Not to go on and on about it. But, these Mystical Forces always fascinate me!!! I love the mystical forces that increase system complexity because they are so tricky to identify and implement controls for. It makes for fun experiments. Thanks, you guys, for the articles. I’ve been needing articles about things like this for a while. Now, I know where to start reading about them. Even if I know know ‘why’ things happen, I like to know what variables might be at play.
Yes, time spent as a diabetic is identified as a critical factor. No way to know, for certain, about the mechanism…as always. I will call them ‘mystical diabetic forces.’ And Brian’s right that ‘glucose recovery,’ is hard to interpret. But, the most surprising part of the article was that the innate mechanisms (although they can’t say, specifically, what they are) that help counter balance hypos deteriorate with ‘diabetic age’ or duration of the disease.
I guess I am struggling with an increase in diabetic symptomatology associated with hypos, or perhaps, “an increase in severity of hypo.” I would think that could be a result of my body putting out less glucagon or epi, or performing less breakdown of fat into simple sugar (mystical forces). I have always blamed sugar output from one of these mystical variables for bumping me high when I exercise. Seems feasible that a decrease in them might impact the experience/severity of lows. I’m not sure if going blind represents a decreased ability to recover from lows or an instance of ‘severe hypoglycemia,’ but it might. This is my 20th anniversary of being type one, so I maybe I’m just a late bloomer on some of those impaired functioning they speak of. If they have demonstrated that the rate of change decreases during recovery time, might there also be an analogous increased rate of change during the drop, increasing symptoms?
“Because most patients who have had type 1 diabetes for 1-2 decades have totally lost their glucagon response to IIH and have blunted epinephrine responses, these studies helped to explain the impairment of glucose recovery observed in patients with long-term type 1 diabetes (10-14). In many patients with newly diagnosed type 1 diabetes, both glucagon and epinephrine responses to hypoglycemia are quantitatively normal, as is the rate of glucose recovery from hypoglycemia (15). In contrast, many patients who have had type 1 diabetes for less than a decade have blunted glucagon responses with normal epinephrine responses, but a delayed glucose recovery (15). From these studies, the concept emerged that the glucagon response is critical for normal glucose recovery and that impairment of the glucagon response is a major factor in the susceptibility of patients with type 1 diabetes to episodes of prolonged and severe hypoglycemia (5).”
I think they are more concerned with the ‘prolonged’ part of recovery (rate of increase shown in red) and I am more concerned with ‘severity’ (rate of decrease on the way down). Not at all a bad article for starting to think about this problem.