PREVENTING LOW BLOOD SUGAR LEVELS
Report #7205
There's a new treatment for a frightening complication of diabetes: insulin causing the blood sugar level to drop too low and damage the brain.
Many insulin dependant diabetics require insulin overnight. Otherwise, their blood sugars would rise to very high levels during the night and harm them, but there is a fine balance between having too little and too much insulin. Night-time insulin can drive blood sugar levels too low and damage the brains of diabetics. So doctors have to cover the insulin they give at night/ so they often recommend an evening snack, but the evening snack maintains blood sugar levels only for the first part of the night/ and diabetics can still develop very low blood sugar levels in the early morning. Exciting new research shows doctors can keep blood sugar levels from dropping too low throughout the night and the morning be prescribing that their patients take a safe amino acid, called alanine, at bedtime. It causes the body to increase its production of a natural hormone called glucagon that raises blood sugar levels. Another trick is to give the drug, terbutaline, at bed time. It causes the liver to release extra sugar if blood sugar levels drop too low. See report #D222.
By Gabe Mirkin, M.D., for CBS Radio News
CONCLUSIONS - In patients with IDDM given an evening desk of NPH insulin, a conventional bedtime snack exerts an inconsistent glycemic effect only during the first half of the night, and bedtime administration of the glucagon-releasing amino acid alanine or the epinephrine-simulating beta(2)-adrenergic agonist terbutaline more effectively prevents nocturnal hypoglycemia than a conventional bedtime snack. TY Saleh, PE Cryer. Alanine and terbutaline in the prevention of nocturnal hypoglycemia in IDDM. Diabetes Care 20: 8 (AUG 1997):1231-1236. Address PE Cryer, Washington Univ, Sch Med, Div Endocrinol Diabet & Metab, 600 S Euclid Ave, Box 8127, St Louis, MO 63110 USA.
Reported 9/1/97; Checked 9/5/05