A 56-year-old male presents to your clinic for follow-up on his diabetes. He
has had diabetes since the age of 12 and has always required insulin for ther-
apy. He reports feeling very tremulous and diaphoretic at 2 AM with the blood
sugars in the range of 40 mg/dL, which is very low. He, however, notes that
his morning fasting blood sugar is high without taking any carbohydrates. His
physician describes the morning high sugars as a result of biochemical
processes in response to the nighttime hypoglycemia.
What are the biochemical processes that govern the response to the
nighttime hypoglycemia?
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