低血糖
纯自主神经功能衰竭
医学
肾上腺素
糖尿病
血糖性
胰高血糖素
内科学
重症监护医学
内分泌学
胰岛素
直立生命体征
血压
出处
期刊:American Journal of Physiology-endocrinology and Metabolism
[American Physiological Society]
日期:2001-12-01
卷期号:281 (6): E1115-E1121
被引量:115
标识
DOI:10.1152/ajpendo.2001.281.6.e1115
摘要
Hypoglycemia is the limiting factor in the glycemic management of diabetes. The concept of hypoglycemia-associated autonomic failure (HAAF) in diabetes posits that recent antecedent iatrogenic hypoglycemia causes both defective glucose counterregulation (by reducing the epinephrine response to falling glucose levels in the setting of an absent glucagon response) and hypoglycemia unawareness (by reducing the autonomic and the resulting neurogenic symptom responses) and thus a vicious cycle of recurrent hypoglycemia. Perhaps the most compelling support for HAAF is the finding that as little as 2–3 wk of scrupulous avoidance of hypoglycemia reverses hypoglycemia unawareness and improves the reduced epinephrine component of defective glucose counterregulation in most affected individuals. Insight into this pathophysiology has led to a broader view of the clinical risk factors for hypoglycemia to include indexes of compromised glucose counterregulation and provided a framework for the study of the mechanisms of iatrogenic hypoglycemia and, ultimately, its elimination from the lives of people with diabetes.
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