Diabetes Edutool: Tutorial 2

Low blood glucose and the liver

When we eat, the foods containing starches are broken down into glucose

The glucose is first absorbed into the blood stream

Excess glucose from the blood is stored in the liver

This glucose is then gradually released when needed for energy

Sometimes your blood glucose can fall too low. This might be due to:

• Too much insulin, relative to food eaten

Insulin

Sometimes your blood glucose can fall too low. This might be due to:

• Too much insulin, relative to food eaten

• Too much exercise, relative to food eaten

Insulin

Sometimes your blood glucose can fall too low. This might be due to:

• Too much insulin, relative to food eaten

• Too much exercise, relative to food eaten

• Not eating for a while,with active insulin stillavailable

Insulin

Let’s use Edutool to investigate. Initially, the blood glucose is normal, therefore the

oval is green

Let’s use Edutool to investigate. Initially, the blood glucose is normal, therefore the

oval is greenNormal blood

glucose is close to 5 mmol/l

Now let’s add 5 U of insulin

Insulin stores , causing the blood glucose to drop

As insulin increases, more

is stored

The liver prevents low blood glucose

To prevent low blood glucose, the liver

releases

There is a limit to how much the liver can release

This is shown by the blue line

Let’s add more insulin to see what will happen

The liver has reached its maximum output level

Notice the Energy from liver arrow

The liver cannot release more

The blood glucose starts to

drop

The liver cannot release more

Hypoglycaemia occurs

Let’s add 2 more units of insulin

The blood glucose is now dangerously low

Hypoglycaemic coma is a risk at

this stage

Let’s recap…

Look what happens to the liver arrow and the blood glucose level

To counteract the hypo, we must eat

6 was needed to raise the blood

glucose to a normal level

To counteract the hypo, we must eat

Lessons:

- Relative to food eaten, too much insulin causes low blood glucose

- The liver helps to counteract low blood glucose

- There is a limit to the liver’s counteracting ability

- After exceeding this limit, low blood glucose will occur

-- End of Tutorial 2 --