title: Recovery of hypoglycaemia-associated compromised cerebral function after a short interval of euglycaemia in insulin-dependent diabetic patients.
abstract: To test the hypothesis that compromised cerebral function, induced by recurrent hypoglycaemic episodes, may recover after a short interval of euglycaemia, we examined electrophysiological activity and symptom awareness during two sequential euglycaemic-hypoglycaemic clamp studies in 11 insulin-dependent diabetic patients without any signs of peripheral or autonomic neuropathy. Neurophysiological testing and evaluation of hypoglycaemic symptoms were performed at stable glycaemic plateaus of 5.6, 3.3, 2.2, and 1.7 mmol/l. The first clamp study was preceded by 3 short-term hypoglycaemic episodes, whereas the second clamp study followed a 2 day interval of strict euglycaemia. The latter caused a recovery of electrophysiological activity, which was demonstrated by recovery of delays of the middle latency auditory evoked potentials (latency shift of the P(a) component, MANOVA, P < 0.01). Reversal of hypoglycaemic symptom unawareness involved the overall symptom perception (MANOVA, P < 0.04), as well as the autonomic symptoms of heart pounding (P < 0.05) and sweating (P < 0.05). We conclude that the previously reported impaired cerebral function, occurring as a consequence of repetitive hypoglycaemic episodes, may recover after a single euglycaemic interval.
authors.affiliation: Department of Medicine, Eberhard-Karls University, Tuebingen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Lingenfelser
authors.forename: U W
authors.initials: UW
authors.lastname: Buettner
authors.forename: H
authors.initials: H
authors.lastname: Uhl
authors.forename: W
authors.initials: W
authors.lastname: Renn
authors.forename: M
authors.initials: M
authors.lastname: Tobis
authors.forename: R
authors.initials: R
authors.lastname: Teichmann
authors.forename: M
authors.initials: M
authors.lastname: Eggstein
authors.forename: B
authors.initials: B
authors.lastname: Jakober
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000502:physiology; D001921:Brain / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D004569:Electroencephalography; D005072:Evoked Potentials, Auditory / Q000502:physiology; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007003:Hypoglycemia / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology; D013997:Time Factors
chemical_list: D001786:Blood Glucose