Hypoglycemia-associated autonomic failure in diabetes - PubMed (original) (raw)
Review
Hypoglycemia-associated autonomic failure in diabetes
P E Cryer. Am J Physiol Endocrinol Metab. 2001 Dec.
Free article
Abstract
Hypoglycemia is the limiting factor in the glycemic management of diabetes. The concept of hypoglycemia-associated autonomic failure (HAAF) in diabetes posits that recent antecedent iatrogenic hypoglycemia causes both defective glucose counterregulation (by reducing the epinephrine response to falling glucose levels in the setting of an absent glucagon response) and hypoglycemia unawareness (by reducing the autonomic and the resulting neurogenic symptom responses) and thus a vicious cycle of recurrent hypoglycemia. Perhaps the most compelling support for HAAF is the finding that as little as 2-3 wk of scrupulous avoidance of hypoglycemia reverses hypoglycemia unawareness and improves the reduced epinephrine component of defective glucose counterregulation in most affected individuals. Insight into this pathophysiology has led to a broader view of the clinical risk factors for hypoglycemia to include indexes of compromised glucose counterregulation and provided a framework for the study of the mechanisms of iatrogenic hypoglycemia and, ultimately, its elimination from the lives of people with diabetes.
Similar articles
- Mechanisms of hypoglycemia-associated autonomic failure and its component syndromes in diabetes.
Cryer PE. Cryer PE. Diabetes. 2005 Dec;54(12):3592-601. doi: 10.2337/diabetes.54.12.3592. Diabetes. 2005. PMID: 16306382 Review. - Hypoglycemia in diabetes: pathophysiological mechanisms and diurnal variation.
Cryer PE. Cryer PE. Prog Brain Res. 2006;153:361-5. doi: 10.1016/S0079-6123(06)53021-3. Prog Brain Res. 2006. PMID: 16876586 Review. - Hypoglycemia-associated autonomic failure in diabetes.
Cryer PE. Cryer PE. Handb Clin Neurol. 2013;117:295-307. doi: 10.1016/B978-0-444-53491-0.00023-7. Handb Clin Neurol. 2013. PMID: 24095133 Review. - Hypoglycaemia: the limiting factor in the glycaemic management of Type I and Type II diabetes.
Cryer PE. Cryer PE. Diabetologia. 2002 Jul;45(7):937-48. doi: 10.1007/s00125-002-0822-9. Epub 2002 Apr 26. Diabetologia. 2002. PMID: 12136392 Review. - Hypoglycemia in diabetes.
Cryer PE, Davis SN, Shamoon H. Cryer PE, et al. Diabetes Care. 2003 Jun;26(6):1902-12. doi: 10.2337/diacare.26.6.1902. Diabetes Care. 2003. PMID: 12766131 Review.
Cited by
- Hypoglycemia Unawareness-A Review on Pathophysiology and Clinical Implications.
Hölzen L, Schultes B, Meyhöfer SM, Meyhöfer S. Hölzen L, et al. Biomedicines. 2024 Feb 8;12(2):391. doi: 10.3390/biomedicines12020391. Biomedicines. 2024. PMID: 38397994 Free PMC article. Review. - Glycemia-Induced miRNA Changes: A Review.
Al-Mahayni S, Ali M, Khan M, Jamsheer F, Moin ASM, Butler AE. Al-Mahayni S, et al. Int J Mol Sci. 2023 Apr 19;24(8):7488. doi: 10.3390/ijms24087488. Int J Mol Sci. 2023. PMID: 37108651 Free PMC article. Review. - The Antinarcolepsy Drug Modafinil Reverses Hypoglycemia Unawareness and Normalizes Glucose Sensing of Orexin Neurons in Male Mice.
Patel V, Sarkar P, Siegel DM, Teegala SB, Hirschberg PR, Wajid H, Itani O, Routh VH. Patel V, et al. Diabetes. 2023 Aug 1;72(8):1144-1153. doi: 10.2337/db22-0639. Diabetes. 2023. PMID: 36525384 Free PMC article. - Experimentally Induced Hypoglycemia-associated Autonomic Failure in Humans: Determinants, Designs, and Drawbacks.
Bisgaard Bengtsen M, Møller N. Bisgaard Bengtsen M, et al. J Endocr Soc. 2022 Aug 9;6(10):bvac123. doi: 10.1210/jendso/bvac123. eCollection 2022 Oct 1. J Endocr Soc. 2022. PMID: 36042977 Free PMC article. Review.
Publication types
MeSH terms
Substances
Grants and funding
- M01-RR-00036/RR/NCRR NIH HHS/United States
- P60-DK-20579/DK/NIDDK NIH HHS/United States
- R37-DK-27085/DK/NIDDK NIH HHS/United States
- T32-DK-07120/DK/NIDDK NIH HHS/United States
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical