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RE: [IPk] severe hypo or not?

This info came from something I read some years ago, by  Dr.David Schwartz
who is  a paediatric endocrinologist.

Kind regards
Jackie J

-----Original Message-----
From: email @ redacted [mailto:email @ redacted] On Behalf
Of Diana Maynard
Sent: 21 June 2011 10:36
To: email @ redacted
Subject: Re: [IPk] severe hypo or not?

HI Jackie
That's interesting, I never knew about the spinal fluid!

On 21/06/11 10:27, Jackie Jacombs wrote:
> Hi Brenda
> Is David any better today?
> It maybe that although the finger stick reading was 3.4 mmols several
> minutes
> after the seizure, the glucose level in the brain could well have been
> previously.
> Adrenalin released as the hypo was getting worse would also raise the BG
> levels.
> The first hormone released is adrenaline; this produces symptoms like a
> pounding heart rate,
> Feeling shaky, sick and sweaty.  Adrenalin is released to enable the body
> respond to stress.
> The hormone glucagon would also be released to "tell" the liver to release
> store of glycogen.
> If someone has just had a severe hypo and/or has been exercising the
> glycogen stores maybe
> depleted. So giving glucagon would not always work. You would need to  IV
> glucose very quickly.
> After a hypo the BG levels should be left to run a little higher than
> and glucose/carbs should be eaten to restock the liver stores.
> The  major fuel for energy for the brain (and the rest of the body) is
> glucose. The glucose is carried by the various blood vessels to the brain
> where it must then leave the circulation and enter into the spinal fluid
> which "bathes" the brain. Most of the time, the spinal fluid glucose
> concentration is really close to the glucose concentration in the blood
> stream. But, under the right/wrong set of circumstances, there can be a
> "delay" in the filtration and recovery/change of spinal fluid glucose
> relative to the blood glucose level. We sort of measure the blood
> glucose as a surrogate marker for the spinal fluid glucose because you
> can't get spinal fluid easily or without harm!!
> The fact that there can be a time lag between blood glucose levels and
> spinal fluid/brain glucose is one of the reasons for sometimes finding
> "normal" BG levels but feeling like crap and shaking from the lack of
> glucose. This time- lag and the blood brain barrier is also the reason why
> sometimes someone can have an extremely low reading on the meter but look
> and feel fine, though quite often as you start to treat the hypo, the
> symptoms begin to "catch up" as the spinal fluid bathing the brain is
> getting low in glucose.
> Kind regards
> Jackie J
> -----Original Message-----
> From: email @ redacted [mailto:email @ redacted] On
> Of email @ redacted
> Sent: 20 June 2011 10:57
> To: email @ redacted
> Subject: RE: [IPk] severe hypo or not?
> Hi Di
> He did have a seizure when he was on holiday in Bulgaria a few years ago
> and I have been told that it took 12-24 hours for him to be fully
> coherent. However, the 24 hours is now up and the second seizure is
> obviously possibly very significant.
> The 3.4 reading was immediately after the seizure and I did think that
> it could possibly have been lower when he seized and he had rebounded -
> can't remember the exact terminology for all this because I'm not
> thinking straight! The previous occasion also occurred in the morning
> before he got up so I would really class it as a nightime hypo, although
> not sure if that makes a difference orr not.
> Brenda, mum of David, 22
> .
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