長期にわたるインスリン依存型糖尿病患者の低血糖意識の回復

I Cranston¹, J Lomas, A Maran

¹Unit for Metabolic Medicine, Guy's Hospital, London, UK.

Lancet (London, England)

|July 30, 1994

まとめ

インスリン依存型糖尿病の低血糖に対する意識を回復することは可能である. 数ヶ月間低血糖症を回避すると,認知機能障害以前の警告症状が回復し,患者の安全性が向上します.

科学分野:

エンドクリノロジーエンドクリノロジー
メタボリック障害メタボリック障害
神経科学は神経科学である.

背景:

低血糖症の無意識は,インスリン依存性糖尿病の危険な合併症である.
この無意識は,慢性糖尿病の合併症の管理に不可欠なインスリン治療の強化を制限しています.

研究の目的:

インスリン依存型糖尿病患者において,低血糖症の意識が回復できるかどうかを調査する.
症状,認知,ホルモン反応に対する低血糖症を回避することの影響を評価する.

主な方法:

インスリン依存症の糖尿病患者で,長期にわたる疾患 (良いと悪い血糖コントロール) を研究した.
制御された低血糖症に対するモニタリングされた反応は,低血糖症を回避する期間前のおよび後のものです.
測定されたアドレナリン,症状スコア,および血糖値の低下に反応する認知機能.

主要な成果:

当初,すべての患者は低血糖症の認識が欠け,反応は,著しく低いグルコースレベルでのみ発生しました.
低血糖症を避ける約4ヶ月後,ホルモン (アドレナリン) と症状の反応が著しく増加しました.
これらの回復した反応は,高血糖濃度で始まり,認知機能不全が先行した.

結論:

低血糖期間の認知機能不全に先立つ主観的な意識の正常な階層は,回復することができます.
低血糖の意識の回復は,低血糖を注意深く回避することによって達成できます.
この改善は,インスリン依存型糖尿病における疾患の持続時間や初期代謝制御とは無関係です.

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