Everyone has experienced hypoglycemia, a lack of sugar in the blood. Headache, nervousness, feeling of ravenous hunger. For a person who does not suffer from diabetes, these are unpleasant symptoms, but they do not threaten his life. In diabetics, however, the so-called hypoglycemic shock can lead to loss of consciousness and death if not treated.
Diabetes is a disease when a diabetic has an excessive amount of glucose, i.e. sugar in the blood. This chronically damages the organism. But even its lack can paradoxically cause an acute condition! Hypoglycemia is the biggest fear, especially for people with type 1 diabetes and, in the case of children with this type of diabetes, for their parents as well. “Type 1 diabetes is an autoimmune disease where the pancreas completely stops producing insulin. It usually appears in childhood and adolescence, but it can occur at any age. Patients are dependent on insulin administration for life,” explains MUDr. Ľubomír Barák from the Children’s Diabetes Center in Bratislava. It is also called juvenile diabetes.
Approximately 27,000 patients live with type 1 diabetes in Slovakia, of which 1,740 are children under the age of 19. Only during the last monitored year, 193 of them were added. 90% of patients with juvenile diabetes claim that they have already experienced a hypoglycemic state and others have also experienced it, they just didn’t realize it. Hypoglycemia is insidious in that it can also be asymptomatic, i.e. without symptoms. Up to 30% of diabetics are not aware of it. Severe hypoglycemia requires the intervention of another person, because at that moment the diabetic is weak, has reduced concentration, sweats, may have convulsions, his vision deteriorates, he babbles. He acts like he’s drunk. In fact, his life is at stake. A layman on the street can help with a dose of sugar in the mouth, rescuers administer glucose directly into a vein.
“I experienced severe post-alcohol hypoglycemia in a patient who was so aggressive that he tore the leather straps with which we tied him to the stretcher, broke three ribs of the ambulance doctor and bit my artery,” recalls MUDr. Barak. The well-known meteorologist Miriam Jarošová, who has been diabetic for more than 13 years, experienced hypoglycemic shock at the bus stop, and the woman standing next to her thought she was a drug addict because of her shaking and sweating. They only helped her at the neighboring pharmacy.
Hypoglycemia occurs when blood sugar levels are equal to or less than 2.5 mmol/l. “However, we consider a level in the range of 2.6-3.3 mmol/l to be borderline,” adds Ľubomír Barák. “We were already taught in medicine that it is a state of serious illness that you can get into very quickly from full health. As a student, I assisted my first hypoglycemic patient in the park. It is enough if you overdo it with a dose of insulin, inject yourself with insulin and skip a meal, excessive physical exertion, certain medications or alcohol also lead to hypoglycemia. Some diabetics feel hypoglycemia already at a level of 4 mmol/l, when it is possible to intervene in time, but sometimes you do not feel it even at the lower limit during physical work. And from a certain stage, the patient can no longer help himself.” Repeated and frequent hypoglycemia also damages the brain.
Since July, the new MiniMed 640G insulin pump from Medtronic has been available in Slovakia, which, in addition to administering insulin, can protect the patient from impending hypoglycemia and subsequent loss of consciousness. Thanks to the built-in intelligent system, it can predict the blood sugar level and thus recognize impending risks for the patient half an hour before they even occur. At the same time, it is able to react to these risks and regulate the amount and time of administered insulin.
“It’s no longer just about the precise application of insulin. As the first ever pump in the world, it provides 24-hour protection against a dangerous situation such as hypoglycemia and its consequences. Medicine thus records further progress, thanks to which we are ever closer to the development of an artificial pancreas,” praises doc. MUDr. Emil Martinka, PhD., president of the Slovak Diabetological Society.
“Many hypoglycemias occur at night when the patient cannot help himself. It is extremely important to monitor, for example, pregnant diabetics. It should also be remembered that even a small hypoglycemia can cause death in a high-risk diabetic who has already had a stroke. This insulin pump can react and turn off insulin delivery even before hypoglycemia develops, 30 minutes in advance based on continuous blood glucose measurements. During the Pilgrim study, when pediatric diabetics tried to induce hypoglycemia by physical activity, cycling on exercise bikes, it was proven that this insulin pump was able to prevent up to 80% of hypoglycemic states.” And that’s good news like a candy bar at the end.