The brain is a mysterious thing. And when diabetes is thrown into the mix, there's even more mystery.

At Yale University, researchers have recently uncovered some answers to a brain-related question for those in the Diabetes Community: Why don't we all feel low blood sugars?

Bottom line: One size (hypoglycemia reaction) does not fit all.

Yep, that figures. While scientists are trying to answer these questions, there are also efforts underway to provide an insider's view of what hypoglycemia feels like. There's a lot on the mind (hah!) with these topics lately, and today we're taking a look at a few news-makers.


Studying D-Brains

Published in the Journal of Clinical Investigation at the end of January, this NIH-funded study from Yale looked at the brains of 42 individuals (16 living with T1D) and how insulin use impacts their low blood sugar responses.

Yale UniversityIn those without diabetes, a drop in BG stimulates the body to make glucose and find food.

But those with T1D apparently don’t have the same responses.

MRI scans in this research traced that back to key regions of the brain – linked to reward, motivation, and decision-making. Half of those with T1D had altered activity relating to attention.

This presented some answers relating to “hypo unawareness” (when we can’t feel Lows), that often increases over time.

“There is a progressive loss of coordinated brain response to low blood sugar as you go from healthy adult to aware and unaware,” says Janice Hwang, M.D., Yal Assistant Professor of Medicine and lead investigator of this study. “The first areas in the brain to go are associated with regulating feeding behavior.”

Interesting, for sure. But a bit depressing in that our diabetes brains are impacted this way.

Add in the research that's been published previously about how diabetes messes with our nerves and can actually cause our brains to become less alert... to the tune of Alzheimer's, sometimes referred to as Type 3 diabetes.

Well, that's just great, isn't it...? (see also: sarcasm portion of the brain)

Hopefully, this research and similar studies happening worldwide can eventually lead to treatment options that counter the D-Brain effects. It'd be a wonder if someday (short of a cure, that is) we could "cure" hypo unawareness to ensure that PWDs feel the important warning signs before dipping dangerously low.

That'd be a giant step in diabetes research, for sure.


Hypo Simulation (!)

Of course, the other side of the mystery coin here beyond the science of WHY our brains do what they do is:

What does it feel like to have a low blood sugar?

Many of us have had that question thrown our way from "sugar-normals" (who don't live with diabetes). At times, we've tried to explain in ernest when the question came from concerned parents or medical professionals trying to get a better grasp of our plight.

Last November at the Diabetes Professional Care 2017 conference in London, Novo Nordisk made a valliant effort to answer this question with their so-called Hypo Hub, including an online resource portal and actual simulator designed to provide a first-hand experience of low blood sugar symptoms. It used a Virtual Reality headset that offered “unique insight” regarding hypoglycemia and how it affects PWDs. It's actually an upgrade from an earlier Hypo Simulator they were showing off six years ago at the EASD conference in Berlin. Some who tried it essentially say the enhanced VR aspect is "pretty trippy."

It's hard to imagine of course that this could really recreate the heart-palpitating feeling of having a low. And of course not every patient's low symptoms are the same. (Your Hypo May Vary). But if the Virtual Reality immersion is able to bring some level of fresh understanding to doctors and other non-PWDs, then go Hypo Hub! Now, if we could just create a simulator for all the other icky aspects of living with diabetes...

What we'd like to see is a full-fledged Brain Simulator that our doctors could use to really get a sense of, "This is your brain on diabetes."


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