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This podcast explores how one doctor is working toward better health for diabetics. Effects of high blood sugar, or hyperglycemia, is well-studied in diabetic patients, often considered the dominant endocrinology, diabetes, and metabolism impact factor to control. But Dr. Ahmed Iqbal is examining the role low blood sugar may play in heart attacks and sudden cardiac death.

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Listen and learn

  • How exactly scientists define severe episodes of hypoglycemia and what problems those definitions pose,
  • What effect hypoglycemia has on the cell and what role hormones like adrenaline play, and
  • Why this complex interplay of endocrinology and diabetes may lead to heart stress under hypoglycemic conditions and how he hopes to address this issue.

Ahmed Iqbal is a NIHR Academic Clinical Lecturer in Diabetes and Endocrinology at the University of Sheffield and studies endocrinology diseases. He specializes in the effects of hypoglycemia on type 1 and 2 diabetics.

He offers listeners a baseline of how both diseases work biochemically in the human endocrine system and what role hormones like adrenaline play.

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Because glucose is an obligate fuel for the brain, its dips and rises can have an impact on how the body works. He lays out the role of liver and counter regulations of glycogen, explaining the mismatch between amount of carbohydrates taken in and amount of insulin delivery that leads to hypoglycemia in type 1 diabetics and a slightly different issue in type 2 regulation, which serves as a diminished or blunted response.

He explains the basis of his study, which involves subjects with both continuous glucose monitors and heart monitors, looking at the effect of hypoglycemia on the heart. He explains that scientists know that a key defense of the body against hypoglycemia is the release of catecholamines, like adrenaline and noradrenaline, to correct blood values. However, high adrenaline is not necessarily good for the heart: such hormones can increase heart rate and the resistance against which the heart has to pump. This increases the demand on the heart, which can be problematic for those with existing heart issues. These hormones also lower potassium, which can lead to dangerous heart rhythm values.

Finally, they can make platelets stickier and release immune cells, which may travel to the heart and release plaque already in the coronary arteries.  His goal is to come up with mitigating strategies for these hypoglycemic effects on the heart.

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For more, see his web page and contact him through twitter at @Ahmed742Iqbal.

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