Metabolism - Clinical and Experimental
Volume 55, Issue 3 , Pages 331-338 , March 2006

Hormonal, subjective, and neurocognitive responses to brief hypoglycemia in postmenopausal women and age-matched men with type 2 diabetes mellitus

  • Jan Phillip Bremer

      Affiliations

    • Department of Internal Medicine I, University of Luebeck, D-23538 Luebeck, Germany
    • ,
  • Maria Baron

      Affiliations

    • Department of Internal Medicine I, University of Luebeck, D-23538 Luebeck, Germany
    • ,
  • Horst Peters

      Affiliations

    • Department of Internal Medicine I, University of Luebeck, D-23538 Luebeck, Germany
    • ,
  • Kerstin M. Oltmanns

      Affiliations

    • Department of Neuroendocrinology, University of Luebeck, D-23538 Luebeck, Germany
    • ,
  • Werner Kern

      Affiliations

    • Department of Internal Medicine I, University of Luebeck, D-23538 Luebeck, Germany
    • ,
  • Horst L. Fehm

      Affiliations

    • Department of Internal Medicine I, University of Luebeck, D-23538 Luebeck, Germany
    • ,
  • Jan Born

      Affiliations

    • Department of Neuroendocrinology, University of Luebeck, D-23538 Luebeck, Germany
    • ,
  • Bernd Schultes

      Affiliations

    • Department of Internal Medicine I, University of Luebeck, D-23538 Luebeck, Germany
    • Corresponding Author InformationCorresponding author. Tel.: +49 451 500 3639; fax: +49 451 500 3640.

Received 15 March 2006 ,Accepted 22 September 2006.

References 

  1. The DCCT Research Group. Epidemiology of severe hypoglycemia in the diabetes control and complications trial. The DCCT Research Group. Am J Med. 1991;90:450–459
  2. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352:854–865
  3. Veneman TF, Erkelens DW. Clinical review 88: hypoglycemia unawareness in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab. 1997;82:1682–1684
  4. Hepburn DA, MacLeod KM, Pell AC, et al. Frequency and symptoms of hypoglycaemia experienced by patients with type 2 diabetes treated with insulin. Diabet Med. 1993;10:231–237
  5. Banarer S, Cryer PE. Hypoglycemia in type 2 diabetes. Med Clin North Am. 2004;88:1107–1111
  6. Heller SR. What we know about counterregulation in type 2 diabetes. Diabetes Nutr Metab. 2002;15:372–375
  7. Segel SA, Paramore DS, Cryer PE. Hypoglycemia-associated autonomic failure in advanced type 2 diabetes. Diabetes. 2002;51:724–733
  8. Dagogo-Jack SE, Craft S, Cryer PE. Hypoglycemia-associated autonomic failure in insulin-dependent diabetes mellitus. Recent antecedent hypoglycemia reduces autonomic response to, symptoms of, and defense against subsequent hypoglycemia. J Clin Invest. 1993;91:819–828
  9. Korzon-Burakowska A, Hopkins D, Matyka K, et al. Effects of glycemic control on protective responses against hypoglycemia in type 2 diabetes. Diabetes Care. 1998;21:283–290
  10. Davis SN, Fowler S, Costa F. Hypoglycemic counterregulatory responses differ between men and women with type 1 diabetes. Diabetes. 2000;49:65–72
  11. Davis SN, Shavers C, Costa F. Gender-related differences in counterregulatory responses to antecedent hypoglycemia in normal humans. J Clin Endocrinol Metab. 2000;85:2148–2157
  12. Diamond MP, Jones T, Caprio S, et al. Gender influences counterregulatory hormone responses to hypoglycemia. Metabolism. 1993;42:1568–1572
  13. Amiel SA, Maran A, Powrie JK, et al. Gender differences in counterregulation to hypoglycaemia. Diabetologia. 1993;36:460–464
  14. Sandoval DA, Ertl AC, Richardson MA, et al. Estrogen blunts neuroendocrine and metabolic responses to hypoglycemia. Diabetes. 2003;52:1749–1755
  15. Veneman T, Mitrakou A, Mokan M, et al. Induction of hypoglycemia unawareness by asymptomatic nocturnal hypoglycemia. Diabetes. 1993;42:1233–1237
  16. Fruehwald-Schultes B, Born J, Kern W, et al. Adaptation of cognitive function to hypoglycemia in healthy men. Diabetes Care. 2000;23:1059–1066
  17. Schultes B, Kern W, Oltmanns K, et al. Differential adaptation of neurocognitive brain functions to recurrent hypoglycemia in healthy men. Psychoneuroendocrinology. 2005;30:149–161
  18. Mitrakou A, Ryan C, Veneman T, et al. Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction. Am J Physiol. 1991;260:E67–E74
  19. Davis SN, Shavers C, Costa F. Differential gender responses to hypoglycemia are due to alterations in CNS drive and not glycemic thresholds. Am J Physiol Endocrinol Metab. 2000;279:E1054–E1063
  20. Davis SN, Shavers C, Collins L, et al. Effects of physiological hyperinsulinemia on counterregulatory response to prolonged hypoglycemia in normal humans. Am J Physiol. 1994;267:E402–E410
  21. Davis SN, Goldstein RE, Jacobs J, et al. The effect of differing insulin levels on the hormonal and metabolic response to equivalent hypoglycemia in normal humans. Diabetes. 1993;42:263–272
  22. Davis SN, Dobbins R, Tarumi C, et al. Effects of differing insulin levels on response to equivalent hypoglycemia in conscious dogs. Am J Physiol. 1992;263:E688–E695
  23. Fruehwald-Schultes B, Kern W, Deininger E, et al. Protective effect of insulin against hypoglycemia-associated counterregulatory failure. J Clin Endocrinol Metab. 1999;84:1551–1557
  24. Fisher SJ, Bruning JC, Lannon S, et al. Insulin signaling in the central nervous system is critical for the normal sympathoadrenal response to hypoglycemia. Diabetes. 2005;54:1447–1451
  25. Liu D, Moberg E, Kollind M, et al. A high concentration of circulating insulin suppresses the glucagon response to hypoglycemia in normal man. J Clin Endocrinol Metab. 1991;23:1123–1128

PII: S0026-0495(05)00363-X

doi: 10.1016/j.metabol.2005.09.006

Metabolism - Clinical and Experimental
Volume 55, Issue 3 , Pages 331-338 , March 2006

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