Hypoglycaemia

Czech version

Authors: M. Mokáň
Authors‘ workplace: I. interná klinika Jesseniovej lekárskej fakulty UK a MFN Martin, Slovenská republika, prednosta prof. MUDr. Marián Mokáň, DrSc.
Published in: Vnitř Lék 2008; 54(4): 387-394
Category: Review

Overview

Hypoglycaemia is a serious, frequent and recurrent complication of treatment of diabetes mellitus which may become a direct danger to the patient’s life. In clinical practice, it is best defined descriptively as Whipple's triad involving the presence of typical clinical symptoms of hypoglycaemia, low plasma glucose concentration and the disappearance of symptoms of hypoglycaemia after the administration of glucose. The overview article focuses, in more detail, on the issues of definition of hypoglycaemia based on the optimal threshold value of glycaemia, classification of hypoglycaemia based on its causes, rate of occurrence and factors provoking hypoglycaemia in patients with type 1 and 2 diabetes mellitus, as well as modern diagnosis and treatment of hypoglycaemic states.

Key words:
hypoglycaemia – diabetes mellitus – diagnosis and treatment of hypoglycaemia

Sources

1. Allen C, LeCaire T, Palta M et al. Risk factor for frequent and severe hypoglycemia in type 1 diabetes. Diabetes Care 2001; 24: 1878-1881.

2. American Diabetes Association: Defining and reporting hypoglycemia in diabetes. A report from American Workgroup on Hypoglycemia. Diabetes Care 2005; 28: 1245-1249.

3. Amiel SA, Tamborlane WV, Sacca L et al. Hypoglycemia and glucose counterregulation in normal and insulin-dependent diabetic subjects. Diabetes/Metab Rev 1988; 4: 71-89.

4. Anderson JH jr, Brunelle RL, Koivisto VA et al.: Reduction of postprandial hyperglycemia and frequency of hypoglycemia in IDDM patients on insulin analog treatment. Diabetes 1997; 46: 265-270.

5. Bastyr EJ, Huang Y, Brunelle RL et al. Factors associated with nocturnal hypoglycaemia among patients with type 2 diabetes new to insulin therapy: experience with insulin lispro. Diabetes, Obesity and Metabolism 2002; 2: 39-46.

6. Bode BW, Steed RD, Davidson PC. Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in type 1 diabetes. Diabetes Care 1996; 19: 324-327.

7. Bode BW, Tomborlane WV, Davidson P. Insulin pump therapy in the 21st century. Pump Therapy 2002; 111: 69-77.

8. Boehm B, Home P, Kamp N et al. Biphasic insulin aspart and biphasic human insulin compared in type 2 diabetic subjects. Diabetologia 2001; 44(Suppl 1): S210.

9. Braak EWMT, Appelman AMMF, van De Laak MF Clinical characteristics of type 1 diabetic patients with and without severe hypoglycemia. Diabetes Care 2000; 23: 1467-1471.

10. Bradley KJ, Paton RC Silent hypoglycaemia at the diabetic clinic. Diabetes UK Diabet Med 2001; 18: 423-426.

11. Briscoe VJ, Davis SN. Hypoglycemia in type 1 and type 2 diabetes: physiology, pathophysiology and management. Clin Diabetes 2006; 24: 115-121.

12. Brunelle RL, Llewelyn J, Anderson JH jr. et al. Meta-analysis of the effect of insulin lispro on severe hypoglycemia in patients with type 1 diabetes. Diabetes Care 1998; 21: 1726-1731.

13. Calan BE, Schouwenberg BJ, Tack CJ et al. Pathophysiology and management of reccurent hypoglycaemia and hypoglycaemia unaawareness in diabetes. Net J Med 2006; 64: 269-279.

14. Campbell IW. Hypoglycaemia and type 2 diabetes: sulphonylureas. In: Frier BM, Fisher BM (eds.) Hypoglycaemia and Diabetes: Clinical and Physiological Aspects. London: Edward Arnold 1993: 387-392.

15. Clarke WL, Cox DJ, Gonder-Frederick LA et al. Reduced awareness of hypoglycemia in adults with IDDM. A prospective study of hypoglycemic frequency and associated symptoms. Diabetes Care 1995; 18: 517-522.

16. Cryer PE. Managing diabetes: lessons from type 1 diabetes mellitus. Diabet Med 1998; 15(Suppl 4): S8-S12.

17. Cryer PE. Mechanism of hypoglycemia-associated autonomic failure and its components syndromes in diabetes. Diabetes 2005; 54: 3592-3601.

18. Cryer PE. Mechanisms of sympathoadrenal failure and hypoglycemia in diabetes. J Clin Invest 2006; 116: 1470-1473.

19. Cryer PE. Hypoglycemia, functional brain failure and brain death. J Clin Invest 2007; 117: 868-870.

20. Field JB. Hypoglycemia. Definition, clinical presentations, classification, and laboratory tests. Endocrinol Metab Clin North America 1989; 18: 27-43.

21. Frier BM, Fisher BM. Hypoglycaemia in Clinical Diabetes. New York: John Wiley and Sons 1999: 290.

22. Frier BM. Epidemiology, short and long-term consequences of hypoglycaemia. Diab Nutr Metab 2002; 15: 378-385.

23. Gerich JE, Campbell PJ. Overview of counterregulation and its abnormalities in diabetes mellitus and other conditions. Diabetes/Metab Rev 1988; 4: 93-111.

24. Heller S. Reducing hypoglycaemia with insulin analogues. Int J Obes 2002; 26(Suppl 3): 531-536.

25. Henderson JN, Allen KV, Deary IJ et al. Hypoglyceamia in insulin-treated Type 2 diabetes: frequency, symptoms and impaired awareness. Diabet Med 2003; 20: 1016-1021.

26. Marks V, Rose FC. Hypoglycemia. 2nd ed. Oxford: Blackwell 1981.

27. Mitrakou A, Ryan C, Veneman T et al. Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms and cerebral dysfunction. Am J Physiol 1991; 260: E67-E74.

28. Mokáň M. Hypoglykémia. In: Vozár J, Kreze A, Klimeš I. Diabetes mellitus. Bratislava: Slovak Academic Press 1998: 153-162.

29. Mokáň M. Hypoglykémia. Martin: Vydavateľstvo P+M Turany 2005.

30. Ritzel RA, Isermann B, Schilling T et al. Diagnosis and localization of insulinoma after negative laparotomy by hyperinsulinemic hypoglycemic clamp and intra-arterial calcium stimulation. Rev Diabetic Stud 2004; 1: 42-46.

31. Ryan CHMR, Dulay D, Suprasongsin CH et al. Detection of symptoms by adolescents and young adults with type 1 diabetes during experimental induction of mild hypoglycemia. Diabetes Care 2002; 25: 852-858.

32. Service FJ. Classification of hypoglycemic disorders. Endocrinol Metab Clin Norh America 1999; 28: 501-517.

33. Shorr RI, Ray WA, Daugherty JR et al. Incidence and risk factors for severe hypoglycemia in older persons using insulin or sulfonylureas. Arch Intern Med 1997; 157: 1681-1686.

34. Staa T von, Abenhaim L, Monette J. Rates of hypoglycemia in users of sulfonylureas. J Clin Epidemiol 1997; 50: 735-741.

35. The Diabetes Control and Complications Trial Research Group. 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 1993; 329: 977-986.

36. The Diabetes Control and Complications Trial Research Group: Hypoglycemia in the Diabetes Control and Complications Trial. Diabetes 1997; 46: 271-286.

37. Tomky D. Detection, prevention and treatment of hypoglycemia in the hospital. Diabetes Spectrum 2005; 18: 39-44.

38. Vague P, Selam JL, Skeie S et al. Insulin detemir is associated with more predictable glycemic control and reduced risk of hypoglycemia than NPH insulin in patients with type 1 diabetes on a basal-bolus regimen with premeal insulin aspart. Diabetes Care 2003; 26: 590-596.

39. Zammitt NN, Frier BM. Hypoglycemia in type 2 diabetes. Pathophysiology, frequency and effects of different tretment modalities. Diabetes Care 2005; 28: 2946-2961.