低血糖对2型糖尿病患者的影响课件_2.pptVIP

* Prior Hypoglycemia Blunts Counterregulatory Response to Subsequent Comparable Hypoglycemia in Adults Without Diabetes A study was conducted in adults without diabetes to determine whether prior hypoglycemia reduces neuroendocrine and symptomatic responses to subsequent hypoglycemia.1 On 2 consecutive mornings, glucose clamps were performed to achieve hypoglycemia. This 2-morning procedure was repeated after an interval of at least 4 weeks. On the afternoon between 1 set of 2-morning procedures, euglycemia was induced; on the afternoon between the other set of 2 consecutive mornings, hypoglycemia was induced.1 This slide shows results from the 2-morning set in which hypoglycemia was induced in the afternoon of the first day.1 The chart in the upper left corner shows that hypoglycemia was consistently achieved on both mornings.1 The other 3 charts show reductions in responses to morning hypoglycemia after afternoon hypoglycemia in terms of total symptom score, epinephrine level, and glucagon level.1 The researchers found, however, that responses on the second morning were not reduced from those of the first morning when euglycemia was achieved during the intervening afternoon.1 Reference 1. Heller SR, Cryer PE. Reduced neuroendocrine and symptomatic responses to subsequent hypoglycemia after 1 episode of hypoglycemia in nondiabetic humans. Diabetes. 1991;40(2):223–226. Purpose To demonstrate whether prior episodes of hypoglycemia affect later episodes. TakeawayPrior hypoglycemia reduces neuroendocrine and symptomatic responses to subsequent hypoglycemia. * Impaired Awareness Is Associated With Increased Risk of Severe Hypoglycemia in Insulin-Treated Patients With Type 2 Diabetes Impaired awareness is associated with increased risk of severe hypoglycemia in patients with type 2 diabetes.1 To assess the influence of various risk factors on the rate of severe hypoglycemia, a survey was taken of patients with type 2 diabetes who received treatment with