title: Long-term follow-up of insulin-dependent diabetes mellitus patients with recurrent episodes of severe hypoglycaemia.
abstract: We conducted a long-term clinical follow-up of 20 insulin-treated diabetic patients with the problem of repeated severe hypoglycaemic events, identified during 1982-1984. Furthermore, we investigated the reproducibility of a standardized insulin-infusion test among eight of these patients and 10 insulin-dependent diabetes mellitus patients without the problem of severe hypoglycaemia. At start of the follow-up, the patients were characterized, which revealed that proposed risk factors for severe hypoglycaemia were very common and that at least one predisposing factor was present in all patients. No fatal episode of hypoglycaemia occurred in this group of patients during the follow-up. Emergency visits due to hypoglycaemia decreased during the follow-up from 1.05 year(-1) in 1982-1984 to 0.42 year(-1) in 1992-1994 (P=0.024). No association to HbAlc was seen (P=0.11). A correlation with the change to multiple insulin regimen was seen with a incidence of 1.27 year(-1) before the change to 0.47 year(-1) after (P=0.003). The glucose response to an insulin-infusion test appeared reproducible among the patients with recurrent attacks of severe hypoglycaemia.
authors.affiliation: Department of Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Oskarsson
authors.forename: U
authors.initials: U
authors.lastname: Adamson
authors.forename: N C
authors.initials: NC
authors.lastname: Sjöbom
authors.forename: P E
authors.initials: PE
authors.lastname: Lins
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D001786:Blood Glucose / Q000032:analysis; D002853:Chromatography, Liquid; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000503:physiopathology*; D007328:Insulin / Q000378:metabolism*; D007525:Isoelectric Focusing; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D005947:Glucose; D006442:Glycated Hemoglobin; D007328:Insulin