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July 13, 2001


Question from Ludhiana, Punjab, India:

It's known that type 1 diabetes is caused by some natural action of some antibodies in the human body which kill the beta cells in the Islets of Langerhans. These islets also contain alpha cells which produce glucagon to raise blood sugar levels in blood in case of hypoglycemia. If only beta cells are dead in type 1 diabetes, why does hypoglycemia occur when alpha cells have not been killed? Is it that all types of cells are destroyed?


Blood sugars are controlled by many factors; but the most important is the balance between ingested glucose and the action of a number of hormones like glucagon and the glucocorticoids that raise blood sugar on the one hand and the output of insulin which lowers blood sugar by allowing it to access the intracellular energy cycle or by converting it to glycogen. In diabetes, abnormally low blood sugars are primarily due administering too much insulin in relation to the food intake and very occasionally to an inappropriately delayed insulin response to a rise in blood sugar.