Hypoglycaemia Habituation

Question 1

Describe how blood glucose fluctuates

Answer 1

After meal - blood glucose spikes and insulin released from beta cells and glucose is either transported into cells or converted into glycogen
After fasting - blood glucose drops and pancreas releases glucagon and there is a breakdown of glycogen to glucose and increased gluconeogenesis

Question 2

What is iatrogenic hypoglycaemia?

Answer 2

Low glucose due to the way we administer it

Question 3

How does iatrogenic hypoglycaemia cause recurrent hypoglycaemia?

Answer 3

It impairs defences against subsequent hypoglycaemia

Question 4

What happens in impaired awareness of hypoglycaemia?

Answer 4

When an individual who is on insulin no longer displays symptoms of hypoglycaemia and so doesn’t recognise they are having a hypoglycaemic episode

Question 5

With intact awareness of hypoglycaemia, what occurs in the checkpoint system?

Answer 5

Glucose falls and you have a release of hormones
Then warning symptoms
Then cognitive impairment

Question 6

What range of glucose does the checkpoint system cover with intact awareness of hypoglycaemia?

Answer 6

2-3mmol of glucose

Question 7

What is habituation?

Answer 7

Reduction in psychological, behavioural or physiological response to a stimulus as a result of repeated or prolonged exposure

Question 8

How many criteria of habituation are there?

Answer 8

Nine

Question 9

Can hypoglycaemia habituation be reversed?

Answer 9

Yes, via “dis-habituating stimuli”, must be acute and novel

Question 10

What is a dis-habituating stimulus?

Answer 10

Another (usually strong) stimulus that is presented alongside the stimulus that is habituated