Prevalence and contributing factors of impaired awareness of hypoglycemia in patients with type 2 diabetes: a meta-analysis

Li, Xiangning; Kan, Yinshi; Liu, Hong-Yuan; Pang, Juan; He, Ying; Liu, Lin; Zou, Yan; Zhang, Ning; Zhang, Yu

doi:10.1007/s00592-023-02102-2

Cited by 2 publications

(1 citation statement)

References 51 publications

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“…People with diabetes with IAH develop neuroglycopenic symptoms, that is, altered mental status before the occurrence of autonomic symptoms which include tremors, palpitations, anxiety and diaphoresis ( Martín-Timón and Cañizo-Gómez, 2015 ). It has been estimated that 20%–25% of people with T1D and 10% with T2D have IAH ( McNeilly and McCrimmon, 2018 ; Van Meijel et al, 2020 ; Li et al, 2023 ) which increases the risk of subsequent severe hypoglycemia ( Schopman et al, 2010 ; Li et al, 2023 ). Clinical predictors associated with increased risk of IAH include longer duration of diabetes, recent history of recurrent hypoglycemia, older age and intensive diabetes regimen ( Cryer, 2008 ).…”

Section: Impaired Awareness Of Hypoglycemiamentioning

confidence: 99%

Experimental pharmacological approaches to reverse impaired awareness of hypoglycemia—a review

Hashmi,

Khowaja,

Moheet

2024

Front. Pharmacol.

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The colossal global burden of diabetes management is compounded by the serious complication of hypoglycemia. Protective physiologic hormonal and neurogenic counterregulatory responses to hypoglycemia are essential to preserve glucose homeostasis and avert serious morbidity. With recurrent exposure to hypoglycemic episodes over time, these counterregulatory responses to hypoglycemia can diminish, resulting in an impaired awareness of hypoglycemia (IAH). IAH is characterized by sudden neuroglycopenia rather than preceding cautionary autonomic symptoms. IAH increases the risk of subsequent sudden and severe hypoglycemic episodes in patients with diabetes. The postulated causative mechanisms behind IAH are complex and varied. It is therefore challenging to identify a single effective therapeutic strategy. In this review, we closely examine the efficacy and feasibility of a myriad of pharmaceutical interventions in preventing and treating IAH as described in clinical and preclinical studies. Pharmaceutical agents outlined include N-acetyl cysteine, GABA A receptor blockers, opioid receptor antagonists, AMP activated protein kinase agonists, potassium channel openers, dehydroepiandrosterone, metoclopramide, antiadrenergic agents, antidiabetic agents and glucagon.

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