دورية أكاديمية
Mechanisms of hypoglycemia unawareness and implications in diabetic patients.
| العنوان: | Mechanisms of hypoglycemia unawareness and implications in diabetic patients. |
|---|---|
| المؤلفون: | Martín-Timón I; Iciar Martín-Timón, Francisco Javier del Cañizo-Gómez, Section of Endocrinology, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, 28031 Madrid, Spain., Del Cañizo-Gómez FJ; Iciar Martín-Timón, Francisco Javier del Cañizo-Gómez, Section of Endocrinology, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, 28031 Madrid, Spain. |
| المصدر: | World journal of diabetes [World J Diabetes] 2015 Jul 10; Vol. 6 (7), pp. 912-26. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101547524 Publication Model: Print Cited Medium: Print ISSN: 1948-9358 (Print) Linking ISSN: 19489358 NLM ISO Abbreviation: World J Diabetes Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: 2014-: Pleasanton, CA : Baishideng Publishing Group Original Publication: Beijing, China : Beijing Baishideng BioMed Scientifc Company |
| مستخلص: | Hypoglycemia unawareness (HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms. It is a major limitation to achieving tight diabetes and reduced quality of life. HU occurs in approximately 40% of people with type 1 diabetes mellitus (T1DM) and with less frequency in T2DM. Though the aetiology of HU is multifactorial, possible mechanisms include chronic exposure to low blood glucose, antecedent hypoglycaemia, recurrent severe hypoglycaemia and the failure of counter-regulatory hormones. Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms, but the mechanisms and mediators remain largely unknown. Prevention and management of HU is complex, and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team. Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes. Several medications are thought to worsen or promote HU, whereas others may have an attenuating effect on the problem. This article reviews recent advances in how the brain senses and responds to hypoglycaemia, novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses. The consequences that HU has on the person with diabetes and their family are also described. Finally, it examines the evidence for prevention and treatment of HU, and summarizes the effects of medications that may influence it. |
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| فهرسة مساهمة: | Keywords: Counter-regulation; Diabetes mellitus; Hypoglycemia associated autonomic failure; Hypoglycemia unawareness; Impaired awareness of hypoglycemia |
| تواريخ الأحداث: | Date Created: 20150718 Date Completed: 20150718 Latest Revision: 20220408 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC4499525 |
| DOI: | 10.4239/wjd.v6.i7.912 |
| PMID: | 26185599 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1948-9358 |
|---|---|
| DOI: | 10.4239/wjd.v6.i7.912 |