
July 16, 2008
Complications, Hyperglycemia and DKA
Question from India:
Does it look possible that hyperglycemia cause peripheral neuropathy whereas occasional HYPOglycemia causes autonomic neuropathy?
The body’s system considers hypoglycemia as a stress and induces counterregulatory mechanism so getting stress tolerance/hypoglycemia unawareness is possible. Is hyperglycemia also a stress?
Answer:
Hypoglycemia unawareness that occurs with persistent intermittent hypoglycemia can be looked at as a form of central nervous system neuropathy. It does not fit as well as the cause for peripheral neuropathy. Hypoglycemia is not the same kind of stress as the hyperglycemia that leads to microvascular problems. This is evident in our patients where they may have hypoglycemia unawareness with a good A1c and no neuropathy.
JTL