Document Detail


Episodes of severe hypoglycemia in type 1 diabetes are preceded and followed within 48 hours by measurable disturbances in blood glucose.
MedLine Citation:
PMID:  11095469     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study quantifies blood glucose (BG) disturbances occurring before and after episodes of severe hypoglycemia (SH). For 6-8 months, 85 individuals with type 1 diabetes and a history of SH (age, 44+/-10 yr; 41 women and 44 men; duration of diabetes, 26+/-11 yr; hemoglobin A1c, 7.7+/-1.1%) used Lifescan One Touch BG meters for self-monitoring three to five times daily and recorded the date and time of SH episodes in diaries. For each subject, the timing of SH episodes was located in the temporal stream of SMBG readings recorded by the meter, and characteristics, including the Low BG index (LBGI), were computed in 24-h increments. In the 24-h period before the SH episode LBGI rose (P < 0.001), average BG was lower (P = 0.001), and BG variance increased (P = 0.001). In the 24 h after SH, LBGI and BGvariance remained elevated (P < 0.001), but average BG returned to baseline. These disturbances disappeared in 48 h. On the basis of LBGI we identified subjects at low, moderate, and high risk of SH, who reported, on the average, 1.7, 3.4, and 7.4 SH episodes (P < 0.005) during the study. In addition, we designed an algorithm that predicted 50% of all SH episodes that occurred in this subject group. We conclude that episodes of SH are preceded and followed by quantifiable BG disturbances, which could be used to devise warnings of imminent SH.
Authors:
B P Kovatchev; D J Cox; L S Farhy; M Straume; L Gonder-Frederick; W L Clarke
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  85     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-29     Completed Date:  2000-12-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  4287-92     Citation Subset:  AIM; IM    
Affiliation:
University of Virginia Health System and National Science Foundation Center for Biological Timing, Charlottesville 22908, USA.
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MeSH Terms
Descriptor/Qualifier:
Activity Cycles*
Adult
Blood Glucose / metabolism*
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 1 / blood*,  drug therapy,  physiopathology*
Female
Hemoglobin A, Glycosylated / analysis
Humans
Hypoglycemia / blood,  physiopathology*
Insulin / therapeutic use
Male
Periodicity
Recurrence
Grant Support
ID/Acronym/Agency:
R01-DK-28288/DK/NIDDK NIH HHS; R01-DK-51562/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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