Hypoglycemia is the limiting factor in the management of diabetes

✍ Scribed by Philip E. Cryer

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 64 KB
• Volume: 15
• Category: Article
• ISSN: 1520-7552
• DOI: 10.1002/(sici)1520-7560(199901/02)15:1<42::aid-dmrr1>3.0.co;2-b

✦ Synopsis

Hypoglycemia is the limiting factor, both conceptually and in practice, in the management of diabetes mellitus. While the long-term goal of diabetes research must remain the cure and the prevention of the disease and reasonable near-term goals might include perfect insulin replacement or prevention of complications despite ongoing hyperglycemia, the most pressing short-term goal for people with diabetes would seem to be insight leading to strategies that effectively minimize the risk of hypoglycemia and thus permit low-risk glycemic control. Having reviewed the ®eld in detail recently, the author offers his personal views of the key questions ± concerning the physiology of glucose counterregulation, its pathophysiology in diabetes, and hypoglycemia in diabetes ± that, if answered, might lead to a reduced risk of iatrogenic hypoglycemia in people with diabetes. The overriding question is: How can we learn to replace insulin more perfectly, prevent, correct or compensate for compromised glucose counterregulation, or both?