Journal ArticleDOI
Effect of Intensive Insulin Therapy on Glycemic Thresholds for Counterregulatory Hormone Release
Reads0
Chats0
TLDR
It is concluded that strict glycemie control of IDDM lowers the plasma glucose level required to generate epinephrine release during hypoglycemia, which may diminish patient recognition of moderate hypoglyCEmia and increase the risk of severe hypoglycesmia in intensively treated IDDM.Abstract:
To evaluate the effect of strict glycemie control of insulin-dependent diabetes mellitus (IDDM) on the plasma glucose threshold initiating counterregulatory hormone responses to hypoglycemia, we used the glucose clamp technique to produce a standardized gradual glucose decline from 90 to 40 mg/dl in seven young IDDM patients before and after 2–6 mo of intensified insulin therapy. Before intensive therapy [hemoglobin A 1 (HbA 1 ) 9.6 ± 1.1%], epinephrine responses were triggered at a higher plasma glucose level (67 ± 4 mg/dl) than in normal control subjects (56 ± 1 mg/dl, P Pread more
Citations
More filters
Journal ArticleDOI
Diabetic Autonomic Neuropathy
TL;DR: There are studies in progress that suggest that autonomic nerves can be induced to regenerate, and the future for patients with diabetic autonomic neuropathy is brighter.
Journal ArticleDOI
Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society
Elizabeth R. Seaquist,John E. Anderson,Belinda P. Childs,Philip E. Cryer,Samuel Dagogo-Jack,Lisa Fish,Simon Heller,Henry Rodriguez,James L. Rosenzweig,Robert A. Vigersky +9 more
TL;DR: The evidence about the impact of hypoglycemia on patients with diabetes that has become available since the past reviews by the American Diabetes Association and The Endocrine Society is reviewed to provide guidance about how this new information should be incorporated into clinical practice.
Book
Hypoglycemia in Diabetes
TL;DR: Pending the prevention and cure of diabetes or the development of methods that provide glucose-regulated insulin replacement or secretion, the authors need to learn to replace insulin in a much more physiological fashion, to prevent, correct, or compensate for compromised glucose counterregulation, or both if they are to achieve near-euglycemia safely in most people with diabetes.
Journal ArticleDOI
Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia.
Journal ArticleDOI
Evaluation and Management of Adult Hypoglycemic Disorders: An Endocrine Society Clinical Practice Guideline
Philip E. Cryer,Lloyd Axelrod,Ashley B. Grossman,Simon Heller,Victor M. Montori,Elizabeth R. Seaquist +5 more
TL;DR: The practice of hypoglycemia risk factor reduction is recommended--addressing the issue of hypglycemia, applying the principles of intensive glycemic therapy, and considering both the conventional risk factors and those indicative of compromised defenses against falling plasma glucose concentrations--in persons with diabetes.
References
More filters
Journal ArticleDOI
Preparation of Iodine-131 Labelled Human Growth Hormone of High Specific Activity
W M Hunter,F. C. Greenwood +1 more
TL;DR: Current procedures for the immunological assay of protein hormones in human plasma require the routine preparation of hormones labelled with iodine-131 of high specific activity, and this work demonstrates the importance of knowing the carrier and removal status of iodine.
Journal ArticleDOI
Immunoassay of Insulin: Two Antibody System: Plasma Insulin Levels of Normal, Subdiabetic and Diabetic Rats
Carl R Morgan,Arnold Lazarow +1 more
TL;DR: A two antibody system of insulin assay for immunoassay of insulin induces the production of specific nonprecipitating antibodies, both in experimental animals and in humans.
Journal ArticleDOI
Effects of arterial versus venous sampling on analysis of glucose kinetics in man
TL;DR: It is suggested that for analysis of whole-body kinetics such data should be used along with the compartmental model correction when arterial data cannot be obtained, because of the smaller correction required and the smaller variation among individuals when heated hand rather than antecubital vein data are obtained.
Journal ArticleDOI
Determination of Free and Total Insulin and C-Peptide in Insulin-treated Diabetics
TL;DR: Clinical studies using this approach indicate that combined measurements of serum free and total insulin and C-peptide provide information that is helpful in understanding the contribution of endogenous and exogenous insulin to the course and metabolic control of insulin-requiring diabetic patients.
Journal ArticleDOI
Lack of glucagon response to hypoglycemia in diabetes: evidence for an intrinsic pancreatic alpha cell defect.
TL;DR: Despite excessive glucagon responses to infusion of arginine, plasma glucagon did not rise in six juvenile-type diabetics during severe insulin-induced hypoglycemia, whereas glucagon in the controls rose significantly, indicating that pancreatic alpha cells are insensitive to glucose even in the presence of large amounts of circulating insulin.
Related Papers (5)
Reduced neuroendocrine and symptomatic responses to subsequent hypoglycemia after 1 episode of hypoglycemia in nondiabetic humans
Simon Heller,Philip E. Cryer +1 more