Why do many people with diabetes have low blood sugar?

Diabetic patients generally need to take insulin supplements, but if they do not eat or do not have enough sugar, they will cause hypoglycemia.

Because diabetic patients do not consume enough energy, take hypoglycemic drugs, inject insulin on an empty stomach, have irregular work and rest, and exercise too much, they may all cause hypoglycemia.

Because these patients have poor glucose metabolism, this is the case.

The causes of hypoglycemia in diabetic patients are as follows:

1.In diabetic patients, the rhythm of insulin secretion is disturbed in the early stage, and the blood glucose level has decreased when the preprandial insulin level is secreted more, which can be manifested as preprandial hypoglycemia.

2.Hypoglycemia caused by excessive doses of hypoglycemic drugs in diabetic patients. For example, if a sulfonylurea hypoglycemic drug is used, or if the insulin dose is too large, the drug dose needs to be adjusted.

3.In some patients, hyperinsulinemia occurs due to excessive insulin accumulation, and when the body regains insulin sensitivity, a large amount of insulin in the body acts at the same time, resulting in hypoglycemia.

Due to the absolute or relative insufficiency of insulin in diabetic patients, the insulin (about half) used to synthesize liver glycogen from the blood sugar that rises after a meal is also insufficient. In this way, the liver glycogen that can be decomposed into glucose during starvation and hypoglycemia is not enough, which is the main reason why diabetics are more prone to hypoglycemia and cannot rise. People with type 1 diabetes are absolutely deficient in insulin, so they are more likely to have severe hypoglycemia.

Some people may ask, so why is liver glycogen still insufficient when people with type 1 diabetes have already injected enough insulin? To explain this problem, we first clarify the difference between the metabolic pathways of endogenous and exogenous insulin, that is, the two types of insulin enter the body in different ways. Self-secreted insulin, also known as endogenous insulin, is secreted by pancreatic islet cells and then enters the entry vein quickly, and quickly enters the liver through the portal vein, the insulin concentration in the liver will rise rapidly, and more than half of the endogenous insulin will be metabolized in the liver, that is to say, more than half of the insulin quickly promotes blood sugar synthesis and liver glycogen is stored in the liver, so as to reserve a lot of energy. Then it flows with the blood circulation to the organs and tissues of the whole body, and the concentration in the liver has no peak (small concentration), so that only a small part of the blood sugar is stored in the form of liver glycogen, and the energy reserve is reduced.

In a word, the ability of exogenous insulin to synthesize liver glycogen is much weaker than that of endogenous insulin, which is caused by the different metabolic pathways of the two. Therefore, when hypoglycemia comes, healthy people have enough liver glycogen to quickly convert into blood sugar under the action of glycemic hormones (such as glucagon) to raise blood sugar and make the peripheral tissues get sufficient energy; Diabetics do not have enough glycogen to raise their blood sugar, so their blood sugar will always be low. This also explains the phenomenon that healthy people are more energetic and have stronger work endurance, while diabetics are often low in energy and lack of energy.

Of course, another reason why people with type 1 diabetes are more likely to have severe hypoglycemia is that due to their own immune system, the islet cells are also damaged, and the secretion of glucagon by the islet cells is also reduced, resulting in the inability to raise blood sugar in time.

In summary, why don't A-cells play a role in hypoglycemia at a critical moment to raise blood sugar? The answer is that there is not enough insulin to cause insufficient glycogen in the liver, and the other may also be the destruction of A-cells. Therefore, diabetics should not only pay attention to high blood sugar, low blood sugar is more dangerous, and they need to pay enough attention!

Hypoglycemia in diabetes may be due to drinking too much alcohol or drinking alcohol on an empty stomach will cause hypoglycemia, and if the patient is taking hypoglycemic drugs, excessive use will also cause hypoglycemia, generally diabetic patients should have a reasonable diet, and do not drink alcohol on an empty stomach, especially at breakfast, and try not to take antihypertensive drugs at the same time.

Diabetic hypoglycemia is because patients are overly nervous or have anxiety and headaches, hypoglycemia will occur, and diabetic patients take anti-inflammatory drugs or some hypoglycemic drug doses for a long time, which will cause hypoglycemia, and try not to inject too much insulin, and it is likely to have a certain impact on cranial nerve function.

Hypoglycemia is a common complication of diabetes, and it is often caused by irregular diet, too few meals, too much activity, or too much insulin and medication. Severe hypoglycemia can be life-threatening, so be sure to prevent it aggressively by carrying sugary foods or beverages with you.

People with diabetes often experience hypoglycemia due to a variety of factors, such as a decrease in the amount of food and drink, and an increase in the amount of exercise without changing the dose of the drug. Or due to factors such as excessive insulin secretion in the body. It is recommended to pay attention to a reasonable diet, pay attention to a low-sugar diet, eat small and frequent meals, lose weight with obesity, check blood sugar regularly, and take medication regularly to maintain blood sugar at a normal level.

Most of the causes of hypoglycemia in diabetic patients are due to an overdose of oral drugs or incorrect oral administration of hypoglycemic drugs. After insulin injection, patients are prone to symptoms of hypoglycemia if they do not eat in time.

Hypoglycemia in diabetic patients may be caused by drinking too much alcohol or on an empty stomach, and if the patient is taking hypoglycemic substances, an overdose can also cause hypoglycemia. In general, diabetic patients should eat a reasonable diet and do not drink alcohol on an empty stomach, especially.

Because diabetic patients need to use drugs to control blood sugar, they should eat on time, and when they eat a small amount or late, it is easy to cause hypoglycemia.

If a diabetic patient has hypoglycemia, it is likely to be due to not eating in time after taking hypoglycemic drugs or insulin injections, or because of excessive exercise.

In the pre-diabetic stage, patients may have hypoglycemia in normal people, and the body's insulin function is normal, so after we eat each meal, the pancreas can quickly secrete an appropriate amount of insulin, so that the food after eating will be affected by the action of insulin and prevent the blood sugar from rising significantly. After the body's blood sugar decreases, the pancreas can also reduce the secretion of insulin in time to prevent the blood sugar from dropping rapidly, so even if a normal person eats food, the blood sugar is still high within the normal range, not very high; And our body will also reduce insulin after eating for a long time, which will not lower blood sugar much.

In short, hypoglycemia is just a symptom of a person, and the appearance of this symptom is related to the existence of diabetes, but it does not mean that there will be no diabetes, and diabetes does not necessarily mean that hypoglycemia will not exist. Therefore, everyone should distinguish clearly.

Low blood sugar does not necessarily lead to diabetes, but many diabetic patients will have pre-meal hypoglycemia in the early stage, so it is necessary to clarify whether the patient's low blood sugar occurs before or after meals, whether it is fasting or before the next meal. If the patient has a high fasting blood glucose frequently, it is necessary to be alert to the presence of insulinoma.

If the patient often has hypoglycemia before the next meal, it is recommended that the patient go to the endocrinology department of the hospital in time, and the fasting blood glucose and 2h postprandial blood glucose need to be improved, and if necessary, the OGTT test of 75g anhydrous glucose can be completed to determine the glucose tolerance, and if necessary, the glycosylated hemoglobin can be improved to help confirm the diagnosis of diabetes or prediabetes.

People with hypoglycemia can develop diabetes, the most common example is in the early stages of diabetes, some patients do not have a significant absolute insulin deficiency, but there is a delay in the peak of insulin secretion. In normal people, the peak of insulin secretion should occur within 30-60 minutes after eating, while the peak of insulin secretion in such patients can occur in 2-3 hours. Due to improper secretion of insulin, it can cause hypoglycemia before the next meal.