Hypoglycaemia unawareness.

Vignesh, J P and Mohan, V (2004) Hypoglycaemia unawareness. The Journal of the Association of Physicians of India, 52 . pp. 727-32. ISSN 0004-5772



Hypoglycaemia is the most frequent and serious complication of insulin therapy and is three times more common in those who are intensively treated. Impaired awareness of hypoglycaemia is a major limitation to achieving tight diabetes. Asymptomatic biochemical hypoglycaemia occurs more frequently during routine blood glucose monitoring and this should alert the clinician that the individual is developing hypoglycaemic unawareness. Though the etiology of hypoglycaemic unawareness is multifactorial, possible mechanisms include chronic exposure to low blood glucose, antecedent hypoglycaemia, recurrent severe hypoglycaemia and the failure of counter-regulatory hormones. Diabetic patients with history of impaired awareness of hypoglycaemia perform poorly on cognitive function testing and this may be restored by relaxation of glycaemic control. The question of whether human insulin produces hypoglycaemia awareness has been hotly debated but this does not appear to be a major problem considering the number of patients on human insulin. The decision to use one or other of the insulins therefore rests entirely with the physician. Low blood glucose awareness training programmes can help to identify and prevent hypoglycaemia unawareness. Impaired awareness of hypoglycaemia can probably be reversed by scrupulous avoidance of hypoglycaemia.

Item Type:Article
Official URL/DOI:http://www.japi.org
Uncontrolled Keywords:Diabetes;Hypoglycaemia
Subjects:Diabetes > Diabetes Treatment
Diabetes > Diabetes Awareness and Prevention
Divisions:Department of Diabetology
ID Code:124
Deposited On:26 Oct 2009 15:06
Last Modified:26 Oct 2009 15:06

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