title: Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus.
abstract: Recurrent hypoglycemia has been shown to blunt hypoglycemia symptom scores and counterregulatory hormonal responses during subsequent hypoglycemia. We therefore studied whether hypoglycemia-associated electroencephalogram (EEG) changes are affected by an antecedent episode of hypoglycemia.
  
  
  
  Twenty-four patients with type 1 diabetes mellitus (10 with normal hypoglycemia awareness, 14 with hypoglycemia unawareness) were studied on 2 consecutive days by hyperinsulinemic glucose clamp at hypoglycemia (2.0-2.5 mmol/L) during a 1-h period. EEG was recorded, cognitive function assessed, and hypoglycemia symptom scores and counterregulatory hormonal responses were obtained.
  
  
  
  Twenty-one patients completed the study. Hypoglycemia-associated EEG changes were identified on both days with no differences in power or frequency distribution in the theta, alpha, or the combined theta-alpha band during hypoglycemia on the 2 days. Similar degree of cognitive dysfunction was also present during hypoglycemia on both days. When comparing the aware and unaware group, there were no differences in the hypoglycemia-associated EEG changes. There were very subtle differences in cognitive function between the two groups on day 2. The symptom response was higher in the aware group on both days, while only subtle differences were seen in the counterregulatory hormonal response.
  
  
  
  Antecedent hypoglycemia does not affect hypoglycemia-associated EEG changes in patients with type 1 diabetes mellitus.
authors.affiliation: 1 Faculty of Health, University of Southern Denmark , Odense, Denmark .|2 Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital , Hillerød, Denmark .
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Sejling
authors.affiliation: 3 Department of Neurology, Roskilde Hospital , Roskilde, Denmark .|4 Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark .|5 Department of Neurophysiology, Rigshospitalet , Copenhagen, Denmark .
authors.forename: Troels W
authors.initials: TW
authors.lastname: Kjaer
authors.affiliation: 2 Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital , Hillerød, Denmark .|4 Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark .
authors.forename: Ulrik
authors.initials: U
authors.lastname: Pedersen-Bjergaard
authors.affiliation: 6 HypoSafe A/S , Lyngby, Denmark .
authors.forename: Line S
authors.initials: LS
authors.lastname: Remvig
authors.affiliation: 2 Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital , Hillerød, Denmark .|7 Department of Endocrinology, Hvidovre Hospital , Hvidovre, Denmark .
authors.forename: Christian S
authors.initials: CS
authors.lastname: Frandsen
authors.affiliation: 8 Department of Clinical Biochemistry, Rigshospitalet , Copenhagen, Denmark .
authors.forename: Linda
authors.initials: L
authors.lastname: Hilsted
authors.affiliation: 4 Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark .|9 Department of Endocrinology, Herlev Hospital , Herlev, Denmark .
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
authors.affiliation: 10 NNF Center for Basic Metabolic Research, University of Copenhagen , Copenhagen, Denmark .
authors.forename: Jens Juul
authors.initials: JJ
authors.lastname: Holst
authors.affiliation: 11 Health, Aarhus University , Aarhus, Denmark .|12 Steno Diabetes Center , Gentofte, Denmark .|13 The Research Unit, Nordsjællands Hospital , Hillerød, Denmark .
authors.forename: Lise
authors.initials: L
authors.lastname: Tarnow
authors.affiliation: 3 Department of Neurology, Roskilde Hospital , Roskilde, Denmark .
authors.forename: Jakob Skadkær
authors.initials: JS
authors.lastname: Møller
authors.affiliation: 5 Department of Neurophysiology, Rigshospitalet , Copenhagen, Denmark .
authors.forename: Martin N
authors.initials: MN
authors.lastname: Nielsen
authors.affiliation: 2 Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital , Hillerød, Denmark .|4 Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark .
authors.forename: Birger
authors.initials: B
authors.lastname: Thorsteinsson
authors.affiliation: 1 Faculty of Health, University of Southern Denmark , Odense, Denmark .|6 HypoSafe A/S , Lyngby, Denmark .|14 Department of Medicine, Hospital of South West Jutland , Esbjerg, Denmark .
authors.forename: Claus B
authors.initials: CB
authors.lastname: Juhl
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D001921:Brain / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D004569:Electroencephalography; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007003:Hypoglycemia / Q000503:physiopathology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Antecedent hypoglycemia; Cognitive function; Counterregulatory hormonal response; EEG; Hypoglycemia awareness; Hypoglycemia symptom score; Hypoglycemia-associated EEG changes; Type 1 diabetes mellitus