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Hypoglycemia and Glucagon

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...

Oral Hypoglycemic Agents: Glinides

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...

Hormones Regulating Blood Glucose

Hormones Regulating Blood Glucose

Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
In addition to accelerating glucose uptake and utilization, insulin has...

Hypoglycemia

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...

Hyperglycemia

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...

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Related Experiment Video

Updated: Jun 17, 2026

A Method for Manipulating Blood Glucose and Measuring Resulting Changes in Cognitive Accessibility of Target Stimuli

A Method for Manipulating Blood Glucose and Measuring Resulting Changes in Cognitive Accessibility of Target Stimuli

Published on: August 12, 2016

Blood glucose test strips: options to reduce usage.

Tara Gomes¹, David N Juurlink, Baiju R Shah

¹Institute for Clinical Evaluative Sciences, Toronto, Ont.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne

|December 23, 2009

Summary

Many older adults with diabetes use excessive blood glucose test strips, even those at low risk for hypoglycemia. More selective policies could significantly reduce waste and redirect funds to better diabetes care.

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Last Updated: Jun 17, 2026

A Method for Manipulating Blood Glucose and Measuring Resulting Changes in Cognitive Accessibility of Target Stimuli

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Improving IV Insulin Administration in a Community Hospital

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Published on: June 11, 2012

Low-Cost, Volume-Controlled Dipstick Urinalysis for Home-Testing

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Published on: May 8, 2021

Area of Science:

Endocrinology
Health Economics
Public Health Policy

Background:

Self-monitoring of blood glucose (SMBG) is widely used by patients with diabetes.
Evidence suggests SMBG offers limited clinical benefit for many patients.
Targeted public payer policies for blood glucose test strips could yield substantial economic impacts.

Purpose of the Study:

To analyze trends in blood glucose test strip utilization among older adults with diabetes in Ontario.
To assess the potential impact of policy interventions aimed at optimizing test strip use.

Main Methods:

Cross-sectional analysis of annual prescription claims for test strips (1997-2008).
Stratification of patients (aged 65+) by diabetes treatment intensity.
Calculation of annual test strip use and modeling of 5 hypothetical policy scenarios.

Main Results:

Test strip use surged nearly 250% from 1997 to 2008.
In 2008, 52.6% of patients received prescriptions; nearly half were low-risk for hypoglycemia.
Over 117 million strips dispensed in 2008; policies could have reduced this by 9.5-74.5 million.

Conclusions:

A significant proportion of older adults with diabetes engaging in self-monitoring are at low risk for drug-induced hypoglycemia.
Selective testing policies could generate economic savings.
Redirecting these savings could fund more effective diabetes interventions.