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Related Experiment Videos

Hypoglycemia unawareness in IDDM

M Mokan1, A Mitrakou, T Veneman

  • 1Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania.

Diabetes Care
|December 1, 1994
PubMed
Summary
This summary is machine-generated.

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Hypoglycemia unawareness in diabetes is linked to longer diabetes duration, poorer glycemic control, and increased insulin sensitivity. Autonomic and neuroglycopenic symptoms are affected, but beta-adrenergic sensitivity remains unchanged.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Diabetes Mellitus Research

Background:

  • Hypoglycemia unawareness is a complication of insulin-dependent diabetes mellitus (IDDM).
  • It is characterized by the absence of autonomic warning symptoms before neuroglycopenia.
  • Predisposing factors require further elucidation.

Purpose of the Study:

  • To characterize patients with hypoglycemia unawareness.
  • To identify predisposing factors for this condition.

Main Methods:

  • A study of 43 IDDM patients using a stepped hypoglycemic clamp technique.
  • Objective categorization of hypoglycemia using plasma glucose clamping and symptom onset criteria.
  • Assessment of clinical characteristics, hormonal, symptomatic, and cognitive responses.

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Main Results:

  • 26% of patients had hypoglycemia unawareness.
  • Unaware patients had longer diabetes duration, lower HbA1c, and history of severe hypoglycemia.
  • Autonomic and neuroglycopenic symptoms, and cognitive dysfunction occurred at lower glucose levels in unaware patients.
  • Increased insulin sensitivity was observed in unaware patients.

Conclusions:

  • Hypoglycemia unawareness is associated with diabetes duration, glycemic control, and severe hypoglycemia history.
  • Both autonomic and neuroglycopenic symptoms are impacted.
  • Increased insulin sensitivity is a key finding, while beta-adrenergic sensitivity is not diminished.