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Erschienen in: Der Diabetologe 1/2013

01.02.2013 | Leitthema

Hypoglykämien

Epidemiologie und Pathophysiologie

verfasst von: Prof. Dr. W. Kern

Erschienen in: Die Diabetologie | Ausgabe 1/2013

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Zusammenfassung

Rezidivierende Hypoglykämien sind der wichtigste Risikofaktor für das Auftreten von schweren Hypoglykämien, da sie zu einer abgeschwächten hormonellen Gegenregulation und eingeschränkter Hypoglykämiewahrnehmung führen. Weitere Risikofaktoren sind lange Erkrankungsdauer und höheres Alter. Im Schlaf setzt die hormonelle Gegenregulation erst bei niedrigeren Blutglukosespiegeln ein, und die Gesamtmenge der gegenregulatorischen Hormone ist reduziert. Viele nächtliche Hypoglykämien bleiben daher von Patient und Arzt unerkannt.
Literatur
1.
Zurück zum Zitat Bode BW et al (2005) Glycemic characteristics in continuously monitored patients with type 1 and type 2 diabetes. Diabetes Care 28:2361–2366PubMedCrossRef Bode BW et al (2005) Glycemic characteristics in continuously monitored patients with type 1 and type 2 diabetes. Diabetes Care 28:2361–2366PubMedCrossRef
2.
Zurück zum Zitat Bremer JP, Jauch-Chara K, Hallschmid M et al (2009) Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabetes Care 32:1513–1517PubMedCrossRef Bremer JP, Jauch-Chara K, Hallschmid M et al (2009) Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabetes Care 32:1513–1517PubMedCrossRef
3.
Zurück zum Zitat Choi IY et al (2003) In vivo 13C NMR assessment of brain glycogen concentration and turnover in the awake rat. J Neurocsci Res 43:317–322 Choi IY et al (2003) In vivo 13C NMR assessment of brain glycogen concentration and turnover in the awake rat. J Neurocsci Res 43:317–322
4.
Zurück zum Zitat Fanelli CG, Epifano L, Rambotti AM et al (1993) Meticulous prevention of hypoglycemia normalizes the glycemic thresholds and magnitude of most of neuroendocrine responses to, symptoms of, and cognitive function during hypoglycemia in intensively treated patients with short-term IDDM. Diabetes 42:1683–1689PubMedCrossRef Fanelli CG, Epifano L, Rambotti AM et al (1993) Meticulous prevention of hypoglycemia normalizes the glycemic thresholds and magnitude of most of neuroendocrine responses to, symptoms of, and cognitive function during hypoglycemia in intensively treated patients with short-term IDDM. Diabetes 42:1683–1689PubMedCrossRef
5.
Zurück zum Zitat Frier BM, Fisher BM (2007) Hypoglycaemia in clinical diabetes (diabetes in practice). 2. Aufl. Wiley & Sons, Chichester Frier BM, Fisher BM (2007) Hypoglycaemia in clinical diabetes (diabetes in practice). 2. Aufl. Wiley & Sons, Chichester
6.
Zurück zum Zitat Fruehwald-Schultes B, Kern W, Deininger E et al (1999) Protective effect of insulin against hypoglycemia-associated counterregulatory failure. J Clin Endocrinol Metab 84:1551–1557PubMedCrossRef Fruehwald-Schultes B, Kern W, Deininger E et al (1999) Protective effect of insulin against hypoglycemia-associated counterregulatory failure. J Clin Endocrinol Metab 84:1551–1557PubMedCrossRef
7.
Zurück zum Zitat Gais S, Born J, Peters A et al (2003) Hypoglycemia counterregulation during sleep. Sleep 6:55–59 Gais S, Born J, Peters A et al (2003) Hypoglycemia counterregulation during sleep. Sleep 6:55–59
8.
Zurück zum Zitat Holstein A et al (2003) Clinical characterisation of severe hypoglycaemia–a prospective population-based study. Exp Clin Endocrinol Diabetes 111:364–369PubMedCrossRef Holstein A et al (2003) Clinical characterisation of severe hypoglycaemia–a prospective population-based study. Exp Clin Endocrinol Diabetes 111:364–369PubMedCrossRef
9.
Zurück zum Zitat Holstein A et al (2012) Substantial increase in incidence of severe hypoglycaemia between 1997–2000 and 2007–2010: a German longitudinal population-based study. Diabetes Care 35:972–975PubMedCrossRef Holstein A et al (2012) Substantial increase in incidence of severe hypoglycaemia between 1997–2000 and 2007–2010: a German longitudinal population-based study. Diabetes Care 35:972–975PubMedCrossRef
10.
Zurück zum Zitat Jaap AJ, Jones GC, McCrimmon RJ et al (1998) Perceived symptoms of hypoglycaemia in elderly type 2 diabetic patients treated with insulin. Diabet Med 15:398–401PubMedCrossRef Jaap AJ, Jones GC, McCrimmon RJ et al (1998) Perceived symptoms of hypoglycaemia in elderly type 2 diabetic patients treated with insulin. Diabet Med 15:398–401PubMedCrossRef
11.
Zurück zum Zitat Jauch-Chara K, Hallschmid M, Gais S et al (2007) Awakening and counterregulatory response to hypoglycemia during early and late sleep. Diabetes 56:1938–1942PubMedCrossRef Jauch-Chara K, Hallschmid M, Gais S et al (2007) Awakening and counterregulatory response to hypoglycemia during early and late sleep. Diabetes 56:1938–1942PubMedCrossRef
12.
Zurück zum Zitat Kang L et al (2008) Prior hypoglycemia enhances glucose responsiveness in some ventromedial hypothalamic glucosensing neurons. Am J Physiol Integr Comp Physiol 294:R784–792CrossRef Kang L et al (2008) Prior hypoglycemia enhances glucose responsiveness in some ventromedial hypothalamic glucosensing neurons. Am J Physiol Integr Comp Physiol 294:R784–792CrossRef
13.
Zurück zum Zitat Kern W, Peters A, Fruehwald-Schultes B et al (2001) Improving influence of insulin on cognitive functions in humans. Neuroendocrinology 74:270–280PubMedCrossRef Kern W, Peters A, Fruehwald-Schultes B et al (2001) Improving influence of insulin on cognitive functions in humans. Neuroendocrinology 74:270–280PubMedCrossRef
14.
Zurück zum Zitat Levin BE, Routh VH, Kang L et al (2004) Neuronal glucosensing: what do we know after 50 years? Diabetes 53:2521–2528PubMedCrossRef Levin BE, Routh VH, Kang L et al (2004) Neuronal glucosensing: what do we know after 50 years? Diabetes 53:2521–2528PubMedCrossRef
15.
Zurück zum Zitat Levy CJ, Kinsley BT, Bajaj M et al (1998) Effect of glycemic control on glucose counterregulation during hypoglycemia in NIDDM. Diabetes Care 21:1330–1338PubMedCrossRef Levy CJ, Kinsley BT, Bajaj M et al (1998) Effect of glycemic control on glucose counterregulation during hypoglycemia in NIDDM. Diabetes Care 21:1330–1338PubMedCrossRef
16.
Zurück zum Zitat Mason GF, Petersen KF, Lebon V et al (2006) Increased brain monocarboxylic acid transport and utilization in Type 1 diabetes. Diabetes 55:929–934PubMedCrossRef Mason GF, Petersen KF, Lebon V et al (2006) Increased brain monocarboxylic acid transport and utilization in Type 1 diabetes. Diabetes 55:929–934PubMedCrossRef
17.
Zurück zum Zitat Munshi MN, Segal AR, Suhl E et al (2011) Frequent hypoglycemia among elderly patients with poor glycemic control. Arch Intern Med 28:362–364CrossRef Munshi MN, Segal AR, Suhl E et al (2011) Frequent hypoglycemia among elderly patients with poor glycemic control. Arch Intern Med 28:362–364CrossRef
18.
Zurück zum Zitat Puente EC, Silverstein J, Bree AJ et al (2010) Recurrent, moderate hypoglycemia ameliorates brain damage and cognitive dysfunction induced by severe hypoglycemia. Diabetes 59:1055–1062PubMedCrossRef Puente EC, Silverstein J, Bree AJ et al (2010) Recurrent, moderate hypoglycemia ameliorates brain damage and cognitive dysfunction induced by severe hypoglycemia. Diabetes 59:1055–1062PubMedCrossRef
19.
Zurück zum Zitat Schultes B, Jauch-Chara K, Gais S et al (2007) Defective awakening response to nocturnal hypoglycaemia in patients with type 1 diabetes. PLoS Med 4:361–369CrossRef Schultes B, Jauch-Chara K, Gais S et al (2007) Defective awakening response to nocturnal hypoglycaemia in patients with type 1 diabetes. PLoS Med 4:361–369CrossRef
20.
Zurück zum Zitat Segel SA, Paramore DS, Cryer PE (2002) Hypoglycemia-associated autonomic failure in advanced type 2 diabetes. Diabetes 51:724–733PubMedCrossRef Segel SA, Paramore DS, Cryer PE (2002) Hypoglycemia-associated autonomic failure in advanced type 2 diabetes. Diabetes 51:724–733PubMedCrossRef
21.
Zurück zum Zitat Simpson IA, Appel NM, Hokari M et al (1999) Blood–Brain Barrier Glucose Transporter: Effects of Hypo- and Hyperglycemia Revisited. J Neurochem 72:238–247PubMedCrossRef Simpson IA, Appel NM, Hokari M et al (1999) Blood–Brain Barrier Glucose Transporter: Effects of Hypo- and Hyperglycemia Revisited. J Neurochem 72:238–247PubMedCrossRef
22.
Zurück zum Zitat The Diabetes Control and Complications Trial Research Group (1997) Hypoglycemia in the diabetes control and complcations trial. Diabetes 46:271–286CrossRef The Diabetes Control and Complications Trial Research Group (1997) Hypoglycemia in the diabetes control and complcations trial. Diabetes 46:271–286CrossRef
23.
Zurück zum Zitat UK Hypoglycaemia Study Group (2007) Risk of hypoglycaemia in types 1 and 2 diabetes: effects of treatment modalities and their duration. Diabetologia 50:1140–1147CrossRef UK Hypoglycaemia Study Group (2007) Risk of hypoglycaemia in types 1 and 2 diabetes: effects of treatment modalities and their duration. Diabetologia 50:1140–1147CrossRef
24.
Zurück zum Zitat Workgroup on Hypoglycaemia (2005) Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care 28:1245–1249CrossRef Workgroup on Hypoglycaemia (2005) Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care 28:1245–1249CrossRef
Metadaten
Titel
Hypoglykämien
Epidemiologie und Pathophysiologie
verfasst von
Prof. Dr. W. Kern
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Die Diabetologie / Ausgabe 1/2013
Print ISSN: 2731-7447
Elektronische ISSN: 2731-7455
DOI
https://doi.org/10.1007/s11428-012-0907-0

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