Skip to main content

„Hypoglycemia unawareness“

  • Chapter
Book cover Kompendium Diabetologie

Zusammenfassung

Ein 42jähriger Patient mit einem seit dem 19. Lebensjahr bekannten Diabetes mellitus stellte sich in der Sprechstunde vor. Vorstellungs-grund war die Erstmanifestation einer Hypoglykämie ohne Sympto-me. Hypoglykämisch war er mit seinem Auto gegen ein parkendes Fahrzeug gefahren. Er berichtet, daß in letzter Zeit gehäuft leichtere Hypoglykämien aufgetreten seien, die allerdings bisher symptoma-tisch gewesen waren. Aber es fiel ihm auf, daß neuerdings eine Hypo-glykämiesymptomatik zunehmend erst bei relativ niedrigen Blutglu-kosewerten, oder wie ietzt zum ersten Mai nicht mehr aufgetreten sei.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 84.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Bolli G, De Feo P, Compagnucci P, Cartechini MG, Angeletti G, Santeusanio F (1983) Abnormal glucose counter-regulation in insulin-dependent diabetes mellitus: interaction of anti-insulin antibodies and impaired glucagon and epinephrine secretion. Diabetes 32:134–141.

    Article  PubMed  CAS  Google Scholar 

  • Bottini P, Boschetti E, Pampanelli S, Ciofetta M, Del Sindaco P, Scionti L, Bru-netti P, Bolli GB (1997) Contribution of autonomic neuropathy to reduced plasma adrenaline responses to hypoglycemia in IDDM: evidence for a non-selective defect. Diabetes 46: 814–823.

    Article  PubMed  CAS  Google Scholar 

  • Clarke WL, Cox DJ, Gonder-Frederick LA, Julian D, Schlundt D, Polonsky W (1995) Reduced awareness of hypoglycemia in adults with IDDM. A prospective study of hypoglycemic frequency and associated symptoms. Diabetes Care 18: 517–522.

    CAS  Google Scholar 

  • Clarke WL, Haymond MW, Santiago JV (1980) Overnight basal insulin requirements in fasting insulin-dependent diabetics. Diabetes 29: 78–80.

    Article  PubMed  CAS  Google Scholar 

  • Cox D, Gonder-Frederick L, Polonsky W, Schlundt D, Julian D, Clarke W (1995) A multicenter evaluation of blood glucose awareness training-II. Diabetes Care 18: 523–528.

    Article  PubMed  CAS  Google Scholar 

  • Cryer PE (1992a) Glucose homeostasis and hypoglycemia. In: Wilson JD, Foster DW (eds) Williams textbook of endocrinology, 8th ed. Philadelphia, Saunders,pp 1223–1253.

    Google Scholar 

  • Cryer PE (1992b). Iatrogenic hypoglycemia as a cause of hypoglycemia-associ-ated autonomic failure in IDDM: a vicious circle. Diabetes 41: 255–260.

    Article  PubMed  CAS  Google Scholar 

  • Cryer PE (1993). Hypoglycemia unawareness in IDDM. Diabetes Care 16: 40–47.

    PubMed  Google Scholar 

  • Cryer PE, Frier BM (1997) Hypoglycaemia. In: Alberti KGMM, Zimmet P, De-Fronzo RA, Keen H (eds) International textbook of diabetes mellitus. 2nd ed. Wiley, pp 1193-1213.

    Google Scholar 

  • Dagogo-Jack SE, Craft S, Cryer PE (1993) Hypoglycemia-associated autonomic failure in insulin dependent diabetes mellitus. J Clin Invest 91: 819–828.

    Article  PubMed  CAS  Google Scholar 

  • Dagogo-Jack S, Rattarasarn C, Cryer PE (1994) Reversal of hypoglycemia unawareness, but not defective glucose counterregulation, in IDDM. Diabetes 43: 1426–1434.

    Article  PubMed  CAS  Google Scholar 

  • Fanelli CG, Epifano L, Rambotti AM, Pampanelli S, Di Vincenzo A, Modarelli F, Lepore M, Annibale B, Ciofetta M, Bottini P, Porcellati F, Scionti L, Santeusanio F, Brunetti P, Bolli GB (1993) Meticulous prevention of hypoglycemia normalizes the glycemic thresholds and magnitude of most of neuroendocrine responses to, symptoms of, and cognitive function during hypoglycemia in in-tesively treated patients with short-term IDDM. Diabetes 42: 1683–1689.

    Article  PubMed  CAS  Google Scholar 

  • Fanelli C, Pampanelli S, Epifano L, Rambotti AM, Di Vincenzo A, Modarelli F, Ciofetta M, Lepore M, Annibale B, Torlone E, Perriello G, De Feo P, Santeusanio F, Brunetti P, Bolli GB (1994) Long-term recovery from unawareness, deficient counterregulation and lack of cognitive dysfunction during hypoglycemia, following institution of a rationale, intensive insulin therapy in IDDM. Diabetologia 37: 1265–1276.

    Article  PubMed  CAS  Google Scholar 

  • Fanelli C, Pampanelli S, Calderone S, Lepore M, Annibale B, Compagnucci P, Brunetti P, Bolli GB (1995) Effects of recent, short-term hyperglycemia on responses to hypoglycemia in humans. Relevance to the pathogenesis of hy-poglycemia unawareness and hyperglycemia-induced insulin resistance. Diabetes 44: 513–519.

    CAS  Google Scholar 

  • Fukuda M, Tanaka A, Tahara Y, Ikegami H, Yamamoto Y, Kumahara Y, Shima K (1988) Correlation between minimal secretory capacity of pancreatic β-cells and stability of diabetic control. Diabetes 37: 81–88.

    Article  PubMed  CAS  Google Scholar 

  • Gold AE, MacLeod KM, Frier BM (1994) Frequency of severe hypoglycemia in patients with type 1 diabetes with impaired awareness of hypoglycemia. Diabetes Care 17: 697–703.

    Article  PubMed  CAS  Google Scholar 

  • Pramming S, Thorsteinsson B, Bendtson I, Binder C (1991) Symptomatic hypoglycemia in 411 type 1 diabetic patients. Diabet Med 8: 217–222.

    Article  PubMed  CAS  Google Scholar 

  • Hepburn DA, Patrick AW, Eadington DW, Ewing DJ, Frier BM (1990) Unaware-ness of hypoglycemia in insulin-treated diabetic patients: prevalence and relationship to autonomic neuropathy. Diabet Med 7: 711–717.

    Article  PubMed  CAS  Google Scholar 

  • Kalimo H, Olsson Y (1980) Effects of severe hypoglycemia on the human brain. Acta Neurol Scand 62: 345–348.

    Article  PubMed  CAS  Google Scholar 

  • Lingenfelser T, Overkamp D, Renn W, Buettner U, Kimmerle K, Schmalfuss A, Jakober B (1996) Insulin-associated modulation of neuroendocrine counter-regulation, hypoglycemia perception, and cerebral function in insulin-dependent diabetes mellitus: evidence for an intrinsic effect of insulin on the central nervous system. J Clin Endocrinol Metab 81: 1197–1205.

    Article  PubMed  CAS  Google Scholar 

  • Liu D, McManus RM, Ryan EA (1996) Improved counter-regulatory hormonal and symptomatic responses to hypoglycemia in patients with insulin-dependent diabetes mellitus after 3 months of less strict glycemic control. Clin Invest Med 19: 71–82.

    PubMed  Google Scholar 

  • Mokan M, Mitrakou A, Veneman T, Ryan C, Korytowski M, Cryer P, Gerich J (1994) Hypoglycemia unawareness in IDDM. Diabetes Care 17: 1397–1403.

    Article  PubMed  CAS  Google Scholar 

  • Service FJ (1995) Hypoglycemic disorders. N Engl J Med 332: 1144–1152.

    Article  PubMed  CAS  Google Scholar 

  • Tattersall RB, Gill GV (1991) Unexplained deaths of type 1 diabetic patients. Diabet Med 8: 49–58.

    Article  PubMed  CAS  Google Scholar 

  • The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329: 977–986.

    Article  Google Scholar 

  • Turnbridge WMG (1981) Factors contributing to deaths of diabetics under fifty years of age. Lancet 569-572.

    Google Scholar 

  • Veneman TF, Van Haeften TW (1994) Hypoglycemia unawareness in insulin-dependent diabetes mellitus. Europ J Clin Invest 24: 785–793.

    Article  PubMed  CAS  Google Scholar 

  • White NH, Skor DA, Cryer PE, Levandoski L, Bier DM, Santiago JV (1983) Identification of type 1 diabetic patients at increased risk for hypoglycemia during intensive therapy. New Engl J Med 308: 485–491.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Klevesath, M.S., Isermann, B., Nawroth, P.P. (1999). „Hypoglycemia unawareness“. In: Nawroth, P.P. (eds) Kompendium Diabetologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58588-3_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-58588-3_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-64899-4

  • Online ISBN: 978-3-642-58588-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics