A patient tells the nurse that she eats "huge" amounts of food but stays hungry most of the time. The nurse explains that hunger experienced by persons with type 1 diabetes is caused by the:

• A. Excess amount of glucose
• B. Need for additional calories to correct the increased metabolism
• C. Fact that the cells cannot use the blood glucose
• D. Need for exercise to stimulate insulin secretion.

Answer: (C)

In type 1 diabetes, there is little to no insulin, so glucose cannot enter most body cells. Even though blood glucose is high, the cells are effectively starving for energy, which triggers increased hunger as the body tries to obtain more fuel. This cellular glucose deficit is why someone can eat large amounts yet still feel hungry. The hunger is not caused by an excess of glucose in the blood, nor by a need to burn calories from higher metabolism or by exercising to stimulate insulin secretion (in type 1, insulin production is severely limited or absent).