Mechanisms of sympathoadrenal failure and hypoglycemia in diabetes

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Mechanisms of sympathoadrenal failure and hypoglycemia in diabetes.

A reduced sympathoadrenal response, induced by recent antecedent hypoglycemia, is the key feature of hypoglycemia-associated autonomic failure (HAAF) and, thus, the pathogenesis of iatrogenic hypoglycemia in diabetes. Understanding of the mechanism(s) of that reduced response awaits new insight into its basic molecular, cellular, organ, and whole-body physiology and pathophysiology in experimen...

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Mechanisms of hypoglycemia-associated autonomic failure in diabetes.

Copyright © 2013 Massachusetts Medical Society. Iatrogenic hypoglycemia is the limiting factor in the glycemic management of diabetes.1 It causes recurrent illness in most people with type 1 diabetes mellitus and in many with advanced type 2 diabetes mellitus and is sometimes fatal. It generally precludes maintenance of euglycemia over a lifetime of diabetes and thus full realization of the ben...

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Effects of diabetes and recurrent hypoglycemia on the regulation of the sympathoadrenal system and hypothalamo-pituitary- adrenal (HPA) axis Short Running Title: Sympathoadrenal and HPA regulation in diabetes

Epinephrine, norepinephrine, and corticosterone responses to hypoglycemia are impaired in diabetic rats. Recurrent hypoglycemia further diminishes epinephrine responses. This study examined the sympathoadrenal system and hypothalamo-pituitary-adrenal axis for molecular adaptations underlying these defects. Groups: Normal (N); Diabetic (D); Diabetic exposed to 4 days of 2 episodes/day of hyperin...

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Hypoglycemia-associated autonomic failure in diabetes.

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...

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Mechanisms of hypoglycemia-associated autonomic failure and its component syndromes in diabetes.

Iatrogenic hypoglycemia is a problem for people with diabetes. It causes recurrent morbidity, and sometimes death, as well as a vicious cycle of recurrent hypoglycemia, precluding maintenance of euglycemia over a lifetime of diabetes. Improved therapeutic approaches that will minimize both hypo- and hyperglycemia will be based on insight into the pathophysiology of glucoregulation, specifically...

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ژورنال

عنوان ژورنال: Journal of Clinical Investigation

سال: 2006

ISSN: 0021-9738

DOI: 10.1172/jci28735