Hypoglycaemia unawareness: a reversible problem?

Amiel, Stephanie A.

doi:10.1046/j.1464-5491.2001.00456-6.x

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…This area awaits further investigation, but it is well known that type‐1 diabetics who experience a single hypoglycaemic episode are more susceptible to succeeding periods of hypoglycaemia (Frier and Fisher 1999). The mechanism is unknown but in addition to the sympathetic nervous system and noradrenaline (Amiel 2001), glycogen may also be involved (Choi et al . 2003).…”

Section: Other Miscellaneous Pathologiesmentioning

confidence: 99%

Brain glycogen re‐awakened

Brown

2004

Journal of Neurochemistry

288

211

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The mammalian brain contains glycogen, which is located predominantly in astrocytes, but its function is unclear. A principal role for brain glycogen as an energy reserve, analogous to its role in the periphery, had been universally dismissed based on its relatively low concentration, an assumption apparently reinforced by the limited duration that the brain can function in the absence of glucose. However, during insulin-induced hypoglycaemia, where brain glucose availability is limited, glycogen content falls first in areas with the highest metabolic rate, suggesting that glycogen provides fuel to support brain function during pathological hypoglycaemia. General anaesthesia results in elevated brain glycogen suggesting quiescent neurones allow glycogen accumulation, and as long ago as the 1950s it was shown that brain glycogen accumulates during sleep, is mobilized upon waking, and that sleep deprivation results in region-specific decreases in brain glycogen, implying a supportive functional role for brain glycogen in the conscious, awake brain. Interest in brain glycogen has recently been re-awakened by the first continuous in vivo measurements using NMR spectroscopy, by the general acceptance of metabolic coupling between glia and neurones involving intercellular transfer of energy substrate, and by studies supporting a prominent physiological role for brain glycogen as a provider of supplemental energy substrate during periods of increased tissue energy demand, when ambient normoglycaemic glucose is unable to meet immediate energy requirements.

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Section: Other Miscellaneous Pathologiesmentioning

confidence: 99%

Brain glycogen re‐awakened

Brown

2004

Journal of Neurochemistry

288

211

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Recurrent severe hypoglycemia in Type 1 diabetes: potential for prevention?

Henriksen¹,

Due-Andersen²,

Thorsteinsson³

et al. 2014

Diabetes Management

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Aim: To compare characteristics of solitary and recurrent episodes of severe hypoglycemia in order to explore the potential for prevention of recurrent severe hypoglycemia (SH) in a cohort of patients with Type 1 diabetes. Methods: 230 patients with Type 1 diabetes were followed prospectively for 1 year and reported characteristics of SH within 24 h. Results: 239 episodes of SH were reported by 86 patients, corresponding to 1.0 episode per patient year; 82% of the episodes were recurrent (≥2 episodes per patient year). Compared with solitary SH, recurrent SH occurred more often during daytime, primarily in subjects with reduced hypoglycemia awareness, and were characterized by absence of warning symptoms. Conclusion: A large proportion of SH in Type 1 diabetes is recurrent and thereby potentially preventable. Focus should be directed towards patients with reduced hypoglycemia awareness. Summary points Results

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Hypoglycaemia unawareness: a reversible problem?

Cited by 2 publications

References 29 publications

Brain glycogen re‐awakened

Brain glycogen re‐awakened

Recurrent severe hypoglycemia in Type 1 diabetes: potential for prevention?

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