Non Diabetic People

Causes
.  pancreatic tumours (usually benign)
.  Addison’s Disease (adrenal glands)
.  a severe reduction in liver function
.  people who have had their stomachs removed
.  cancer in some people
.  fasting/malnutrition
.  following alcohol ingestion
.  reactive  hypoglycemia

What is Reactive Hypoglycemia?

Reactive hypoglycemia is possibly the most common reason for
hypoglycemia in non-diabetics.
This form of hypoglycemia is probably caused by an overproduction of
insulin from the pancreas after a large meal with a lot of carbohydrates.
This condition is probably most common in overweight people and
those with type 2 diabetes, where the large demand for insulin can
sometimes cause too much insulin to be produced.  There is some
evidence to suggest that reactive hypoglycemia can precede type 2
diabetes.
Signs of hypoglycemia are as for diabetic hypo’s.

Treatment
When reactive hypoglycemia has been diagnosed, the most important
thing to do is change the diet. It should consist of a lot of complex
carbohydrates (potatoes, rice or pasta). Smaller more frequent meals
should be eaten to avoid the big fluctuations in insulin secretion.
If the causes are found to be due to weakened adrenal or pituitary
glands, these can be treated with medication. Operable pancreatic
tumours will be removed; inoperable tumours may be treated with a
drug called “Sandostatin”
* This is an injectable drug, which mimics a hormone, which prevents
the release of insulin.