title: Nocturnal hypoglycaemia in type 1 diabetes--consequences and assessment.
abstract: Hypoglycaemia is inevitable when striving for low HbA1c values. Nocturnal hypoglycaemia often occurs without symptoms, but results in diminished next day well-being and hypoglycaemia unawareness. Frequency of nocturnal hypoglycaemia was first assessed in research ward settings, but suffered from insufficient glucose sampling frequency. This may have resulted in overestimation of the duration of hypoglycaemic episodes. The advent of the first continuous glucose sensor, the needle-type MedtronicMiniMed Continuous Glucose Measurement System, revolutionized the assessment of glucose values. However, on scrutiny, the first version of this sensor showed a drift into the hypoglycaemic area and delayed recovery from hypoglycaemia. Using the microdialysis-based GlucoDay system, our group reported a lower frequency of nocturnal hypoglycaemia in type 1 diabetes patients using an insulin pump, than that expected from the existing literature. Today, more than 80 years after the introduction of insulin for the treatment of type 1 diabetes, the associated frequency of nocturnal hypoglycaemia still awaits its definitive assessment.
authors.affiliation: Academic Medical Center Amsterdam, Department of Internal Medicine, The Netherlands. j.h.devries@amc.uva.nl
authors.forename: J Hans
authors.initials: JH
authors.lastname: DeVries
authors.forename: Iris M E
authors.initials: IM
authors.lastname: Wentholt
authors.forename: Nathalie
authors.initials: N
authors.lastname: Masurel
authors.forename: Itske
authors.initials: I
authors.lastname: Mantel
authors.forename: Alessandro
authors.initials: A
authors.lastname: Poscia
authors.forename: Alberto
authors.initials: A
authors.lastname: Maran
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Heine
mesh_terms: D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology* / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007328:Insulin / Q000009:adverse effects
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin