Lately the news has seen a lot of devastating diabetic events due to hypoglycemic unawareness. Hypoglycemic unawareness is commonly defined as an inability to recognize the symptoms (sweating, tremor, hunger, anxiety, and palpitations) of decreased blood sugar or a failure of the warning signs to occur before development of neuroglycopenia, which means a shortage of glucose in the brain. Curiously, this term was not coined for diabetes until 10 years after the introduction of genetically modified human synthetic insulin and insulin analogues.

I hate to say it but diabetes is a crapshoot. You never know what you are going to get, but you can sure try your best to keep your eye on the ball. Removing the inherent dangers of hypoglycemic unawareness would make me a happier diabetic, and improve the lives of all those I care about (diabetics like myself). The answer might lie in the only type of treatment available nowadays, insulin analogues. Diabetics who do not take any form of drug to control blood sugar do NOT have hypoglycemic unawareness.

It's called human but it is nothing like natural human insulin. It may be faster acting or longer lasting but I'm sure He didn't intend for insulin to break sound barriers or last three moons. If Big Pharmaceutical companies were asked to compare insulin analogues with natural human insulin you'd hear crickets. I promise you NO Big Pharma will fund a study that would become the antithesis of their marketing campaigns, human insulin is better. It's not better, it's just different -- totally different! Natural insulin is fat-loving. Insulin analogues are water-loving. The global command center of the body (the brain) is one big blob of fatty material. This means as your blood sugar is dropping, your brain is last fed, if it eats at all. Here in the United States we are victims of circumstance in hypoglycemic unawareness. Sorry brain, no soup for you.

Today I compose an ode in remembrance for our islets of Langerhan. Their job is far more complex than balancing blood sugar. They balance everything in our metabolism, starting with the hormones that tell us to eat or stop eating. The islets of Langerhan house 4 critical cell groups: beta cells, alpha cells, delta cells, and gamma cells - also referred to as the PP cells and D1 cells.

Beta cells are activated by a rise in glucose which results in secreting insulin. As this insulin lowers the blood glucose, amylin is also released. Amylin supports the stability of blood glucose levels by slowing the rate that digested glucose enters the bloodstream. The alpha cells are the opposite - they are responsible for preventing hypoglycemia by secreting glucagon. Glucagon helps maintain the level of glucose by causing the liver to release stored glucose. Delta cells secrete somatostatin, which is like the hold button of the alpha-beta cell connection, restraining the release of insulin and glucagon. The last of our Langerhan lineup, and seemingly the least understood, is the gamma cells, PP and D1. These cells affect appetite through the secretion of ghrelin or leptin. Ghrelin is a stimulant for appetite and feeding. Leptin is a hormone that suppresses appetite and speeds up metabolism.

To recap Team Langerhan: beta cells respond to rising blood glucose with insulin, alpha cells respond to falling blood glucose with glucagon. Delta cells respond to perfect balance in blood glucose by suppressing insulin and glucagon, and the gamma cells keep an appetite on an even keel with ghrelin and leptin. If the initial blood glucose lowering medicine prescribed affects any one of these hormones (as you can see it does) - it is definitely causing an imbalance in metabolism. As we memorialize the islets of Langerhan- let us consider all they have done for us. Pay tribute to your islets of Langerhan by doing all that is naturally possible to restore metabolic balance in the future. I have a few ideas - but your job today is complete. You are enlightened. Please have a happy and safe Memorial Day!