Talking therapies could help those with type 1 diabetes

New research at King’s College Hospital NHS Foundation Trust is looking to understand whether talking therapies can be used to improve the health of some people with type 1 diabetes.

DiabetesWhen patients with type 1 diabetes eat, they inject insulin to reduce glucose in their blood to a safe level.

However, if too much insulin is injected, it can lead to hypoglycaemia - dangerously low levels of glucose in the blood. Someone suffering from hypoglycaemia can become dizzy, giggly, confused and will eventually become unconscious. In extreme cases they may suffer from seizures or even die.

Most patients with type 1 diabetes experience some hypoglycaemia and can recognise the symptoms. But one in ten lose the ability to recognise mild hypoglycaemia and suffer from severe episodes regularly; some may experience this at least once a day.

New research by Professor Stephanie Amiel and Dr Pratik Choudhary is aimed at understanding more about why these people struggle to avoid severe hypoglycaemia.

Professor Amiel said:

When the brain doesn’t have enough glucose, the body has a stress response. This response includes a negative reaction, so that the person does everything they can to avoid it happening again. However, if a person regularly has hypoglycaemic episodes, over time the brain stops recognising it. It no longer produces a stress response or symptoms, It may also no longer recognise the hypoglycaemia as being bad.

As part of their research Professor Amiel and Dr Choudhary looked at brain scans of patients who have frequent hypoglycaemic episodes.

Professor Amiel said:

The scans revealed those patients who had poor awareness of hypoglycaemia did not have a negative emotional response, as would be expected when the body is going through a stressful situation like this.
Because they did not have the negative reaction, those people found it hard to adjust their diabetes management, even when close monitoring of their blood revealed that their insulin levels were too high for them. They did not prioritise avoiding hypoglycaemia, in part because it did not feel bad for them.

Professor Amiel and Dr Choudhary are now looking at whether a form of therapy based on psychological approaches can help.

King’s College Hospital NHS Foundation Trust has also been awarded €1.5million of a €27million EU grant to assess the impact on people of hypoglycaemic episodes. Part of this research will look at the effect on people with type 2 diabetes, who can suffer from severe hypoglycaemia if they have had their diabetes for a number of years.

Read more on the King's College Hospital NHS Foundation Trust website

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