Endocrine & metabolic · UKMLA & AKT
Hypoglycaemia in diabetes
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise hypoglycaemia in diabetes — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Common triggers: excess insulin or sulfonylurea relative to carbohydrate intake or energy expenditure
- Specific precipitants: missed/delayed meals, unplanned excess exercise, alcohol (inhibits hepatic gluconeogenesis), renal impairment (reduces insulin clearance), lipohypertrophic injection sites
- Counter-regulation: glucagon (alpha cells) → hepatic glycogenolysis/gluconeogenesis; then adrenaline → raises glucose + autonomic warning symptoms
- Repeated hypoglycaemia resets the counter-regulatory threshold lower → adrenaline released only when glucose already dangerously low → hypoglycaemia unawareness (IAH)
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