Fifth thing I hate about low blood sugars

Image of Scott's Dexcom CGM with crazy highs, and a sudden dropThe rebound.

There are a number of things that happen when you experience a low blood sugar. These are things that your body does to defend itself from the low. This includes dumping a couple fast acting hormones (glucagon and epinephrine (adrenaline)) and a couple of slow acting hormones (growth hormone and cortisol).

According to Medscape, the primary defense is the epinephrine because our glucagon secretion systems don’t work like they should. The article gives many more “medspeakly” correct details, if you are interested. The adrenaline comes and goes pretty quick (relatively speaking).

The growth hormone and cortisol responses are really tough because they can wreak havoc on any attempts to keep blood sugars in range later in the day.

So, not only do you have this “late to the party” glucagon and “first to arrive” adrenaline, which can spike you up after dealing with a low, you’ve also got these “missed the party altogether” double whammy of growth hormone & cortisol which mess with you hours later.

I once heard a doctor at a meeting say that the goal of diabetes is to keep blood sugars in range as much of the time as you can, AND AVOID LOWS. It was these “delayed response” hormones that he said cause so many problems later in the day.

I’m not exactly clear on whether these hormones are all released every time you have a low, or if the lows have to be of a certain severity or a certain duration. Based on my personal experience, I don’t think it happens every time.

I think this just about wraps up my mini-series of things I hate about lows. Tomorrow? Back to your regularly scheduled blogging.

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4 thoughts on “Fifth thing I hate about low blood sugars

  1. I just had a 46 and scarfed some Glucose tabs. I went up to 85 and now I am back down to 67. How sad is it that my lottery jackpot dream winnings are first allocated for a Guardian RT? I hate LOWS!!

    Thanks for the posts Scott. I am sending everyone i know your way so they can get a glimspe of what we go thru

  2. Thanks for your series on crappy lows are because don’t we all hate them? The only thing I really like about them is that they can bring my average down.
    Funny that I should read this post about rebounding because that is where I am rigth now. 315 after a morning low of 56 which I did a pretty good job of not overtreating yet still, here is the high and I am starving -ARGH!

  3. Something about the “late to the party glucagon” and “first to arrive adrenaline” reminds me of that skit Jim Bruer does: The stomach serves as the party host for all the alcohol that shows up.

    Mr. Tequila (who brings five of his friends) is my personal favorite.

    … I think I just completely digressed. But anyway, I pretty much agree with everything you’ve written about the Trials and Tribulations of Lows. They are tremendously sucky.

  4. Something that seriously concerns me, is the push to have people use mini doses of Glucagon when bgs won’t come up and the patient can’t eat. It essentially depletes any counter-regulatory hormone that would otherwise be available in response to a severe low. Scary to be so low and push the last droplets of reserves out of the liver and into the blood stream and then go to sleep and continue to go lower and have NOTHING on board to bring you out of it.

    So, my ramble here is, not only do I hate the lows, I hate some of the research on how to treat the lows.