Hypoglycemia is the limiting factor in the management of diabetes

Philip E. Cryer

Research output: Contribution to journalArticlepeer-review

188 Scopus citations


Hypoglycemia is the limiting factor, both conceptually and in practice, in the management of diabetes mellitus. While the long-term goal of diabetes research must remain the cure and the prevention of the disease and reasonable near-term goals might include perfect insulin replacement or prevention of complications despite ongoing hyperglycemia, the most pressing short-term goal for people with diabetes would seem to be insight leading to strategies that effectively minimize the risk of hypoglycemia and thus permit low-risk glycemic control. Having reviewed the field in detail recently, the author offers his personal views of the key questions - concerning the physiology of glucose counterregulation, its pathophysiology in diabetes, and hypoglycemia in diabetes - that, if answered, might lead to a reduced risk of iatrogenic hypoglycemia in people with diabetes. The overriding question is: How can we learn to replace insulin more perfectly, prevent, correct or compensate for compromised glucose counterregulation, or both?

Original languageEnglish
Pages (from-to)42-46
Number of pages5
JournalDiabetes/Metabolism Research and Reviews
Issue number1
StatePublished - Jan 1999


  • Epinephrine
  • Glucagon
  • Glucose counterregulation
  • Hypoglycemia in diabetes


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