Editing Hypoglycemia (section)

==Pathophysiology==
[[Glucose]] is the main source of energy for the brain, and a number of mechanisms are in place to prevent hypoglycemia and protect energy supply to the brain.<ref name="Jameson_2018" /><ref name=":10" /> The body can adjust [[insulin]] production and release, adjust glucose production by the [[liver]], and adjust glucose use by the body.<ref name="Jameson_2018" /><ref name=":10" /> The body naturally produces the hormone [[insulin]], in an organ called the [[pancreas]].<ref name="Jameson_2018" /> Insulin helps to regulate the amount of glucose in the body, especially after meals.<ref name="Jameson_2018" /> [[Glucagon]] is another hormone involved in regulating blood glucose levels, and can be thought of as the opposite of insulin.<ref name="Jameson_2018" /> Glucagon helps to increase blood glucose levels, especially in states of hunger.<ref name="Jameson_2018" />

When blood sugar levels fall to the low-normal range, the first line of defense against hypoglycemia is decreasing [[insulin]] release by the [[pancreas]].<ref name="Jameson_2018" /><ref name=":10" /> This drop in insulin allows the [[liver]] to increase [[glycogenolysis]].<ref name="Jameson_2018" /><ref name=":10" /> [[Glycogenolysis]] is the process of [[glycogen]] breakdown that results in the production of glucose.<ref name="Jameson_2018" /><ref name=":10" /> [[Glycogen]] can be thought of as the inactive, storage form of glucose.<ref name="Jameson_2018" /> Decreased insulin also allows for increased [[gluconeogenesis]] in the [[liver]] and [[kidney]]s.<ref name="Jameson_2018" /><ref name=":10" /> [[Gluconeogenesis]] is the process of glucose production from non-[[carbohydrate]] sources, supplied from muscles and fat.<ref name="Jameson_2018" /><ref name=":10" />

Once blood glucose levels fall out of the normal range, additional protective mechanisms work to prevent hypoglycemia.<ref name="Jameson_2018" /><ref name=":10" /> The [[pancreas]] is signaled to release [[glucagon]], a [[hormone]] that increases glucose production by the liver and kidneys, and increases muscle and fat breakdown to supply [[gluconeogenesis]].<ref name="Jameson_2018" /><ref>{{Cite book |title=Endotext |vauthors=Rix I, Nexøe-Larsen C, Bergmann NC, Lund A, Knop FK |date=2000 |veditors=Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, etal |chapter=Glucagon Physiology |pmid=25905350 |chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK279127/ |archive-url=https://web.archive.org/web/20210115103349/https://www.ncbi.nlm.nih.gov/books/NBK279127/ |archive-date=15 January 2021 |url-status=live}}</ref> If increased glucagon does not raise blood sugar levels to normal, the adrenal glands release [[Adrenaline|epinephrine]].<ref name="Jameson_2018" /><ref name=":10" /> [[Adrenaline|Epinephrine]] works to also increase [[gluconeogenesis]] and [[glycogenolysis]], while also decreasing the use of glucose by organs, protecting the brain's glucose supply.<ref name="Jameson_2018" /><ref name=":10" />

After hypoglycemia has been prolonged, [[cortisol]] and [[growth hormone]] are released to continue [[gluconeogenesis]] and [[glycogenolysis]], while also preventing the use of glucose by other organs.<ref name="Jameson_2018" /><ref name=":10" /> The effects of cortisol and growth hormone are far less effective than epinephrine.<ref name="Jameson_2018" /><ref name=":10" /> In a state of hypoglycemia, the brain also signals a sense of hunger and drives the person to eat, in an attempt to increase glucose.<ref name="Jameson_2018" /><ref name=":10" />