Congress Reporter - effects of hypoglycemia on the brain, potential counterregulatory pathways in hypoglycemia, and hypoglycemia prediction techniques
Martin Gilmour of the Diabetic Hypoglycemia Editorial Team
Diabetic Hypoglycemia September 2008, Volume 1, Issue 2: page 8-10
This edition of Diabetic Hypoglycemia reviews several abstracts presented at the 68th Annual Scientific Sessions of the American Diabetes Association (ADA). These abstracts describe compelling new data about the effects of hypoglycemia on the brain, in particular neuronal function. New evidence detailing the potential counterregulatory pathways involved in hypoglycemia is also presented. We also review two different hypoglycemia prediction techniques.
Hypoglycemia is the major obstacle to optimal therapy in patients with type 1 diabetes. Recurrent hypoglycemia reduces both counterregulatory hormone responses to, and subjective awareness of, subsequent hypoglycemia. This phenomenon may lead to a cycle of recurrent hypoglycemia and glucose counterregulatory failure, of which impaired awareness of hypoglycemia is the main clinical outcome. Impaired awareness of hypoglycemia markedly increases the risk of severe hypoglycemia (by 25-fold). A major concern for individuals with type 1 diabetes is whether severe hypoglycemia leads to significant cognitive dysfunction.
Two abstracts presented at the ADA describe the neurological consequences of both moderate and severe hypoglycemia in more detail. The abstracts do not specify which blood glucose levels (or other parameters) were used to define moderate and severe hypoglycemia in these studies.