Hypoglycemia is the limiting factor in the management of diabetes.
Hypoglycemia is the limiting factor, both conceptually and in practice, in the management of diabetes mellitus. While the long-term goal of diabetes research must remain the cure and the prevention of the disease and reasonable near-term goals might include perfect insulin replacement or prevention of complications despite ongoing hyperglycemia, the most pressing short-term goal for people with diabetes would seem to be insight leading to strategies that effectively minimize the risk of hypoglycemia and thus permit low-risk glycemic control. Having reviewed the field in detail recently, the author offers his personal views of the key questions - concerning the physiology of glucose counterregulation, its pathophysiology in diabetes, and hypoglycemia in diabetes - that, if answered, might lead to a reduced risk of iatrogenic hypoglycemia in people with diabetes. The overriding question is: How can we learn to replace insulin more perfectly, prevent, correct or compensate for compromised glucose counterregulation, or both?
Cryer
P E
PE
Division of Endocrinology, Diabetes and Metabolism, and the General Clinical Research Center and the Diabetes Research and Training Center, Washington University School of Medicine, St Louis, Missouri 63110, USA.
D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000150:complications* / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin