-
Medical journals
- Career
Impaired hypoglycemia awareness in diabetes mellitus
Authors: Jan Brož; Pavlína Piťhová; Denisa Janíčková Žďárská
Authors‘ workplace: Interní klinika 2. LF UK a FN v Motole, Praha
Published in: Vnitř Lék 2016; 62(7-8): 547-550
Category: Reviews
Overview
Impaired hypoglycemia awareness is defined at the onset of neuroglycopenia without the appearance of autonomic warning symptoms. Impaired hypoglycemia awareness is disorder which affects aprox. one third of patients with type 1 diabetes mellitus and 8–10 % of patients with type 2 diabetes mellitus who are treated with insulin. The most dangerous consequence is 6 times higher frequency of severe hypoglycemia in patients with Type 1 diabetes mellitus and 17 times higher in Type 2 diabetic patients treated with insulin. Treatment of impaired hypoglycemia awareness is complex, based on a multifactorial intervention of clinical care and structured patient education.
Key words:
diabetes mellitus – hypoglycemia – impaired hypoglycemia awareness
Sources
1. McCoy RG, Van Houten HK, Ziegenfuss JY et al. Increased mortality of patients with diabetes reporting severe hypoglycemia. Diabetes Care 2012; 35(9): 1897–1901.
2. Hemmingsen B, Lund SS, Gluud C et al. Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials. BMJ 2011; 343: d6898. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.d6898>.
3. Bolek T, Samoš M, Mokáň M et al. Akútne príčiny náhlych úmrtí u pacientov so závažnou hypoglykémiou. Vnitř Lék 2016; 62(6): 462–466.
4. [International Hypoglycemia Study Group]. Minimizing Hypoglycemia in Diabetes. Diabetes Care 2015; 38(3): 1583–1591.
5. Seaquist ER, Anderson J, Childs B et al. Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society. Diabetes Care 2013; 36(5): 1384–1395.
6. de Galan BE, Schouwenberg BJ, Tack CJ et al. Pathophysiology and management of recurrent hypoglycaemia and hypoglycaemia unawareness in diabetes. Neth J Med 2006; 64(8): 269–279.
7. Moghissi E, Ismail-Beigi F, Devine RC. Hypoglycemia: minimizing its impact in type 2 diabetes. Endocr Pract 2013; 19(3): 526–535.
8. Yeoh E, Choudhary P, Nwokolo M et al. Interventions That Restore Awareness of Hypoglycemia in Adults With Type 1 Diabetes: A Systematic Review and Meta-analysis. Diabetes Care 2015; 38(8): 1592–1609.
9. Czyzewska K, Czerniawska E, Szadkowska A. Prevalence of hypoglycemia unawareness in patients with type 1 diabetes. Pediatr Diabet 2012; 13(Suppl 17): 77.
10. Schopman JE, Geddes J, Frier BM. Prevalence of impaired awareness of hypoglycaemia and frequency of hypoglycaemia in insulin-treated type 2 diabetes. Diabetes Res Clin Pract 2010; 87(1): 64–68.
11. Gerstein HC, Miller ME, Byington RP et al. [Action to Control Cardiovascular Risk in Diabetes Study Group]. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008; 358(24): 2545–2559.
12. Martín-Timón I, del Cañizo-Gómez FJ. Mechanisms of hypoglycemia unawareness and implications in diabetic patients. World J Diabetes 2015; 6(7): 912–926.
13. Geddes J, Schopman JE, Zammitt NN et al. Prevalence of impaired awareness of hypoglycaemia in adults with Type 1 diabetes. Diabet Med 2008; 25(4): 501–504.
14. Schopman JE, Geddes J, Frier BM. Prevalence of impaired awareness of hypoglycaemia and frequency of hypoglycaemia in insulin-treated type 2 diabetes. Diabetes Res Clin Pract 2010; 87(1): 64–68.
15. Cryer PE. The barrier of hypoglycemia in diabetes. Diabetes 2008; 57(12): 3169–3176.
16. Seaquist ER, Anderson J, Childs B et al. Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care 2013; 36(5): 1384–1395.
17. Zammitt NN, Warren RE, Deary IJ et al. Delayed recovery of cognitive function following hypoglycemia in adults with type 1 diabetes: effect of impaired awareness of hypoglycemia. Diabetes 2008; 57(3): 732–736.
18. Cranston I, Reed LJ, Marsden PK et al. Changes in regional brain (18)F-fluorodeoxyglucose uptake at hypoglycemia in type 1 diabetic men associated with hypoglycemia unawareness and counter-regulatory failure. Diabetes 2001; 50(10): 2329–2336.
19. Dunn JT, Cranston I, Marsden PK et al. Attenuation of amydgala and frontal cortical responses to low blood glucose concentration in asymptomatic hypoglycemia in type 1 diabetes: a new player in hypoglycemia unawareness? Diabetes 2007; 56(11): 2766–2773.
20. Mangia S, Tesfaye N, De Martino F et al. Hypoglycemia-induced increases in thalamic cerebral blood flow are blunted in subjects with type 1 diabetes and hypoglycemia unawareness. J Cereb Blood Flow Metab 2012; 32(11): 2084–2090.
21. Tesfaye N, Mangia S, De Martino F et al. Hypoglycemia-induced increases in cerebral blood flow (CBF) are blunted in subjects with type 1 diabetes (TID) and hypoglycemia unawareness (HU) Diabetes 2011; 60: A79-A80.
22. Criego AB, Tkac I, Kumar A et al. Brain glucose concentrations in patients with type 1 diabetes and hypoglycemia unawareness. J Neurosci Res 2005; 79(1–2): 42–47.
23. Oz G, Kumar A, Rao JP et al. Human brain glycogen metabolism during and after hypoglycemia. Diabetes 2009; 58(9): 1978–1985.
24. Canada SE, Weaver SA, Sharpe SN et al. Brain glycogen supercompensation in the mouse after recovery from insulin-induced hypoglycemia. J Neurosci Res 2011; 89(4): 585–591.
25. Gulanski BI, De Feyter HM, Page KA et al. Increased brain transport and metabolism of acetate in hypoglycemia unawareness. J Clin Endocrinol Metab 2013; 98(9): 3811–3820.
26. De Feyter HM, Mason GF, Shulman GI et al. Increased brain lactate concentrations without increased lactate oxidation during hypoglycemia in type 1 diabetic individuals. Diabetes 2013; 62(9): 3075–3080.
27. Dagogo-Jack S, Rattarasarn C, Cryer PE. Reversal of hypoglycemia unawareness, but not defective glucose counterregulation, in IDDM. Diabetes 1994; 43(12): 1426–1434.
28. Fanelli C, Pampanelli S, Epifano L et al. Long-term recovery from unawareness, deficient counterregulation and lack of cognitive dysfunction during hypoglycaemia, following institution of rational, intensive insulin therapy in IDDM. Diabetologia 1994; 37(12): 1265–1276.
29. Jones TW, Porter P, Sherwin RS et al. Decreased epinephrine responses to hypoglycemia during sleep. N Engl J Med 1998; 338(23): 1657–1662.
30. Banarer S, Cryer PE. Sleep-related hypoglycemia-associated autonomic failure in type 1 diabetes: reduced awakening from sleep during hypoglycemia. Diabetes 2003; 52(5): 1195–1203.
31. Caprio S, Gerety G, Tamborlane WV et al. Opiate blockade enhances hypoglycemic counterregulation in normal and insulin-dependent diabetic subjects. Am J Physiol 1991; 260(6 Pt 1): E852-E858.
32. Vele S, Milman S, Shamoon H et al. Opioid receptor blockade improves hypoglycemia-associated autonomic failure in type 1 diabetes mellitus. J Clin Endocrinol Metab 2011; 96(11): 3424–3431.
33. Milman S, Leu J, Shamoon H et al. Magnitude of exercise-induced β-endorphin response is associated with subsequent development of altered hypoglycemia counterregulation. J Clin Endocrinol Metab 2012; 97(2): 623–631.
34. Mindlová M, Saudek F. Autonomní selhání způsobené recidivujícími hypoglykemiemi, jeho klinické hodnocení a terapie. Prakt Lek 2007; 87(1): 52–57.
35. Cranston I, Lomas J, Maran A et al. Restoration of hypoglycaemia awareness in patients with long-duration insulin-dependent diabetes. Lancet 1994; 344(8918): 283–287.
36. De Galan BE, De Mol P, Wennekes L et al. Preserved sensitivity to beta2-adrenergic receptor agonists in patients with type 1 diabetes mellitus and hypoglycemia unawareness. J Clin Endocrinol Metab 2006; 91(8): 2878–2881.
37. Kerr D, Sherwin RS, Pavalkis F et al. Effect of caffeine on the recognition of and responses to hypoglycemia in humans. Ann Intern Med 1993; 119(8): 799–804.
38. Rosenthal MJ, Smith D, Yaguez L et al. Caffeine restores regional brain activation in acute hypoglycaemia in healthy volunteers. Diabet Med 2007; 24(7): 720–727.
39. Watson JM, Jenkins EJ, Hamilton P et al. Influence of caffeine on the frequency and perception of hypoglycemia in free-living patients with type 1 diabetes. Diabetes Care 2000; 23(4): 455–459. Erratum in Diabetes Care 2000; 23(10): 1598.
40. de Galan BE, Tack CJ, Lenders JW et al. Theophylline improves hypoglycemia unawareness in type 1 diabetes. Diabetes 2002; 51(3): 790–796.
Labels
Diabetology Endocrinology Internal medicine
Article was published inInternal Medicine
2016 Issue 7-8-
All articles in this issue
- Estimating the prevalence of potential drug interactions in patients treated with 5 and more drugs in the Czech Republic and Slovac Repuplic
-
Autoimmune insulitis in patients with type 2 diabetes mellitus
A randomized clinical trial in hospitalized patients - Clinical contribution of new basal analogue insulin
- Changes in nutritional recommendations for a healthy population and their influence on a diabetic diet
- Impaired hypoglycemia awareness in diabetes mellitus
- Treatment of liver cirrhosis – actually possibility of ambulant internist
- Hypoglycemia as a symptom of cancer in adults
- Sepsis – how to recognize and what to focus on – back to basics in the light of the new definition
- The skin – a mirror of internal diseases
- The effect of antidiabetic treatment on the bone of patients with type 2 diabetes
- The benefit of urgent endoscopic retrograde cholangiopancreatography for the therapy of acute pancreatitis
- Type 2 diabetes mellitus and heart failure
- The differential diagnosis of pleural effusions
- Adverse effects of biological therapy in rheumatology
-
Possibilities of influencing cardiovascular risk in type 2 diabetes mellitus by antidiabetic treatment
Lowering of cardiovascular risk in treatment with liraglutide – Results of the LEADER - Methanol: the threat of intoxication is still there
- Diabetic retinopathy: pathogenesis and therapeutic implications
- The difference and ratio between serum concentrations of natrium and chlorides in patients with hyponatremia
- Systolic blood pressure targets
- Clinical significance of natriuretic peptides in the differential diagnosis of dyspnea
- Heart failure with preserved ejection fraction
- A near future of treatment of dyslipidemia in type 2 diabetics
- Glucagon antagonists open a new way in treatment of type 2 diabetes Mellitus
- Breviary of diabetes education for internist
- Prevention and therapy of sarcopenia in the ageing
- Granulomatosis with polyangiitis manifested as diabetes insipidus
- Internal Medicine
- Journal archive
- Current issue
- Online only
- About the journal
Most read in this issue- Treatment of liver cirrhosis – actually possibility of ambulant internist
- Sepsis – how to recognize and what to focus on – back to basics in the light of the new definition
- The skin – a mirror of internal diseases
- Prevention and therapy of sarcopenia in the ageing
Login#ADS_BOTTOM_SCRIPTS#Forgotten passwordEnter the email address that you registered with. We will send you instructions on how to set a new password.
- Career