[Diagnosis and treatment of hypoglycemia unawareness in type 1 and type 2 diabetes].
Hypoglycemia unawareness and the associated condition of hypoglycemia associated autonomic failure (HAAF) is a serious acute complication that in the early phase often goes undiagnosed, and in the advanced stage is frequently not treated. The underlying cause is recurrent episodes of hypoglycemia, and it is seen predominantly in patients with type 1 diabetes, but may also occur in type 2 diabetics with low C-peptide levels. In the etiology a self-protection mechanism of the CNS with the maintenance of higher glucose concentrations in the brain appears to play a central role. Treatment is formally simple and involves the scrupulous avoidance of hypoglycemia for a period of at least 4 weeks. In practice, however, this requires a high expenditure of effort, and is not always successful. The focus of the present review is on a practical diagnostic and therapeutic strategy.
Lüddeke
Hans-J
HJ
Internist, diabe- tologische Schwerpunktpraxis, München. hj-lueddeke@t-online.de
D000208:Acute Disease; D001341:Autonomic Nervous System / Q000503:physiopathology; D001364:Awareness; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007328:Insulin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000502:physiology / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin