- Part 1 Principles of international endocrine practice
- Part 2 Pituitary and hypothalamic diseases
- Part 3 The thyroid
- Part 4 Parathyroid, calcium, and bone metabolism
- Part 5 The adrenal gland and endocrine hypertension
- Part 6 Neuroendocrine tumours and genetic disorders
- Part 7 Growth and development during childhood
- Part 8 Female endocrinology and pregnancy
- Part 9 Male hypogonadism and infertility
- Part 10 Endocrinology of ageing and systemic disease
- Part 11 Endocrinology of cancer
- Part 12 Obesity, lipids, and metabolic disorders
- Part 13 Diabetes mellitus
- 13.1 Classification and diagnosis of diabetes mellitus
- 13.2 Aetiology and pathogenesis of type 1 diabetes mellitus
- 13.3 Aetiology and pathogenesis of type 2 diabetes mellitus
- 13.4 Management of diabetes mellitus
- 13.4.1 Clinical features, lifestyle management, and glycaemic targets in type 2 diabetes mellitus
- 13.4.2 Pharmacological therapy of hyperglycaemia in type 2 diabetes mellitus
- 13.4.3 Diabetes in diverse ethnic groups
- 13.4.4 Structured education for people with type 2 diabetes mellitus
- 13.4.5 Metabolic surgery in the treatment of type 2 diabetes mellitus
- 13.4.6 Management of type 1 diabetes mellitus
- 13.4.7 Type 1 and type 2 diabetes mellitus in children
- 13.4.8 Hypoglycaemia in the treatment of diabetes mellitus
- 13.4.9 Non-biological technologies in glucose sensing
- 13.4.10 Management of diabetes mellitus in special situations
- 13.5 Microvascular complications
- 13.6 Macrovascular diseases and diabetes mellitus
- 13.7 The diabetic foot
- 13.8 Mental health and diabetes mellitus
- 13.9 Organization of diabetes care
- 13.10 Transplantation in Diabetes
- 13.11 Gene therapy in diabetes mellitus
(p. 1849) Hypoglycaemia in the treatment of diabetes mellitus
- Chapter:
- (p. 1849) Hypoglycaemia in the treatment of diabetes mellitus
- Author(s):
Pratik Choudhary
and Stephanie A. Amiel
- DOI:
- 10.1093/med/9780199235292.003.1435
Hypoglycaemia (low blood glucose concentration) is the most important acute complication of the pharmacological treatment of diabetes mellitus. Low blood glucose impairs brain (and, potentially, cardiac) function. The brain has minimal endogenous stores of energy, with small amounts of glycogen in astroglial cells. The brain is therefore largely dependent on circulating glucose as the substrate to fuel cerebral metabolism and support cognitive performance. If blood glucose levels fall sufficiently, cognitive dysfunction is inevitable. In health, efficient glucose sensing and counterregulatory mechanisms exist to prevent clinically significant hypoglycaemia. These are impaired by diabetes and by its therapies. Patients with diabetes rank fear of hypoglycaemia as highly as fear of chronic complications such as nephropathy or retinopathy (1). Fear of hypoglycaemia, hypoglycaemia itself and attempts to avoid hypoglycaemia limit the degree to which glycaemic control can be intensified to reduce the risk of chronic complications of diabetes both for type 1 and type 2 diabetes.
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- Part 1 Principles of international endocrine practice
- Part 2 Pituitary and hypothalamic diseases
- Part 3 The thyroid
- Part 4 Parathyroid, calcium, and bone metabolism
- Part 5 The adrenal gland and endocrine hypertension
- Part 6 Neuroendocrine tumours and genetic disorders
- Part 7 Growth and development during childhood
- Part 8 Female endocrinology and pregnancy
- Part 9 Male hypogonadism and infertility
- Part 10 Endocrinology of ageing and systemic disease
- Part 11 Endocrinology of cancer
- Part 12 Obesity, lipids, and metabolic disorders
- Part 13 Diabetes mellitus
- 13.1 Classification and diagnosis of diabetes mellitus
- 13.2 Aetiology and pathogenesis of type 1 diabetes mellitus
- 13.3 Aetiology and pathogenesis of type 2 diabetes mellitus
- 13.4 Management of diabetes mellitus
- 13.4.1 Clinical features, lifestyle management, and glycaemic targets in type 2 diabetes mellitus
- 13.4.2 Pharmacological therapy of hyperglycaemia in type 2 diabetes mellitus
- 13.4.3 Diabetes in diverse ethnic groups
- 13.4.4 Structured education for people with type 2 diabetes mellitus
- 13.4.5 Metabolic surgery in the treatment of type 2 diabetes mellitus
- 13.4.6 Management of type 1 diabetes mellitus
- 13.4.7 Type 1 and type 2 diabetes mellitus in children
- 13.4.8 Hypoglycaemia in the treatment of diabetes mellitus
- 13.4.9 Non-biological technologies in glucose sensing
- 13.4.10 Management of diabetes mellitus in special situations
- 13.5 Microvascular complications
- 13.6 Macrovascular diseases and diabetes mellitus
- 13.7 The diabetic foot
- 13.8 Mental health and diabetes mellitus
- 13.9 Organization of diabetes care
- 13.10 Transplantation in Diabetes
- 13.11 Gene therapy in diabetes mellitus