diabetes...high and low?


I need clarification re: hypo/hyperglycemia. I understand it for what it is, just need clarification as to how it affects the body. For instance, I realize hyperglycemia is the resultant of high blood sugars and lack of insulin. furthermore, insulin converts glucose into glycogen for storage, so that it's not so high in the bloodstream. So, my question: is the problem in hyperglycemia r/t the high levels of glucose causing toxicity or the body needs insulin in order for cells to use said glucose, not just to convert into storage? the latter makes sense, since the body begins to breakdown ketones for cellular usage. as for hypoglycemia, my understanding is that there is not enough sugars/glucose for cells to use, creating hypoglycemic symptoms, esp neurologically wherein the brain cannot use fats and/or proteins for breakdown to get energy. having said that, the body can convert the glycogen back to glucose for uptake. if its insulin r/t, is it because the insulin is simply converting any glucose back to glycogen? making there be no glucose available for cellular metabolism? I feel like I have the fundamental understanding, but want to grasp the "big picture" of a very real disease that is making so many lives difficult. Thanks.


38 Posts

When you have low blood sugar, the pancreas secretes the hormone glucagon, which stimulates the liver to turn some glycogen back to glucose for use in the body and brain. Glycogen is stored in the liver and the muscles. Glycogen stored in the muscles cannot be converted back to glucose for use, glycogen in the muscles can only be used by the muscle for energy. Hope this helps:nurse:


6 Posts

i understand that. in the case of insulin r/t hypoglycemia (say giving insulin to a pt with BS 6 mmol/L and pt doesn't eat), would the insulin convert glucose-to-glycogen faster than glucagon converts glycogen-to-glucose, causing hypoglycemia. also, considering the fact that no sugars are being absorbed from missing said meal, relying on glucagon/glycogen storage from the liver will eventually deplete. brain needs sugar transport from the bloodstream to receive glucose, so if glucose levels decrease in the blood, then eventually neurological deficits (loc, motor skills, etc) will develop from lack thereof glucose...brain cannot use fats and protein. Thanks, I'm trying to work this out in my head.


38 Posts

Regular insulin would work almost immediatly, so yes, glucoseglycogen would occur faster than the liver can convert glycogen back to glucose. That said, if the patient is not receiving insulin, and is relying on the body to regulate, the hypoglycemia occurs a little slower.


456 Posts

The best visual for insulin is that it's like a bridge that gets glucose from digested food into the cells. Insulin helps the cells use glucose for immediate energy, then store the leftover glucose as glycogen.

So with a high blood sugar the cells are starving because there's not enough insulin, while all that glucose in the blood is being flushed out through the kidneys.

Blood with a high glucose content is physically thicker than normal blood, so it overworks all the little blood vessels in the extremities and eyes, which causes some diabetes complications like retinopathy and neuropathy. Then like you know, the body burns fat for fuel, creating toxic keytones.

This is a kids book published by the Barbara Davis Center for Childhood Diabetes in Denver, but Chapter 2 does a good job of explaining the physiology in simple terms. http://www.ucdenver.edu/academics/colleges/medicalschool/centers/BarbaraDavis/OnlineBooks/books/Pages/UnderstandingDiabetes.aspx

Hope this helps.