Therapeutic strategies to prevent hypoglycemia using pharmacologic interventions

TY - JOUR

T1 - Therapeutic strategies to prevent hypoglycemia using pharmacologic interventions

AU - George, Priya S.

AU - McCrimmon, Rory J.

N1 - Copyright 2013 Elsevier B.V., All rights reserved.

PY - 2012/10

Y1 - 2012/10

N2 - On average, a person with type 1 diabetes has at least two symptomatic hypoglycemia episodes per week and therefore, hypoglycemia poses a significant psychologic and pathologic barrier to achieving optimal glucose control. Recurrent hypoglycemia can diminish the symptomatic, hormonal and cognitive responses during further hypoglycemia, by causing the normal glycemic thresholds for these responses to hypoglycemia to be shifted to lower glucose levels and so leading to impaired hypoglycemia awareness (IHA). Intact awareness is crucial to both recognizing and treating hypoglycemia before it becomes sufficiently severe to affect cognition and threaten consciousness. One of the main strategies for improving this response clinically is through strict avoidance of hypoglycemia. The pharmacologic approaches that may improve counter-regulatory responses and symptomatic responses are reviewed, through modulation of the responses either by addressing a cell defects in the pancreas or by approaching central defects of counter-regulation and the various glucose-sensing mechanisms that operate during hypoglycemia.

AB - On average, a person with type 1 diabetes has at least two symptomatic hypoglycemia episodes per week and therefore, hypoglycemia poses a significant psychologic and pathologic barrier to achieving optimal glucose control. Recurrent hypoglycemia can diminish the symptomatic, hormonal and cognitive responses during further hypoglycemia, by causing the normal glycemic thresholds for these responses to hypoglycemia to be shifted to lower glucose levels and so leading to impaired hypoglycemia awareness (IHA). Intact awareness is crucial to both recognizing and treating hypoglycemia before it becomes sufficiently severe to affect cognition and threaten consciousness. One of the main strategies for improving this response clinically is through strict avoidance of hypoglycemia. The pharmacologic approaches that may improve counter-regulatory responses and symptomatic responses are reviewed, through modulation of the responses either by addressing a cell defects in the pancreas or by approaching central defects of counter-regulation and the various glucose-sensing mechanisms that operate during hypoglycemia.

UR - https://www.scopus.com/pages/publications/84872729094

M3 - Article

AN - SCOPUS:84872729094

SN - 1757-2428

VL - 5

SP - 13

EP - 16

JO - Diabetic Hypoglycemia

JF - Diabetic Hypoglycemia

IS - 2

ER -