3 ms·

Yes, your body cannot have zero insulin. You do not need/want more insulin once your glucose is 70-75, though. I'm quite familiar with both hypoglycemia and ket

Yes, your body cannot have zero insulin. You do not need/want more insulin once your glucose is 70-75, though. I'm quite familiar with both hypoglycemia and ketoacidosis, having nearly died of undiagnosed type 1 last Spring. Ketoacidosis is typically associated with hyperglycemia. It happens when your body has no insulin. There is what's called euglycemic ketoacidosis but it's rare. In typical ketoacidosis, your blood is very high in glucose, but lacking insulin, your cells have no way to obtain it. Since your body cannot get energy out of your blood in the normal fashion it starts to digest ketones, which acidifies the blood and creates many harmful effects. In the situation we are discussing, when your glucose rises above 75 from food or liver secretion, the novel insulin would start working, preventing ketoacidosis.

cperciva 5y ago
Yes, your body cannot have zero insulin. You do not need/want more insulin once your glucose is 70-75, though. I'm quite familiar with both hypoglycemia and ketoacidosis, having nearly died of undiagnosed type 1 last Spring. Get another two decades of experience and then we can talk. It's entirely possible to have blood glucose below 70 mg/dL without having "too much insulin"; healthy adults routinely fall below this level during periods of metabolic starvation. At such times, the body is in a state of ketosis -- this is normal and healthy! -- but as long as there's enough insulin (which there is, in healthy adults) this does not result in acidosis. When A.B. fasted for 382 days, his blood glucose levels stabilized around 30 mg/dL while he remained ambulant. Ketoacidosis is not so much caused by hyperglycaemia as it is co-occuring as a result of hypoinsulinaemia.
- code_duck 5y ago
  Okay. See you in 20 years then! Just don't raise the bar and tell me it's 40. Currently I have 18 months experience thinking about this. In the meantime, I am not an expert and am quite willing to be informed. I generally assume that other people in a general discussion audience are not familiar with diabetes treatment or biology at all. If you are, that’s great. I have not heard of healthy states of hypoglycemia before, other than that many people naturally experience it during sleep. I have a friend whose mother suffers from hypoglycemia and she suffers the same ill effects as it how 1 diabetics commonly experience. I am aware that other metabolic causes exist for blood glucose levels to be reduced besides insulin. Do you mean metabolic ketosis, the type that people try to achieve intentionally through diet? I am aware that states of ketosis exist without acidosis, such as that one. I’m not intimately familiar with the biological details. Yes, I am aware that ketoacidosis is caused by a complete lack of insulin, and the complete lack of insulin leads to hyperglycemia, not some other causative relationship.
  - cperciva 5y ago
    I have a friend whose mother suffers from hypoglycemia and she suffers the same ill effects as it how 1 diabetics commonly experience. I'm guessing reactive hypoglycaemia? That's caused by the body overproducing insulin in response to meals; it's also believed to be a common prologue to T2D since it "trains" the body to be less sensitive to the (over)produced insulin. No surprise that hypoglycaemia resulting from an excess of insulin is similar to hypoglycaemia resulting from an excess of insulin!
    - code_duck 5y ago
      You know, I didn’t find it that surprising either. I’m not sure what you’re trying to tell me about these edge cases of hypoglycemia. I feel like I did a reasonable job describing how it works for individuals on insulin therapy. I have not found much in medical literature that says hypoglycemia is anything other than abnormal and dangerous condition that should be treated immediately. This study starts out with the lines, for example, “Among otherwise healthy adults, there is a subgroup of individuals who develop symptoms of hypoglycemia during episodes of food restriction.” https://www.nature.com/articles/1602785 https://www.nature.com/articles/1602785 It appears these medical researchers do not consider hypoglycemia during periods of fasting normal or healthy.
      - cperciva 5y ago
        Key word there is symptoms of hypoglycemia. Hypoglycaemia can be entirely asymptomatic in food-restricted healthy adults.
        code_duck 5y ago
        That’s certainly interesting since I thought the symptoms resulted from a basic lack of energy for cells. What’s the difference? Can you point to where I can learn more about that?

cperciva 5y ago

Yes, your body cannot have zero insulin. You do not need/want more insulin once your glucose is 70-75, though. I'm quite familiar with both hypoglycemia and ketoacidosis, having nearly died of undiagnosed type 1 last Spring. Get another two decades of experience and then we can talk. It's entirely possible to have blood glucose below 70 mg/dL without having "too much insulin"; healthy adults routinely fall below this level during periods of metabolic starvation. At such times, the body is in a state of ketosis -- this is normal and healthy! -- but as long as there's enough insulin (which there is, in healthy adults) this does not result in acidosis. When A.B. fasted for 382 days, his blood glucose levels stabilized around 30 mg/dL while he remained ambulant. Ketoacidosis is not so much caused by hyperglycaemia as it is co-occuring as a result of hypoinsulinaemia.

code_duck 5y ago
Okay. See you in 20 years then! Just don't raise the bar and tell me it's 40. Currently I have 18 months experience thinking about this. In the meantime, I am not an expert and am quite willing to be informed. I generally assume that other people in a general discussion audience are not familiar with diabetes treatment or biology at all. If you are, that’s great. I have not heard of healthy states of hypoglycemia before, other than that many people naturally experience it during sleep. I have a friend whose mother suffers from hypoglycemia and she suffers the same ill effects as it how 1 diabetics commonly experience. I am aware that other metabolic causes exist for blood glucose levels to be reduced besides insulin. Do you mean metabolic ketosis, the type that people try to achieve intentionally through diet? I am aware that states of ketosis exist without acidosis, such as that one. I’m not intimately familiar with the biological details. Yes, I am aware that ketoacidosis is caused by a complete lack of insulin, and the complete lack of insulin leads to hyperglycemia, not some other causative relationship.
- cperciva 5y ago
  I have a friend whose mother suffers from hypoglycemia and she suffers the same ill effects as it how 1 diabetics commonly experience. I'm guessing reactive hypoglycaemia? That's caused by the body overproducing insulin in response to meals; it's also believed to be a common prologue to T2D since it "trains" the body to be less sensitive to the (over)produced insulin. No surprise that hypoglycaemia resulting from an excess of insulin is similar to hypoglycaemia resulting from an excess of insulin!
  - code_duck 5y ago
    You know, I didn’t find it that surprising either. I’m not sure what you’re trying to tell me about these edge cases of hypoglycemia. I feel like I did a reasonable job describing how it works for individuals on insulin therapy. I have not found much in medical literature that says hypoglycemia is anything other than abnormal and dangerous condition that should be treated immediately. This study starts out with the lines, for example, “Among otherwise healthy adults, there is a subgroup of individuals who develop symptoms of hypoglycemia during episodes of food restriction.” https://www.nature.com/articles/1602785 https://www.nature.com/articles/1602785 It appears these medical researchers do not consider hypoglycemia during periods of fasting normal or healthy.
    - cperciva 5y ago
      Key word there is symptoms of hypoglycemia. Hypoglycaemia can be entirely asymptomatic in food-restricted healthy adults.
      - code_duck 5y ago
        That’s certainly interesting since I thought the symptoms resulted from a basic lack of energy for cells. What’s the difference? Can you point to where I can learn more about that?