Insulin hypoglycaemia with

Ratner RE, Hirsch IB, Neifing JL, Garg SK, Mecca TE, Wilson CA. Less hypoglycaemia with insulin glargine in intensive insulin therapy for Type 1 diabetes. Diabetes Care 2000 23 639-643. 

Reduced snacking due to predictable 24-h plasma profile of insulin detemir, with reduced hypoglycaemia risk. 

Destruction of the adrenal cortex results in a deficiency of glucocorticoids, mineralocorticoids and androgens, and the features of the disease are a reflection of this. Mineralocorticoid deficiency leads to sodium deficiency, which in turn leads to dehydration and this can present as an Addisonian crisis. The deficiency of glucocorticoids leads to hypoglycaemia and pronounced insulin sensitivity with a flat glucose tolerance curve. Because of the glucocorticoid deficiency, the pituitary produces maximal... 

Hypoglycaemia remains the most frequent complication of insulin administration to diabetics. It usually occurs due to (a) administration of an excessive amount of insulin (b) administration of insulin prior to a mealtime, but with subsequent omission of the meal or (c) due to increased physical activity. In severe cases this can lead to loss of consciousness, and even death. Although it may be treated by oral or i.v. administration of glucose, insulin-induced hypoglycaemia is sometimes treated by administration of glucagon. 

When compared with soluble insulin, the human analogue insulin aspart has a faster onset and a shorter duration of action, resulting in a higher fasting and preprandial blood glucose concentration. The incidence of hypoglycaemia tends to be lower with insulin aspart than with soluble insulin. 

Exercise is an essential yet neglected aspect of treatment for type 2 diabetes especially in its early stages where insulin resistance may predominate. Accumulation of at least 30 0 minutes of moderate physical activity on most days of the week is recommended. For type 1 diabetes the emphasis must be on adjusting the therapeutic regimen to allow safe sports participation to prevent precipitation of ketoacidosis or hypoglycaemia. Extra care is required in cases with known complications like proliferative retinopathy, nephropathy, foot ulcers and cardiac or peripheral vascular disease. 

Hvidberg A, Christensen NJ, Hilsted J. Counterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia. Diabet Med 1998 15(3) 199-204. 

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