Hypoglycemia unawareness and autonomic dysfunction in diabetes: Lessons learned and roles of diabetes technologies
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- Yu Kuei Lin
- Division of Metabolism, Endocrinology and Diabetes Department of Internal Medicine University of Michigan Medical School Ann Arbor Michigan USA
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- Simon J Fisher
- Division of Endocrinology, Metabolism and Diabetes Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah USA
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- Rodica Pop‐Busui
- Division of Metabolism, Endocrinology and Diabetes Department of Internal Medicine University of Michigan Medical School Ann Arbor Michigan USA
説明
<jats:title>Abstract</jats:title><jats:p>Impaired awareness of hypoglycemia (IAH) is a reduction in the ability to recognize low blood glucose levels that would otherwise prompt an appropriate corrective therapy. Identified in approximately 25% of patients with type 1 diabetes, IAH has complex pathophysiology, and might lead to serious and potentially lethal consequences in patients with diabetes, particularly in those with more advanced disease and comorbidities. Continuous glucose monitoring systems can provide real‐time glucose information and generate timely alerts on rapidly falling or low blood glucose levels. Given their improvements in accuracy, affordability and integration with insulin pump technology, continuous glucose monitoring systems are emerging as critical tools to help prevent serious hypoglycemia and mitigate its consequences in patients with diabetes. This review discusses the current knowledge on IAH and effective diagnostic methods, the relationship between hypoglycemia and cardiovascular autonomic neuropathy, a practical approach to evaluating cardiovascular autonomic neuropathy for clinicians, and recent evidence from clinical trials assessing the effects of the use of CGM technologies in patients with type 1 diabetes with IAH.</jats:p>
収録刊行物
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- Journal of Diabetes Investigation
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Journal of Diabetes Investigation 11 (6), 1388-1402, 2020-07-07
Wiley