Asymptomatic hypoglycaemia: identification and impact.
The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive management in people with type 1 diabetes delays the onset and the progression of microvascular complications associated with the disease. However, it is also known that intensive regimens can increase the number of hypoglycaemias and that the perception of symptoms decreases in relation to the statutes of metabolic control 1. Impairment of hypoglycaemic awareness is reported by up to 50% of patients with type 1 diabetes and it is associated with an increase of severe episodes of hypoglycaemia 2. Self-monitoring of blood glucose (SMBG) has become a major tool in the management of diabetes. Current recommendations suggest frequent SMBG. The major inconvenience of SMBG is due to the limitations of the glycaemic profile obtained from intermittent finger-sticks. This is an incomplete picture of blood glucose excursions; moreover, the frequent SMBG is not readily accepted by patients suffering from diabetes because it is invasive and painful.
Gomis
Ramon
R
Endocrinology and Diabetes Service, Hospital Clínic Universitari, IDIBAPS, Faculty of Medicine, University of Barcelona, Barcelona, Spain. gomis@medicina.ub.es
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D001364:Awareness; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D003071:Cognition; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000503:physiopathology* / Q000517:prevention & control / Q000523:psychology*; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007328:Insulin / Q000009:adverse effects*; D018670:Monitoring, Ambulatory / Q000379:methods
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin