When blood sugar is falling, the stopper built into the body is the release of glucagon from the alpha cells of the pancreas which stimulates the release of glucose from the liver (but only if your adrenaline is flowing). However, when hypoglycemia is due to injected insulin - the stopper isn't entirely in place. Scientists explain how epinephrine (adrenaline) plays a major role in regulating glucose in times of low blood sugar and how this response could be adversely affected by the use of beta-blockers.

During insulin-induced hypoglycemia in dogs, the roles of adrenaline and glucagon were evaluated. The dogs fasted overnight to remove excess glucose from the blood. The dogs also had their adrenal glands removed. The adrenal glands are the source of adrenaline. Adrenaline is released into the bloodstream in response to physical or mental stress,to initiate the stimulation of glucose, among many other functions. Adrenaline and insulin were released at two different rates: a basal rate or a variable rate to simulate an adrenaline response. When the blood sugar fell to 42 mg/dL, the dogs in the basal rate group failed to release glucagon, but the simulated adrenaline response group increased normally. The liver response to releasing glucose fell in the basal group but increased in the simulated adrenaline response group. The researchers conclude that adrenaline must be responsible for this critical response to insulin-induced hypoglycemia.

Beta blockers are a common class of prescription drugs that counteract the stimulatory effects of adrenaline. Diabetics who inject insulin and take beta-blockers should be extra cautious of hypoglycemia. Hypoglycemic unawareness is already established for diabetics injecting GM insulin (genetically modified human insulin). Given the side effects of beta blockers, there is greater reason to be more aware of hypoglycemis unawareness -- yes, oxymoron. Those individuals who are on the brink of diabetes should avoid beta-blockers at all costs, according to a study in The Lancet (January 2007) beta-blockers used for hypertension increase a patient's risk of developing diabetes.

In the next 3 to 5 years, we will have a new generation of control upon us providing continuous glucose monitoring. Some of these marvelous technologies will not require a drop of blood, while others will embody the tried-and-true stick-to-itiveness we all know and loathe.

Please join me as we browse the isles of things to come (and things now available) for continuous glucose monitoring.

The DexCom STS Continuous Glucose Monitoring System is a glucose sensor that reports glucose values every 5 minutes for up to 72 hours. The sensor is inserted in the abdomen. After a 2 hour start-up period, the STS System is calibrated with 2 fingerstick measurements taken by a traditional glucose meter. Checkout Amy Tenderich's review on Diabetes Mine of the DexCom Continuous Glucose Monitoring Sytem.

MiniMed Medtronic has 3 different versions: the Gold, the Guardian RT, and the Paradigm Real-Time Continuous Monitor.

Menarini GlucoDay S is a device worn by the patient for the continuous monitoring of glucose in the subcutaneous interstitial fluid. Monitoring is performed via insertion in the abdominal region of a microfibre for dialysis having the diameter of a human hair. Inside the microfibre a solution transports the patient's glucose to a biosensor within the instrument.

M-Biotech Glucose Biosensor is a minimally invasive implantation for painless and convenient monitoring. The key feature of our efficient Glucose Biosensor is the combination of a glucose-sensitive hydrogel and a miniature pressure sensor. Glucose-responsive hydrogels are biocompatible materials that either swell or contract when the glucose concentrations change in the body fluid surrounding the hydrogel.

The PreciSense System includes a microcapsule placement unit and a light detecting non-invasive reader unit. The microcapsule placement unit poses the right dose of glucose-responding microcapsules in the upper layer of the skin, painlessly. The glucose assay components in the microcapsules generate a fluorescence signal that corresponds to the glucose level. The non-invasive reader unit monitors this glucose binding event through FRET, Fluorescence Resonance Energy Transfer, which is directly related to the concentration of glucose.

Sensors for Medicine and Science glucose sensor is implanted under the skin in a short outpatient procedure. The sensor automatically measures interstitial glucose every few minutes, without any user intervention. The sensor implant will communicate wirelessly with a small external reader.

Synthetic Blood Implanted Glucose Biosensor claims to offer significantly more accurate glucose readings in a range of 30-500 mg/dl. The implanted Glucose Biosensor continuously monitors blood glucose without the need for finger sticks. The most accurate glucose monitor available, the implanted biosensor can be programmed to monitor blood glucose according to a predetermined schedule, thus eliminating problems of patient compliance. The sensor alarms for dangerous, life threatening conditions such as hypoglycemia.

GlucoLight Corporation is developing a low-cost non-invasive blood glucose monitor for home use by diabetic patents. GlucoLight's unique optical approach, microScatterTM (microscatter) technology, is based on patented technologies in the area of Optical Coherence Tomography (OCT) and Low Coherence Interferometry (LCI). There is a working prototype with published clinical data on healthy volunteers.

The GlucoWatch G2 Biographer was approved to detect glucose level trends and track patterns in people with diabetes. It must be used along with conventional blood glucose monitoring of blood samples. The device, which looks like a wristwatch, pulls body fluid from the skin using small electric currents. It can provide six measurements per hour for 13 hours. (See David Mendosa's review).

Now that the US market is suspiciously saturated with human insulin - and many of us diagnosed within the last 10 years did not have a shot at trying porcine insulin - I'd like to set the record straight. When the pharmaceutical companies cherry pick the studies they wish to use for their gain, and not so much for your enhanced quality of life - they must've lost this study.

Please read the entire study (if you have access to it in a local library) but what grabbed my undivided attention was the sentence that says: it was observed that the action of porcine insulin was associated with... a striking increase of prolactinaemia, in relation to semisynthetic human insulin.

Okay -- so as I look deeper into the function of prolactin -- aside from some definite dopamine enhancing activities (if you know what I mean) :::wink wink::: -- it is responsible for the formation of myelin coatings on axons in the central nervous system. This is a certifiable problem that results in diabetic neuropathy and the related side effects (numbness, nerve dysfunction, i.e, ED).

Ex-queeze me? Does this say that human synthetic insulin may be a cock blocking drug?

Sorry for the blunt delivery -- but this is the truth. Why doesn't human synthetic insulin have this listed as a side effect? My guess is: if you had a choice of human synthetic insulin versus highly purified porcine insulin -- and you knew the side effects of human synthetic might take a toll on the health of your sex life -- you might be praying to the porcine gods.

Shame on the companies who knew about this study and kept it undercover so you couldn't...

Damage to the retina that sometimes comes with diabetes is associated with an increased risk of having a stroke.

A study involving 1,617 middle-aged people with diabetes led researchers to this conclusion, linking retinopathy and stroke risk. At the start of the study, 197 participants had moderate retinopathy and 44 had severe retinopathy. During an average follow-up of almost 8 years, 75 strokes occurred in the group as a whole. Considering all exacerbating factors -- such as blood pressure, insulin treatment and cholesterol levels -- having diabetic retinopathy more than doubled the likelihood of having a stroke.

Dr. Tien Y. Wong advised Reuters Health, "Diabetes can exert its effects on multiple organs in the body, and damage in the blood vessels seen in the eye -- retinopathy -- is a marker of probably unseen damage occurring elsewhere." Detecting blood vessel damage in the eye is linked to blood vessel damage in the brain, which could result in a stroke. He advises all eye care professionals to perform a more comprehensive assessment of stroke risk if they detect retinopathy in a patient.

Another day, another depressing health-related news story. Thanks, Forbes, for today's Scary Statistic! With the ominous headline, "Diabetes Brings Earlier Heart Disease, Death," Forbes reports that a new study shows Type 2 diabetics are likely to suffer fatal and non-fatal heart attacks, strokes and other cardiovascular "events" (my favorite health euphemism!) around fifteen years sooner than non-diabetics. Oh, yikes. That is a scary statistic.

The information comes courtesy of researchers at the Institute of Clinical Evaluative Sciences in Toronto, Canada. The results of the study have been published in the latest issue of The Lancet (July 2006). The study found that you can roughly pinpoint the ages at which people cross over into the "moderate risk" and "high risk" categories for heart problems. For diabetics, this crossover point came about fifteen years earlier than for others.

For Type 2 men "moderate risk" was reached at just under thirty-nine years of age, as opposed to age fifty-five for non-diabetic men. "High risk" was reached at around forty-nine years, instead of sixty-two for non-diabetic men. For Type 2 women, "moderate risk" was reached at around forty-six years, as opposed to sixty-two for non-diabetics, while "high risk" for women began at at fifty-six, instead of sixty-nine for non-diabetics.

Worst of all, the researchers report that Type 2 diabetics who were at moderate or high risk for heart disease died an average of eighteen years earlier than non-diabetics.

The solution? Experts say physicians need to take the lead in pushing their Type 2 diabetic patients to get active and lose weight.