Evaluation of serum markers of neuronal damage following severe hypoglycaemia in adults with insulin-treated diabetes mellitus.
BACKGROUND
Neurone-specific enolase (NSE) and protein S-100 (S-100) may be used as markers of acute neuronal damage in humans with neurological disorders.


METHODS
To evaluate their use following a single episode of severe hypoglycaemia (defined as an episode requiring external assistance to aid recovery), serum concentrations of NSE and S-100 were measured following hypoglycaemia which had not caused persistent neurological impairment in 16 patients with insulin-treated diabetes (the 'hypo' subjects), and in three diabetic patients who died following severe hypoglycaemia. The serum proteins were also measured in 10 subjects with insulin-treated diabetes who had not experienced an episode of severe hypoglycaemia within the preceding year (the 'control' subjects).


RESULTS
No differences in serum concentrations of NSE and S-100 were observed between the 'control' and the 'hypo' subjects at either 36 hours or seven days after the episode of severe hypoglycaemia (p>0.05). However, in two of the three subjects who died following hypoglycaemia, serum concentrations of the markers were markedly elevated.


CONCLUSIONS
Any neuronal injury occurring during severe hypoglycaemia that is not associated with persistent neurological deficit is insufficient to provoke elevation of these serum markers. However, the measurement of serum concentrations of NSE and S-100 may have a prognostic role in evaluating clinical outcome following severe hypoglycaemia which is associated with neurological damage.
Department of Diabetes, Royal Infirmary of Edinburgh, UK. Mark.Strachan@ed.ac.uk
M W
MW
Strachan
H D
HD
Abraha
R A
RA
Sherwood
G A
GA
Lammie
I J
IJ
Deary
F M
FM
Ewing
P
P
Perros
B M
BM
Frier
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D003929:Diabetic Neuropathies / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000502:physiology*; D010751:Phosphopyruvate Hydratase / Q000097:blood; D009418:S100 Proteins / Q000097:blood
D015415:Biomarkers; D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase