Recognition, prevention, and proactive management of hypoglycemia in patients with type 1 diabetes mellitus

Postgraduate Medicine

Volumn 123, Issue 4, 2011, Pages 71-80

  Unger, Jeff ^a   Parkin, Christopher ^b  

^a Catalina Research Institute California   (United States)

^b Health Management Resources Inc   (United States)

Author keywords

Continuous glucose monitoring; Insulin; Self monitoring of blood glucose; Type 1 diabetes mellitus

Indexed keywords

ADRENALIN; GLUCAGON; HEMOGLOBIN A1C; INSULIN;

ADULT; AGED; ATTRIBUTABLE RISK; AUTONOMIC DYSFUNCTION; BLOOD GLUCOSE MONITORING; CAR DRIVING; CASE REPORT; CONTINUOUS GLUCOSE MONITORING; CONTINUOUS INFUSION; DEMENTIA; DEPRESSION; DISEASE SEVERITY; EQUIPMENT DESIGN; GLUCAGON RELEASE; GLYCEMIC CONTROL; HUMAN; HYPOGLYCEMIA; HYPOGLYCEMIA ASSOCIATED AUTONOMIC FAILURE; INSULIN DEPENDENT DIABETES MELLITUS; INSULIN HYPOGLYCEMIA; INSULIN PUMP; INSULIN RELEASE; INSULIN TREATMENT; LIFESTYLE MODIFICATION; MALE; MEMORY; NOCTURNAL HYPOGLYCEMIA; PANCREAS ISLET ALPHA CELL; PANCREAS ISLET BETA CELL; PATHOGENESIS; PATIENT ATTITUDE; PRIMARY MEDICAL CARE; REMINDER SYSTEM; REVIEW; RISK FACTOR; RISK REDUCTION; SELF CARE; SELF MONITORING; SENSOR; SUICIDAL IDEATION; UNCONSCIOUSNESS;

BLOOD GLUCOSE; BLOOD GLUCOSE SELF-MONITORING; DIABETES MELLITUS, TYPE 1; HUMANS; HYPOGLYCEMIA; RISK FACTORS;

EID: 79960335378     PISSN: 00325481     EISSN: 19419260     Source Type: Journal    
DOI: 10.3810/pgm.2011.07.2306     Document Type: Review

References (40)

1. Di Battista AM, Hart TA, Greco L, Gloizer J. Type 1 diabetes among adolescents: reduced diabetes self-care caused by social fear and fear of hypoglycemia. Diabetes Educ. 2009;35(3):465-475.
2. Morris AD, Boyle DI, McMahon AD, Greene SA, MacDonald TM, Newton RW. Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/ MEMO Collaboration. Diabetes Audit and Research in Tayside Scotland. Medicines Monitoring Unit. Lancet. 1997;350(9090):1505-1510.
3. Smith CB, Choudhary P, Pernet A, Hopkins D, Amiel SA. Hypoglycemia unawareness is associated with reduced adherence to therapeutic decisions in patients with type 1 diabetes: evidence from a clinical audit. Diabetes Care. 2009;32(7):1196-1198.
4. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329(14):977-986.
5. Genuth S, Eastman R, Kahn R, et al. Implications of the United kingdom prospective diabetes study. Diabetes Care. 2003;26(suppl 1):S28-S32.
6. Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP Jr, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009;301(15):1565-1572.
7. Wright RJ, Newby DE, Stirling D, Ludlam CA, Macdonald IA, Frier BM. Effects of acute insulin-induced hypoglycemia on indices of inflamma tion: putative mechanism for aggravating vascular disease in diabetes. Diabetes Care. 2010;33(7):1591-1597.
8. Tanenberg RJ, Newton CA, Drake AJ. Confirmation of hypoglycemia in the "dead-in-bed" syndrome, as captured by a retrospective continuous glucose monitoring system. Endocr Pract. 2010;16(2):244-248.
9. Tattersall RB, Gill GV. Unexplained deaths of type 1 diabetic patients. Diabet Med. 1991;8(1):49-58.
10. Pedersen-Bjergaard U, Pramming S, et al. Severe hypoglycaemia in 1076 adult patients with type 1 diabetes: influence of risk markers and selection. Diabetes Metab Res Rev. 2004;20(6):479-486.
11. ter Braak EW, Appelman AM, van de LM, Stolk RP, van Haeften TW, Erkelens DW. Clinical characteristics of type 1 diabetic patients with and without severe hypoglycemia. Diabetes Care. 2000;23(10):1467-1471.
12. Chico A, Vidal-Rios P, Subira M, Novials A. The continuous glucose monitoring system is useful for detecting unrecognized hypoglycemias in patients with type 1 and type 2 diabetes but is not better than frequent capillary glucose measurements for improving metabolic control. Diabetes Care. 2003;26(4):1153-1157.
13. Boland E, Monsod T, Delucia M, Brandt CA, Fernando S, Tamborlane WV. Limitations of conventional methods of self-monitoring of blood glucose: lessons learned from 3 days of continuous glucose sensing in pediatric patients with type 1 diabetes. Diabetes Care. 2001;24(11):1858-1862.
14. Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care. 2003;26(6):1902-1912.
15. Polonsky WH, Jelsovsky Z, Panzera S, Parkin CG, Wagner RS. Primary care physicians identify and act upon glycemic abnormalities found in structured, episodic blood glucose monitoring data from non-insulintreated type 2 diabetes. Diabetes Technol Ther. 2009;11(5):283-291.
16. Cryer PE. Mechanisms of hypoglycemia-associated autonomic failure and its component syndromes in diabetes. Diabetes. 2005;54(12):3592-3601.
17. Gerich JE, Langlois M, Noacco C, Karam JH, Forsham PH. Lack of glucagon response to hypoglycemia in diabetes: evidence for an intrinsic pancreatic alpha cell defect. Science. 1973;182(108):171-173.
18. White NH, Skor DA, Cryer PE, Levandoski LA, Bier DM, Santiago JV. Identification of type I diabetic patients at increased risk for hypoglycemia during intensive therapy. N Engl J Med. 1983;308(9):485-491.
19. Cryer PE. Diverse causes of hypoglycemia-associated autonomic failure in diabetes. N Engl J Med. 2004;350(22):2272-2279.
20. Cranston I, Lomas J, Maran A, Macdonald I, Amiel SA. Restoration of hypoglycaemia awareness in patients with long-duration insulindependent diabetes. Lancet. 1994;344(8918):283-287.
21. Dagogo-Jack S, Rattarasarn C, Cryer PE. Reversal of hypoglycemia unawareness, but not defective glucose counterregulation, in IDDM. Diabetes. 1994;43(12):1426-1434.
22. Leinung M, Thompson S, Nardacci E. Benefits of continuous glucose monitor use in clinical practice. Endocr Pract. 2010;16(3):371-375.
23. Graveling AJ, Warren RE, Frier BM. Hypoglycaemia and driving in people with insulin-treated diabetes: adherence to recommendations for avoidance. Diabet Med. 2004;21(9):1014-1019.
24. Cox DJ, Gonder-Frederick LA, Kovatchev BP, Julian DM, Clarke WL. Progressive hypoglycemia's impact on driving simulation performance. Occurrence, awareness and correction. Diabetes Care. 2000;23(2):163-170.
25. Fanelli CG, Porcellati F, Pampanelli S, Bolli GB. Insulin therapy and hypoglycaemia: the size of the problem. Diabetes Metab Res Rev. 2004;20(suppl 2):S32-S42.
26. Wright RJ, Frier BM. Vascular disease and diabetes: is hypoglycaemia an aggravating factor? Diabetes Metab Res Rev. 2008;24(5):353-363.
27. Suh SW, Hamby AM, Swanson RA. Hypoglycemia, brain energetics, and hypoglycemic neuronal death. Glia. 2007;55(12):1280-1286.
28. Craft S. Insulin resistance syndrome and Alzheimer's disease: ageand obesity-related effects on memory, amyloid, and inflammation. Neurobiol Aging. 2005;26(suppl 1):65-69.
29. Craft S, Watson GS. Insulin and neurodegenerative disease: shared and specific mechanisms. Lancet Neurol. 2004;3(3):169-178.
30. Biessels GJ, Deary IJ, Ryan CM. Cognition and diabetes: a lifespan perspective. Lancet Neurol. 2008;7(2):184-190.
31. Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group; Tamborlane WV, Beck RW, Bode BW, et al. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008;359(14):1464-1476.
32. Bode B, Beck RW, Xing D, et al. Sustained benefit of continuous glucose monitoring on A1C, glucose profiles, and hypoglycemia in adults with type 1 diabetes. Diabetes Care. 2009;32(11):2047-2049.
33. Bergenstal RM, Tamborlane WV, Ahmann A, et al; STAR 3 Study Group. Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med. 2010;363(4):311-320.
34. Garg S, Zisser H, Schwartz S, et al. Improvement in glycemic excursions with a transcutaneous, real-time continuous glucose sensor: a randomized controlled trial. Diabetes Care. 2006;29(1):44-50.
35. Rossetti P, Porcellati F, Bolli GB, et al. Prevention of hypoglycemia while achieving good glycemic control in type 1 diabetes. The role of insulin analogs. Diabetes Care. 2008. 31(suppl 2):S113-S120.
36. Dagogo-Jack S. Hypoglycemia in type 1 diabetes mellitus: pathophysiology and prevention. Treat Endocrinol. 2004;3(2):91-103.
37. Luijf YM, van Bon AC, Hoekstra JB, et al. Premeal injection of rapidacting insulin reduces postprandial glycemic excursions in type 1 diabetes. Diabetes Care. 2010;33(10):2152-2155.
38. Unger J. Physiologic insulin replacement therapy. In: Diabetes Management in Primary Care. Philadelphia, PA: Lippincott, Williams and Wilkins; 2007:192-264.
39. Dexcom. http://www.dexcom.com. Accessed May 9, 2011.
40. Medtronic. http://www.medtronic.com/your-health/diabetes/livingwith/index.htm. Accessed May 9, 2011.