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Come prevenire e trattare l’ipoglicemia e la sindrome dell’“hypoglycaemia unawareness” nel diabete mellito di tipo 1

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Riassunto

L’ipoglicemia ricorrente, conseguenza di un trattamento insulinico non razionale, è il principale fattore causale dell’“hypoglycaemia unawareness” nel diabete mellito di tipo 1 (l’incapacità, parziale o totale, di riconoscere l’ipoglicemia alla soglia glicemica fisiologica di 60–55 mg/dl). I pazienti affetti da tale sindrome sono a rischio di episodi ipoglicemici gravi. L’“hypoglycaemia unawareness” è il risultato di ipoglicemie iatrogeniche, conseguenti all’uso di regimi non-fisiologici di sostituzione insulinica, associati ad una insufficiente istruzione del paziente da parte del diabetologo. Tale sindrome è reversibile nei limiti in cui venga perseguita una prevenzione meticolosa dell’ipoglicemia. A questo scopo è fondamentale che vengano impiegati regimi terapeutici di somministrazione insulinica fisiologici per raggiungere la quasi normo-glicemia, minimizzando il rischio di ipoglicemie. Questo obiettivo è di fatto realizzabile nel momento in cui: 1) si adotti un piano razionale di terapia insulinica; 2) siano individuati obiettivi glicemici realistici; 3) vengano attuati programmi educativi adeguati.

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Authors and Affiliations

  1. Sezione di Medicina Interna, Endocrinologia e Metabolismo, Università di Perugia, Via E. Dal Pozzo, 06126, Perugia, Italia

    Geremia B. Bolli & Francesca Porcellati

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  1. Geremia B. Bolli
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  2. Francesca Porcellati
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Correspondence to Geremia B. Bolli.

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Bolli, G.B., Porcellati, F. Come prevenire e trattare l’ipoglicemia e la sindrome dell’“hypoglycaemia unawareness” nel diabete mellito di tipo 1. L’Endocrinologo 4, 187–197 (2003). https://doi.org/10.1007/BF03344474

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