Type 1 Diabetes Hypoglycaemia: Causes, Symptoms, and More

From healthline.com

• Hypoglycaemia is a common occurrence with type 1 diabetes.
• You can usually treat mild to moderate hypoglycaemia on your own.
• Certain devices can monitor and alert you to hypoglycaemia or stop insulin delivery when blood sugar is low.

For people with type 1 diabetes, testing blood sugar levels is part of the everyday routine. It’s a crucial step in calibrating insulin to keep blood sugar in the ideal zone.

Yet sometimes you might get more insulin than you need. When this happens, you end up with low blood sugar, also known as hypoglycaemia.

Read on to find out more about hypoglycaemia, including why it happens, how to recognize it, and when to call 911.

Understanding type 1 diabetes and hypoglycaemia

The cells in your body need sugar in the form of glucose to make energy. And you need the right amount of insulin to balance your level of blood sugar.

When you have more insulin than you need, you end up with low blood sugar, or hypoglycaemia.

Most people with type 1 diabetes have one or two episodes of mild hypoglycaemia each week, according to research from 2010Trusted Source.

A 2018 studyTrusted Source from Canada and another 2018 studyTrusted Source from Brazil found that hypoglycaemia is a common adverse event in people with type 1 diabetes. And 2017 researchTrusted Source from a hospital in India suggested that it’s one of the leading causes of emergency room visits.

The goal for most people with type 1 diabetes is to keep glucose levels between 70 and 180 milligrams per decilitre (mg/dL). In this range, complications are less likely.

A level between 55 and 70 mg/dL is mild to moderate hypoglycaemia. If levels drop below 55 mg/dL, a person with type 1 diabetes may experience severe hypoglycaemia.

Because everyone is a little different, it’s best to discuss your target zone with a healthcare professional.

What causes hypoglycaemia with type 1 diabetes?

The most common causes of hypoglycaemia are:

• getting too much insulin
• improperly timing insulin
• not eating enough carbs to match the insulin
• skipping a meal
• not monitoring enough while exercising or drinking alcohol

You might be more prone to hypoglycaemia if you have kidney or liver disease or an infection.

Hypoglycaemia may also be more likely to occur if you’re:

• in a hot and humid climate
• on your menstrual period
• travelling
• at a high altitude

The condition may also be more likely in people with type 1 diabetes who are going through puberty.

What are the symptoms of hypoglycaemia?

It’s important to know the symptoms so you can take steps to treat hypoglycaemia. Early symptoms may include:

• sweating
• shakiness
• hunger

These symptoms can be so subtle you may not notice them. As it worsens, you might develop:

• weakness or tiredness
• trouble walking
• blurry vision

Symptoms of severe hypoglycaemia can include:

• fatigue
• fainting
• confusion
• seizures
• loss of consciousness

Severe hypoglycaemia can lead to accidents if you pass out while driving or in some other dangerous situation.

It can also happen while you’re sleeping. Using a continuous glucose monitor can alert you to night-time episodes. Your family members should know how to identify key signs of hypoglycaemia at night, including:

• hot, clammy skin
• damp bedsheets
• changes in breathing
• trembling or shaking

Family members should know where you keep your emergency kit in case of severe hypoglycaemia at night. If a family member suspects their partner is experiencing hypoglycaemia and cannot wake them, they should be prepared to administer glucagon and call a doctor.

The longer you have diabetes, the more difficult it can be to recognize signs of hypoglycaemia. If you experience hypoglycaemia frequently, you can develop what’s called hypoglycaemia unawareness.

Hypoglycaemia unawareness can be very dangerous. You can improve your awareness by strictly avoiding low blood sugar for several weeks.

Certain medications, such as high blood pressure drugs, can also mask symptoms.

Because you may not always recognize hypoglycaemia signs, it’s important to educate people close to you. This way, they can take action if they notice any symptoms.

What’s the difference between hyperglycaemia and hypoglycaemia?

Hypoglycaemia is low blood sugar. Hyperglycaemia, on the other hand, occurs when blood sugar levels are too high.

Hyperglycaemia happens when you don’t have enough insulin to handle the sugar. This can be because you:

• took too little insulin
• ate more than you planned
• exercised less than you thought you would
• are already feeling sick or stressed

Symptoms of hyperglycaemia include thirst and frequent urination.

Treatment for mild to moderate hypoglycaemia

When you first feel symptoms, check your blood sugar right away. When it’s between 51 and 70 mg/dL:

1. Eat 10 to 15 grams of fast-acting carbs like fruit juice or hard candy, or consume 3 to 4 glucose tablets.
2. After 15 minutes, test your blood again. If it’s still low, repeat.

For the next few days, you may be less likely to notice symptoms of low blood sugar, so test your levels regularly.

Tell your doctor if this happens often. Your treatment plan may need some adjusting.

Treatment for severe hypoglycaemia

If hypoglycaemia goes on too long, it can cause permanent damage to your health or become life threatening.

So, if you notice symptoms, you need to act quickly. If you’re weak or disoriented, ask for help.

When blood sugar is under 50 mg/dL:

1. Eat 20 to 30 grams of fast-acting carbs or 6 to 8 glucose tablets.
2. After 15 minutes, test again. If it’s still low, repeat.

If needed, someone can give you an emergency dose of glucagon. This can be administered by injection or nasal spray. Your blood should be tested again in 15 minutes.

Someone should call 911 if:

• You’ve lost consciousness.
• You had glucagon but you needed a second dose or still feel disoriented.
• Your blood sugar remains too low after 20 minutes.

When in doubt, call for help. First responders can give you intravenous glucose to quickly raise your blood sugar.

Diabetes preparedness

Several tools can help prevent and treat hypoglycaemia or provide information if you can’t speak for yourself.

Emergency kit

Keep an emergency kit on hand and include items such as:

• glucagon
• glucose tablets
• fast-acting carb-filled snacks
• a medical ID card or bracelet specifying that you have type 1 diabetes
• written instructions for how someone can help you in an emergency

Medical ID bracelet

A medical ID bracelet or necklace alerts others, including emergency medical personnel, that you have type 1 diabetes. This can save precious time — and your life.

Glucagon

Glucagon is a hormone that raises blood sugar. It’s a prescription medication available as a:

• nasal spray
• prefilled syringe
• auto-injector pen

Close family, friends, and co-workers can be taught how to use it if you can’t administer it yourself.

Continuous glucose monitor

A continuous glucose monitor can alert you when glucose is getting low. Parents and caregivers can also keep track and get smartphone alerts when blood sugar is too low or too high.

If your pump and monitor are on a closed-loop system, the insulin will be automatically adjusted in response to low glucose. These devices are especially helpful during the night in case you don’t wake up when your blood sugar drops.

Takeaway

Hypoglycaemia in type 1 diabetes is when your blood sugar drops below the target range. When you catch it early, you can take steps to raise your blood sugar.

A severe drop in blood sugar can quickly become a life-threatening event. But there are helpful ways to monitor glucose, help keep it in the target zone, and administer quick treatment.

When in doubt, seek emergency care.

https://www.healthline.com/health/type-1-diabetes/type-1-diabetes-hypoglycemia-causes-symptoms-and-more

7 lifestyle habits may lower dementia risk for people with type 2 diabetes

From medicalnewstoday.com

• People with type 2 diabetes can be at an increased risk for dementia.
• Researchers are still working to understand how lifestyle factors can modify dementia risk.
• Data from a recent study indicates that people with type two diabetes are at a lower risk for dementia if they practice certain healthy lifestyle choices.

Dementia is a chronic condition that can be debilitating. Since dementia doesn’t have a cure, people often wonder what steps they can take to reduce their risk of developing dementia. A recent study published in Neurology found that for people with diabetes, incorporating certain healthy lifestyle habits was associated with a decreased risk of developing dementia.

Dementia and its risk factors

DementiaTrusted Source is a broad term for disorders that impact people’s ability to remember, think, and reason. It typically gets more severe with time and can significantly interfere with people’s everyday lives and ability to live independently.

Some risk factors for dementia cannot be altered, such as increased age or family history. However, people can modify other risk factorsTrusted Source to reduce risk. For example, smoking, obesity, and excessive use of alcohol are all risk factors for Alzheimer’s disease and related dementias.

Having diabetes is also a risk factor for dementia, particularly type two diabetes. People with diabetes can work with their doctors to manage their condition and improve their health. Research is ongoing about how healthy lifestyle changes can improve conditions like diabetes and reduce dementia risk. ​

Type 2 diabetes, dementia, and lifestyle factors

Researchers in this current study examined how seven healthy lifestyle habits impacted dementia risk. They looked at how these habits helped people with diabetes and those without diabetes. The habits included:

• not currently smoking
• moderate alcohol consumption
• regular physical activity
• eating a healthy diet
• getting adequate amounts of sleep
• less sedentary behaviour
• having frequent social contact

Researchers utilised the U.K. Biobank in their data collection. They included participants ages 60 years or older without dementia at the start of the study. They specifically excluded people with type one diabetes from data collection so that they could focus on individuals with type two diabetes.

​Researchers assigned participants a healthy lifestyle score based on the seven above behaviour factors. Each category had a definition of what researchers classified as healthy. For example, someone was classified as being regularly physically active if they had “at least 150 minutes/week of moderate activity or 75 minutes/week of vigorous activity or an equivalent combination.”

The study included more than 160,000 participants, including more than 12,000 with diabetes. Researchers followed the participants for an average of 12 years. They found that healthy lifestyle factors were associated with a lower risk of developing dementia. But this risk reduction was even more pronounced among participants with diabetes.

Study author, Dr. Yingli Lu, Ph.D., of Shanghai Jiao Tong University School of Medicine in China, noted to Medical News Today:

“Our findings highlight that although patients with diabetes are at a higher risk of developing dementia later compared with those without, adherence to an overall healthy lifestyle may greatly reduce this risk.”

N​on-study author and Alzheimer’s researcher, Jeroen Mahieu, Ph.D., noted to MNT:

“The most important finding of this study is that adhering to a healthy lifestyle substantially reduces the risk of developing dementia for diabetes patients; significantly more than when you do not have diabetes. This is important given the greater prevalence of dementia among diabetes patients. Yet, due to the nature of the data and the research design we should be cautious with interpreting these effects as causal.”

Study limitations and areas for continued research

The study indicates that incorporating healthy lifestyle habits may decrease the risk for dementia, particularly among people with diabetes. However, the study also had several limitations.

​First, information on lifestyle behaviours was self-reported, increasing the risk of data collection errors. Second, the researchers collected lifestyle factor data at baseline and did collect data on lifestyle factor changes. The study did not collect data about lifestyle factors for participants before they developed diabetes.

The researchers also noted that participants they had to exclude based on missing data were more likely to have lower education and socioeconomic status, which may have impacted the results. Based on the data collection methods, the research team acknowledged that they could have misclassified participants with diabetes or prediabetes as not having diabetes.

In addition, although several confounding factors were adjusted for, such as medication use, the authors acknowledged that there could be unknown or unmeasured factors unaccounted for. The study also included mainly Caucasian participants indicating that more diverse studies will be needed in the future.

Nevertheless, the study adds to a growing body of data regarding how lifestyle choices influence health. Dr. Lu explained to MNT:

“Our data may have important implications for doctors, and other medical professionals who treat people with diabetes. [They] should consider recommending lifestyle changes to their patients. Such changes may not only improve overall health but also contribute to the prevention or delayed onset of dementia in people with diabetes. Future research is needed to determine how combined healthy lifestyle behaviours benefit cognitive outcomes in diabetes and the possible mechanisms.”

https://www.medicalnewstoday.com/articles/7-lifestyle-habits-may-lower-dementia-risk-for-people-with-type-2-diabetes 

Dairy products may protect against type 2 diabetes, but red and processed meat raise risk

From medicalnewstoday.com

• About 90–95% of all diagnosed diabetes cases are type 2 diabetes, according to the CDC.
• A new meta-analysis links low fat dairy products with a reduced risk of developing T2D.
• The study correlated red and processed meats with a greater T2D risk while finding suitable protein alternatives in fish and eggs.
• Other experts have said that T2D may be a reversible condition through diet and lifestyle interventions.

According to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 10 peopleTrusted Source — 37 million Americans — live with diabetes, and over 1 in 3 people have prediabetes.

Type 2 diabetes (T2D), the most prevalent form of diabetes, develops when the body becomes resistant to the insulin the pancreas produces or when the pancreas doesn’t produce enough insulin. Insulin is a hormone that regulates blood glucose levels.

Diabetes can increase the risk of health complications, including cardiovascular disease, kidney failure, stroke, blindness, and circulatory issues, which could necessitate the amputation of toes, feet, or a part of the leg.

In a new study, researchers at the University of Naples Federico II in Naples, Italy, have gathered evidence showing that certain foods can cut the risk of T2D onset.

Annalisa Giosuè, Ph.D., of the institution’s Department of Clinical Medicine, spearheaded an extensive investigation to explore the relationship between different animal-based foods and the condition.

Giosuè presented her team’s findings at the annual meeting of the European Association for the Study of Diabetes (EASD) conference in September.

High-level ‘review of review’

Current dietary guidelinesTrusted Source for T2D prevention recommend limited intake of most animal products.

However, research suggests that certain animal products might offer health benefits for lowering T2D risk.

Type 2 diabetes is one of the major causes of diet-related death worldwide. Learning more about how different dietary components increase or decrease the risk of type 2 diabetes is key to its prevention,” Dr. Giosuè told Medical News Today.

To that end, Giosuè and colleagues examined 13 existing meta-analyses that studied which foods were linked to increased risk of T2D.

They said that this type of “review of reviews” pulls together one of the most comprehensive levels of evidence possible in medical research.

Which meats promote T2D?

The 13 meta-analyses provided estimates of how 12 different animal-based foods may elevate or lower the risk of developing T2D. Categories included:

• total meat
• red meat
• white meat
• processed meat
• total dairy
• full-fat dairy
• low fat dairy
• fish
• milk
• cheese
• yogurt
• eggs

Daily consumption of 100 grams (3.53 ounces) of total meat was associated with a 20% higher risk. The same amount of red meat was associated with a 22% increase in risk.

Half that amount of processed meats, such as deli meat, bacon, and sausages, may have contributed to a 30% increase in T2D risk.

MNT asked Dr. Giosuè why red and processed meats affect how the body processes blood sugar:

“Meat, particularly red and processed meats, is a relevant source of saturated fatty acids, cholesterol, advanced [glycation end] products, and heme [animal-derived] iron, which are known to promote chronic subclinical inflammation and impair insulin sensitivity — the capacity of the cells to properly respond to insulin stimulation by absorbing glucose from the blood, thus lowering glycaemic levels.”

Giosuè further explained that sodium, nitrates, and nitrites in processed meats might “not only damage insulin-producing pancreatic cells but also induce oxidative stress and vascular dysfunction, which, in turn, [reduce] the sensitivity of the cells to insulin.”

On the other hand, 50 g (1.76 oz) of white meat, which includes chicken and turkey, corresponded with only a 4% higher T2D risk.

Dr. Giosuè said she believes this is because this meat has less fat, a healthier fatty acid profile, and less animal-derived iron.

Dairy’s protective potential

Dr. Giosuè and her team found that dairy foods might offer protection against T2D or have no effect on its onset.

Consumption of 200 g (almost 1 cup) of milk was associated with a 10% lower risk of T2D, and 100 g (3.52 oz) of yogurt correlated with a 6% risk reduction.

A cup of total dairy and low-fat dairy were each associated with a 5% and 3% reduced T2D risk, respectively.

However, the meta-analyses showed that cheese and full-fat dairy had no effect on T2D risk. The quality of the evidence was low to moderate, though.

During the interview with MNT, Dr. Giosuè mentioned several benefits of regularly eating dairy products:

“Nutritionally speaking, dairy products are a source of nutrients, vitamins, and other components (namely calcium, proteins, peptides, etc.) with potential beneficial effects on glucose metabolism. For instance, whey protein in milk has a well-known effect on the modulation of the rise of glucose blood levels after meals, and also on the control of appetite and body weight.”

“Protective effects in relation to body weight gain and obesity — drivers of type 2 diabetes development — have [also] been reported for probiotics, which can be found in yogurt, the other dairy item whose consumption is associated with a reduced risk of type 2 diabetes,” she continued.

Other low-quality evidence suggested that neither daily 100 g servings of fish nor one egg per day impact T2D risk significantly.

Eating to curb diabetes

The current study adds credence that limiting or avoiding the consumption of animal-based foods, namely red and processed meat, can help prevent T2D.

“Our findings on the most suitable intake of animal foods to prevent type 2 diabetes incidence are highly concordant with the features of the Mediterranean diet, which is the plant-based dietary pattern that has more consistently shown over time the potential to reduce the risk of type 2 diabetes and cardiovascular diseases.”

– Annalisa Giosuè, Ph.D., lead researcher of the study

Dr. Roy Taylor, a physician, author, professor, and director of Newcastle Magnetic Resonance Centre at Newcastle University in the U.K, not involved in the current study, argued in a September 2022 podcast that the wide availability of “cheaper” and more accessible processed foods is driving the spike in T2D cases.

He was especially concerned about the increase in cases among children.

T2D is considered a chronic condition, though there is evidence to suggest that it may be reversible through diet and lifestyle modifications, according to the American Diabetes Association.

Numerous studies, including this one from 2022Trusted Source, have shown a link between consumption of ultra-processed foods and increased risk of T2D. Other research has shown that interventions like a low-calorie diet, physical activity, or bariatric surgery may be effective for reversing T2D.

While more research is needed to determine whether a mostly plant-based diet, such as the Mediterranean diet, could reverse T2D, a growing body of evidence shows that a Mediterranean-style diet may help prevent or delay the progression of the condition.

Call for stronger evidence

The Italian researchers acknowledged that the 13 meta-analyses included inferior data in some cases. Thus, they are hesitant to offer “solid recommendations” for T2D prevention based on their study at this time.

Nevertheless, Dr. Giosuè commented:

“Our study gives further support to the belief that a plant-based dietary pattern including limited intakes of meat, moderate intakes of fish, eggs and full-fat dairy and the habitual consumption of yogurt, milk or low-fat dairy, might represent the most feasible, sustainable and definitely successful population strategy to optimize the prevention of type 2 diabetes.”

https://www.medicalnewstoday.com/articles/dairy-products-may-protect-against-type-2-diabetes-but-red-and-processed-meat-raise-risk

Night owls may be more prone to heart disease and diabetes, study finds

From theguardian.com

Research shows early birds more sensitive to insulin levels and burn more fat at rest and during exercise 

The findings could have implications for discussions around the health risks of night-shift work and even changing the clocks to suit daylight hours. Photograph: DCPhoto/Alamy

Night owls may be more prone to heart disease and diabetes than early birds because their bodies are less able to burn fat for energy, US researchers say.

People who rise early rely more on fat as an energy source, and are often more active in the day, than those who stay up later, meaning fat may build up more easily in night owls, the scientists found.

The findings may help explain why night owls are at greater risk of type 2 diabetes and cardiovascular disease, and may help doctors to identify patients early on who are more likely to develop the conditions. 

“This could help medical professionals consider another behavioural factor contributing to disease risk,” said Prof Steven Malin, a senior author on the study and expert in metabolism at Rutgers University in New Jersey. 

The researchers divided 51 obese middle-aged adults into early birds and night owls, depending on their answers to a questionnaire on sleeping and activity habits. They monitored the volunteers’ activity patterns for a week and tested their bodies’ fuel preferences at rest and while performing moderate or high-intensity exercise on a treadmill.

Writing in Experimental Physiology, the team describe how early birds were more sensitive to blood levels of the hormone insulin and burned more fat than night owls while at rest and during exercise. The night owls were less sensitive to insulin and their bodies favoured carbohydrates over fat as an energy source.

Malin said it was unclear why differences in metabolism were seen in night owls and early birds, but one possibility, he believes, is a mismatch between the time people go to bed and wake the next morning and the circadian rhythms that govern their body clocks.

“Night owls are reported to have a higher risk of obesity, type 2 diabetes and cardiovascular disease when compared with early birds,” he said. “A potential explanation is they become misaligned with their circadian rhythm for various reasons, but most notably among adults would be work.”

If a person is a night owl, Malin added, they may prefer to go to bed late but still have to get up early to go to work or to look after children, and this may force them to be out of alignment with their body clocks when they would rather be sleeping.

The findings could affect discussions around the health risks of night-shift work and even changing the clocks to suit daylight hours. “If we promote a timing pattern that is out of sync with nature, it could exacerbate health risks,” Malin said. “Whether dietary patterns or activity can help attenuate these is an area we hope becomes clear in time.”

https://www.theguardian.com/science/2022/sep/20/night-owls-may-be-more-prone-to-heart-disease-and-diabetes-study-finds

Four cups of tea a day can help keep diabetes away, say Chinese scientists

From theguardian.com

Black, green or Oolong teas linked to reduced risk of developing type 2 form of the disease 

Drinking plenty of tea – at least four cups a day – can help reduce the risk of developing type 2 diabetes, research has found.

Chinese academics behind the findings say that four or more cups of tea daily can lower the risk by 17% over 10 years. “Our results are exciting because they suggest that people can do something as simple as drinking four cups of tea a day to potentially lessen their risk of developing type 2 diabetes,” said Xiaying Li from the Wuhan University of Science and Technology in China, the lead author.

The protective effect may be even greater if people put milk in their tea, Li said. Although she and her seven co-authors did not investigate the effect of milk in tea as part of their work, previous studies have shown that dairy products can also have an anti-diabetic effect.

“I think the milk would make the effect of tea on diabetes stronger. That is, tea would be more effective with milk in,” Li said.

She will present the findings on Sunday at the European Association for the Study of Diabetes’s annual meeting, in Stockholm, Sweden.

The protective effect of drinking four cups of tea or more a day may be even greater if you add milk, researchers say. Photograph: Realimage/Alamy

The researchers undertook a meta-analysis of 19 previous studies into tea drinking and diabetes which involved almost 1.1 million adults in eight countries in America, Asia or Europe, including one conducted in the UK. They found a “significant linear association” between drinking black, green or Oolong tea – a traditional Chinese tea – and a reduced risk of becoming diabetic.

Compared to non-tea drinkers, people who drank one, two or three cups a day had a 4% reduced risk –but those who consumed four or more cups daily were at 17% less risk. The effect was consistent across both sexes.

Asked why tea might protect against diabetes, Li said: “It is possible that particular components in tea, such as polyphenols, may reduce blood glucose levels, but a sufficient amount of these bioactive compounds may be needed to be effective.”

About 4 million Britons have been diagnosed with diabetes. Of those, about 90% have type 2, which is associated with unhealthy lifestyles, especially being overweight. The others have type 1, an autoimmune condition that is not associated with lifestyle and is usually diagnosed in childhood. Although the findings have not appeared in a medical journal they were peer reviewed by the Stockholm conference organisers.

Li said that while the findings are observational and do not prove that tea drinking causes the lower risk of type 2 diabetes, they believe it is likely to contribute.

https://www.theguardian.com/food/2022/sep/18/four-cups-of-tea-a-day-can-help-keep-diabetes-away-say-chinese-scientists