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Effect of short-term glucose control on glycemic thresholds for epinephrine and hypoglycemic symptoms

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Please use this identifier to cite or link to this item: http://hdl.handle.net/1928/1889

Effect of short-term glucose control on glycemic thresholds for epinephrine and hypoglycemic symptoms

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Title: Effect of short-term glucose control on glycemic thresholds for epinephrine and hypoglycemic symptoms
Author: Burge, MR; Sobhy, TA; Qualls, CR; Schade, DS
Subject(s): Endocrinology
Metabolism
Hypoglycemia
Type 2 diabetes
short-term glucose
Abstract: Hypoglycemia is the principal barrier to achieving target glucose goals in type 2 diabetes. The effect of short-term improvement in glycemic control on plasma glucose thresholds for symptomatic and hormonal responses to hypoglycemia in type 2 diabetes is not known. We hypothesized that the thresholds for these events would be increased by 1 wk of improved glycemic control in elderly patients with type 2 diabetes. Ten elderly patients with type 2 diabetes were admitted for an 8-d inpatient protocol. All subjects underwent insulin-induced hypoglycemia on days 2 (preglucose control) and 8 (postglucose control). Between days 2 and 8, subjects received intensive diabetes management to improve their glycemic control. Timed blood glucose profiles were obtained daily during the week before and during admission. Plasma glucose, counterregulatory hormones, and hypoglycemic symptoms were assessed at baseline and every 10 min during the hypoglycemic studies. Mean blood glucose concentrations were significantly reduced by intensive diabetes management from 9.8 +/- 3.7 mmol/liter to 7.7 +/- 3.3 mmol/liter (P < 0.001). The plasma glucose threshold for epinephrine release during insulin-induced hypoglycemia was significantly increased by intensive management from a glucose concentration of 3.7 +/- 0.5 mmol/liter at baseline to 3.1 +/- 0.3 mmol/liter after intensive management (P < 0.05). The plasma glucose threshold for hypoglycemic symptoms was also increased by intensive therapy from a glucose concentration of 5.3 +/- 1.2 to 3.3 +/- 0.6 mmol/liter (P = 0.003). These rapid changes may increase the risk for severe hypoglycemia in type 2 diabetes and limit the ability of physicians to rapidly correct hyperglycemia in elderly type 2 diabetes patients.
Date: 2006-09-18
Publisher: Burge, MR - The Journal of clinical endocrinology and metabolism
Citation: 2001 Nov;86(11):5471-8
Description: For full-text go to PubMed, ID: 11701724
URI: http://hdl.handle.net/1928/1889

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