UNAWARENESS OF HYPOGLYCEMIA IN INSULIN-TREATED DIABETIC-PATIENTS - PREVALENCE AND RELATIONSHIP TO AUTONOMIC NEUROPATHY

被引：155

作者：

HEPBURN, DA

PATRICK, AW

EADINGTON, DW

EWING, DJ

FRIER, BM

机构：

[1] Diabetic Department, Edinburgh

[2] University Department of Medicine, Royal Infirmary, Edinburgh

来源：

DIABETIC MEDICINE | 1990年 / 7卷 / 08期

关键词：

Autonomic neuropathy; Hypoglycaemia; Hypoglycaemia unawareness; Insulin; Insulin‐treated diabetes mellitus;

D O I：

10.1111/j.1464-5491.1990.tb01475.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Three‐hundred and two insulin‐treated diabetic patients were questioned about hypoglycaemia using a structured questionnaire interview. Two‐hundred and twenty‐six patients (75%) had normal symptomatic awareness, 48 (16%) had partial awareness, 21 (7%) had absent awareness of hypoglycaemia, and 7 (2%) denied ever experiencing hypoglycaemia. Patients with complete loss of awareness of hypoglycaemia had diabetes of longer duration; none had a HbA1c concentration within the non‐diabetic range. Loss of awareness of hypoglycaemia was associated with an increased incidence of severe hypoglycaemia, 19 (91%) of the patients with absent awareness, and 33 (69%) with partial awareness of hypoglycaemia experiencing severe hypoglycaemia over 1 year compared with only 41 (18%) of patients with normal awareness of hypoglycaemia (p < 0.001). Cardiovascular autonomic function tests were performed in 226 (75% of the whole group). Of the patients who had diabetes for more than 15 years, 54% (n = 39) with normal awareness of hypoglycaemia, compared with 59% (n = 10) with absent awareness of hypoglycaemia, had evidence of cardiovascular autonomic impairment (NS). Seven (41%) of the 17 patients with absent awareness of hypoglycaemia and diabetes of > 15 years duration had no evidence of autonomic dysfunction. Loss of hypoglycaemia awareness is a common problem in patients with insulin‐treated diabetes of long duration, is associated with an increased incidence of severe hypoglycaemia, but is not invariably associated with abnormal cardiovascular autonomic function tests. 1990 Diabetes UK

引用

页码：711 / 717

页数：7

共 38 条

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