TY - JOUR
T1 - Symptoms of hypoglycemia, thresholds for their occurrence, and hypoglycemia unawareness
AU - Cryer, P. E.
N1 - Funding Information:
This work was supported, in part, by National Institutes of Health grants RO1 DK27085, MO1 RR00036, P60 DK20579, and T32 DK07120 and by a fellowship award from the American Diabetes Association.
PY - 1999
Y1 - 1999
N2 - Ultimately traceable to neural glucose deprivation, symptoms of hypoglycemia include neurogenic (autonomic) and neuroglycopenic symptoms. Neurogenic symptoms (tremulousness, palpitations, anxiety, sweating, hunger, paresthesias) are the results of the perception of physiologic changes caused by the autonomic nervous system's response to hypoglycemia. Neuroglycopenic symptoms (confusion, sensation of warmth, weakness or fatigue, severe cognitive failure, seizure, coma) are the results of brain glucose deprivation itself. Glycemic thresholds for symptoms of hypoglycemia shift to lower plasma glucose concentrations following recent episodes of hypoglycemia, leading to the syndrome of hypoglycemia unawareness - loss of the warning symptoms of developing hypoglycemia. Thus, patients with recurrent hypoglycemia (e.g., those with tightly controlled diabetes or with an insulinoma) often tolerate abnormally low plasma glucose concentrations without symptoms.
AB - Ultimately traceable to neural glucose deprivation, symptoms of hypoglycemia include neurogenic (autonomic) and neuroglycopenic symptoms. Neurogenic symptoms (tremulousness, palpitations, anxiety, sweating, hunger, paresthesias) are the results of the perception of physiologic changes caused by the autonomic nervous system's response to hypoglycemia. Neuroglycopenic symptoms (confusion, sensation of warmth, weakness or fatigue, severe cognitive failure, seizure, coma) are the results of brain glucose deprivation itself. Glycemic thresholds for symptoms of hypoglycemia shift to lower plasma glucose concentrations following recent episodes of hypoglycemia, leading to the syndrome of hypoglycemia unawareness - loss of the warning symptoms of developing hypoglycemia. Thus, patients with recurrent hypoglycemia (e.g., those with tightly controlled diabetes or with an insulinoma) often tolerate abnormally low plasma glucose concentrations without symptoms.
UR - http://www.scopus.com/inward/record.url?scp=0032873144&partnerID=8YFLogxK
U2 - 10.1016/S0889-8529(05)70084-0
DO - 10.1016/S0889-8529(05)70084-0
M3 - Article
C2 - 10500927
AN - SCOPUS:0032873144
SN - 0889-8529
VL - 28
SP - 495
EP - 500
JO - Endocrinology and Metabolism Clinics of North America
JF - Endocrinology and Metabolism Clinics of North America
IS - 3
ER -