+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Hormonal counterregulation during severe hypoglycaemia under everyday conditions in patients with type 1 and insulin-treated type 2 diabetes mellitus

Hormonal counterregulation during severe hypoglycaemia under everyday conditions in patients with type 1 and insulin-treated type 2 diabetes mellitus

Experimental and Clinical Endocrinology and Diabetes 112(8): 429-434

To determine the counterregulatory hormonal responses to severe hypoglycaemia (SH) in type 1 versus insulin-treated type 2 diabetic patients under everyday conditions. Counterregulatory hormones were determined in 28 consecutive type 1 and thirteen insulin-treated type 2 diabetic patients (age 54 +/- 18 vs. 75 +/- 13 yrs; diabetes duration 27 +/- 16 vs. 21 +/- 6 yrs) with SH requiring emergency treatment. Blood samples were taken prior to and after effective treatment of SH. SH was defined as an event with neuroglycopenic presentation requiring external intervention by administration of intravenous glucose or oral carbohydrates. 68 % (19/28) of type 1 diabetic patients but none of those with type 2 diabetes had reduced awareness of hypoglycaemia. Plasma glucose levels were 30 +/- 14 prior to and 179 +/- 82 mg/dl after treatment of SH; the time between the two measurements was 54 +/- 26 minutes. With the exception of higher levels of human growth hormone in type 1 patients - which were attributed to younger age - the other counterregulatory responses to SH showed no significant differences in type 1 vs. type 2 diabetic patients. In both groups glucagon responses were virtually absent while moderate catecholamine responses could be demonstrated. Treatment with beta-blockers did not affect hormonal counterregulation in type 1 diabetic patients. In patients approaching the insulin-deficient end of the spectrum of type 2 diabetes the hormonal responses to SH are comparable to those in patients with longstanding type 1 diabetes. Thus, in advanced type 2 diabetes the risk of developing SH may be similar to that in individuals with type 1 diabetes.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 012155509

Download citation: RISBibTeXText

PMID: 15372362

DOI: 10.1055/s-2004-821188

Related references

Impaired hormonal counterregulation to biochemical hypoglycaemia does not explain the high incidence of severe hypoglycaemia during pregnancy in women with type 1 diabetes. Scandinavian Journal of Clinical and Laboratory Investigation 73(1): 67-74, 2013

Hormonal counterregulation, symptom awareness, and neurophysiological function in type 1 diabetes during insulin-induced hypoglycaemia. Diabetic Medicine 9(6): 528-535, 1992

A comparative study on the hormonal responses to insulin-induced hypoglycaemia using semisynthetic human insulin and pork insulin in patients with type 1 diabetes mellitus. Diabetic Medicine 7(9): 775-779, 1990

Frequency and predictors of confirmed hypoglycaemia in type 1 and insulin-treated type 2 diabetes mellitus patients in a real-life setting: results from the DIALOG study. Diabetes and Metabolism 41(2): 116-125, 2016

Hormonal counterregulation during severe hypoglycemia in patients with Type 1-versus Type 2-diabetes. Diabetes & Metabolism 29(Hors serie 2): 4S239, August, 2003

Hormonal and metabolic counterregulation during and after high-dose insulin-induced hypoglycemia in diabetes mellitus type 2. Hormone and Metabolic Research 32(10): 417-423, 2000

Low risk of severe hypoglycaemia in patients with type 2 diabetes mellitus starting insulin therapy with premixed insulin analogues BID in outpatient settings. International Journal of Clinical Practice 66(11): 1033-1041, 2013

Similar risk of severe hypoglycaemia in insulin-treated type 2 diabetes and type 1 diabetes with normal awareness. Diabetologia 45(Supplement 2): A 78-A 79, August, 2002

Prospective and retrospective recording of severe hypoglycaemia, and assessment of hypoglycaemia awareness in insulin-treated Type 2 diabetes. Diabetic Medicine 26(12): 1306-1308, 2010

Regional variations in definitions and rates of hypoglycaemia: findings from the global HAT observational study of 27 585 people with Type 1 and insulin-treated Type 2 diabetes mellitus. Diabetic Medicine 2018, 2018

Effect of insulin analogues on frequency of non-severe hypoglycaemia in patients with type 1 diabetes prone to severe hypoglycaemia: The HypoAna trial. Diabetes and Metabolism 42(4): 249-255, 2017

Incidence of and risk factors for severe hypoglycaemia in treated type 2 diabetes mellitus patients in the UK--a nested case-control analysis. Diabetes, Obesity and Metabolism 16(9): 801-811, 2016

The incidence of mild and severe hypoglycaemia in patients with type 2 diabetes mellitus treated with sulfonylureas: a systematic review and meta-analysis. Diabetes/Metabolism Research and Reviews 30(1): 11-22, 2014

Counterregulation during spontaneous nocturnal hypoglycaemia in adolescents with type 1 diabetes mellitus. Diabetes 52(Supplement 1): A45, 2003

Severe hypoglycaemia in patients with type 1 diabetes and impaired awareness of hypoglycaemia: A comparative study of insulin lispro and regular human insulin. Diabetes-Metabolism Research & Reviews 17(4): 285-291, July-August, 2001