Hypoglycemia

In the paper

“Asymptomatic nocturnal hypoglycemia is common and often lasts greater than 4 hours (11,(28)(29)(30)(31).”

What the sources say

• ?Not checked — no full text of the sourcecites [11] 11. The DCCT Research Group. Epidemiology of severe hypoglycemia in the diabe- tes control and complications trial. Am J Med 1991;90:450-9. source
• Partly supported

  The Discussion describes nocturnal hypoglycaemia as common and usually asymptomatic in adolescents with insulin-dependent diabetes; the Abstract reports that five of six affected subjects had no symptoms. The duration passage reports 3.96 hours on average (range 1–7 hours), but does not establish that episodes often lasted more than four hours. (LLM, conf=0.86)

  cites [28] 28. Porter PA, Byrne G, Stick S, et al. Nocturnal hypoglycaemia and sleep distur- bances in young teenagers with insulin dependent diabetes mellitus. Arch Dis Child 1996;75:120-3. sourceExperimental — accuracy not yet measured
• ?Not checked — no full text of the sourcecites [29] 29. Gale EA, Tattersall RB. Unrecognised nocturnal hypoglycaemia in insulin- treated diabetics. Lancet 1979;1:1049-52. source
• ?Not checked — no full text of the sourcecites [30] 30. Beregszàszi M, Tubiana-Rufi N, Benali K, et al. Nocturnal hypoglycemia in chil- dren and adolescents with insulin-dependent diabetes mellitus: Prevalence and risk factors. J Pediatr 1997;131:27-33. source
• ?Not checked — no full text of the sourcecites [31] 31. Vervoort G, Goldschmidt HM, van Doorn LG. Nocturnal blood glucose profiles in patients with type 1 diabetes mellitus on multiple (> or = 4) daily insulin injec- tion regimens. Diabet Med 1996;13:794-9. source

In the paper

“The sympathoadrenal response to hypoglycemia is reduced during sleep, and following exercise or alcohol consumption (26,27).”

What the sources say

• ?Not checked — no full text of the sourcecites [26] 26. Berlin I, Sachon CI, Grimaldi A. Identification of factors associated with impaired hypoglycaemia awareness in patients with type 1 and type 2 diabetes melli- tus. Diabetes Metab 2005;31:246-51. source
• Partly supported

  The Introduction (page unavailable) reports impaired counterregulation against hypoglycemia during sleep and a delayed response threshold during sleep in healthy adults. The paper does not address reduced sympathoadrenal responses following exercise or alcohol consumption. (LLM, conf=0.87)

  cites [27] 27. Schultes B, Jauch-Chara K, Gais S, et al. Defective awakening response to noc- turnal hypoglycemia in patients with type 1 diabetes mellitus. PLoS Med 2007;4:e69. sourceExperimental — accuracy not yet measured

In the paper

“Prospective studies have not found an association between intensive insulin therapy and cognitive function (58)(59)(60), or between severe hypoglycemia and future cognitive function (56,57).”

What the sources say

• ?Not checked — no full text of the sourcecites [58] 58. The Diabetes Control and Complications Trial Research Group. Effects of inten- sive diabetes therapy on neuropsychological function in adults in the Diabetes Control and Complications Trial. Ann Intern Med 1996;124:379-88. source
• ?Not checked — no full text of the sourcecites [59] 59. Reichard P, Pihl M. Mortality and treatment side-effects during long-term inten- sified conventional insulin treatment in the Stockholm Diabetes Intervention Study. Diabetes 1994;43:313-17. source
• ?Not checked — no full text of the sourcecites [60] 60. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interven- tions and Complications Study Research Group, Jacobson AM, Musen G, et al. Long-term effect of diabetes and its treatment on cognitive function. N Engl J Med 2007;356:1842-52. source
• Supported

  The citation to this paper is attached to the severe-hypoglycemia part of the sentence, not the intensive-insulin-therapy part. In the Discussion, the authors report that prior and incident severe hypoglycaemia were not associated with subsequent cognitive decline among participants with normal cognition at baseline. They caution that the sample and follow-up may have limited their ability to detect a subtler association. (LLM, conf=0.92)

  cites [56] 56. Bruce DG, Davis WA, Casey GP, et al. Severe hypoglycaemia and cognitive impair- ment in older patients with diabetes: The Fremantle Diabetes Study. Diabetologia 2009;52:1808-15. source
• Partly supported

  The Introduction (page not provided) reports that the DCCT found no significant correlation between treatment-related hypoglycemic events and neuropsychological function. But this paper’s own prospective analysis measured brain structure, not future cognitive function; the Conclusions explicitly caution that its MRI variables reflect structure, not function. It therefore does not establish the claimed lack of association between severe hypoglycemia and future cognitive function. (LLM, conf=0.83)

  cites [57] 57. Zhang Z, Lovato J, Battapady H, et al. Effect of hypoglycemia on brain structure in people with type 2 diabetes: Epidemiological analysis of the ACCORD- MIND MRI trial. Diabetes Care 2014;37:3279-85. sourceExperimental — accuracy not yet measured

In the paper

“The person with cognitive disorders is at high risk of future severe hypoglycemic episodes, possibly because of medication errors (19,56,57)”

What the sources say

• Partly supported

  The Results (p. 1) report increased severe-hypoglycaemia risk for patients with severe, but not mild, cognitive dysfunction. The Discussion (p. 7) suggests incomplete adherence or inappropriate use of the glucose-control regimen as a possible explanation, but says this could not be assessed with certainty. The claim is broader than the finding because it does not distinguish severe from mild cognitive dysfunction. (LLM, conf=0.88)

  cites [19] 19. de Galan BE, Zoungas S, Chalmers J, et al. Cognitive function and risks of car- diovascular disease and hypoglycaemia in patients with type 2 diabetes: The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Diabetologia 2009;52:2328-36. sourceExperimental — accuracy not yet measured
• Partly supported

  The Abstract reports that dementia predicted future hypoglycaemia requiring health-service use in patients with diabetes aged 70 or older, and that inability to self-manage medications was also a risk factor. The Introduction suggests medication errors as a possible mechanism. The claim is broader than the prospective finding: the paper establishes that risk for dementia, not cognitive disorders generally. (LLM, conf=0.86)

  cites [56] 56. Bruce DG, Davis WA, Casey GP, et al. Severe hypoglycaemia and cognitive impair- ment in older patients with diabetes: The Fremantle Diabetes Study. Diabetologia 2009;52:1808-15. sourceExperimental — accuracy not yet measured
• ?Could not verify

  The Introduction discusses severe hypoglycemia as a possible antecedent of cognitive impairment, not cognitive disorders as a predictor of future episodes. The Results and Conclusions identify other factors associated with hypoglycemia, but do not establish increased risk from cognitive disorders or mention medication errors (searched: future episodes, cognitive impairment, medication errors). (LLM, conf=0.72)

  cites [57] 57. Zhang Z, Lovato J, Battapady H, et al. Effect of hypoglycemia on brain structure in people with type 2 diabetes: Epidemiological analysis of the ACCORD- MIND MRI trial. Diabetes Care 2014;37:3279-85. sourceExperimental — accuracy not yet measured

In the paper

“Both hypoglycemia unawareness and defective glucose counterregulation are potentially reversible.”

What the sources say

• ?Not checked — no full text of the sourcecites [32] 32. Ovalle F, Fanelli CG, Paramore DS, et al. Brief twice-weekly episodes of hypo- glycemia reduce detection of clinical hypoglycemia in type 1 diabetes melli- tus. Diabetes 1998;47:1472-9. source
• Supported

  The Abstract reports that, after meticulous prevention of hypoglycemia in patients with short-term IDDM, symptom and most neuroendocrine responses nearly normalized; it concludes that hypoglycemia unawareness is largely reversible. The Discussion likewise reports improved counterregulatory responses, while noting that some hormone responses remained suppressed. The claim’s “potentially reversible” wording accommodates those limits. (LLM, conf=0.92)

  cites [33] 33. Fanelli CG, Epifano L, Rambotti AM, et al. Meticulous prevention of hypoglyce- mia normalizes the glycemic thresholds and magnitude of most of neuroen- docrine responses to, symptoms of, and cognitive function during hypoglycemia in intensively treated patients with short-term IDDM. Diabetes 1993;42:1683- 9. source
• ?Not checked — no full text of the sourcecites [34] 34. Dagogo-Jack S, Rattarasarn C, Cryer PE. Reversal of hypoglycemia unaware- ness, but not defective glucose counterregulation, in IDDM. Diabetes 1994;43:1426-34. source
• Supported

  The Discussion reports that blunted counterregulatory hormone and symptom responses improved after meticulous prevention of hypoglycaemia. It qualifies the recovery: symptom responses normalized, while some neuroendocrine responses improved without fully normalizing. That supports the claim that both conditions are potentially reversible, not necessarily fully reversible. (LLM, conf=0.93)

  cites [35] 35. Fanelli C, Pampanelli S, Epifano L, et al. Long-term recovery from unaware- ness, deficient counterregulation and lack of cognitive dysfunction during hypoglycaemia, following institution of rational, intensive insulin therapy in IDDM. Diabetologia 1994;37:1265-76. source
• ?Not checked — no full text of the sourcecites [36] 36. Dagogo-Jack S, Fanelli CG, Cryer PE. Durable reversal of hypoglycemia unawareness in type 1 diabetes. Diabetes Care 1999;22:866-7. source
• ?Not checked — no full text of the sourcecites [37] 37. Davis M, Mellman M, Friedman S, et al. Recovery of epinephrine response but not hypoglycemic symptom threshold after intensive therapy in type 1 diabetes. Am J Med 1994;97:535-42. source
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [38] 38. Liu D, McManus RM, Ryan EA. Improved counter-regulatory hormonal and symp- tomatic responses to hypoglycemia in patients with insulin-dependent diabe- tes mellitus after 3 months of less strict glycemic control. Clin Invest Med 1996;19:71-82.
• ?Not checked — no full text of the sourcecites [39] 39. Lingenfelser T, Buettner U, Martin J, et al. Improvement of impaired counterregulatory hormone response and symptom perception by short-term avoidance of hypoglycemia in IDDM. Diabetes Care 1995;18:321-5. source

In the paper

“In people with type 2 diabetes and established, or very high risk for, cardiovascular disease (CVD), there is a clear association between an increased mortality and severe hypoglycemia (62,63) and symptomatic hypoglycemia (64).”

What the sources say

• ?Could not verify

  The cited paper's discussion of treatment harms (section headed “Table 1. Baseline Characteristics,” page not provided) mentions hypoglycemia as a possible side effect, while its mortality results compare intensive with standard glucose control. Neither passage examines whether symptomatic hypoglycemia is associated with increased mortality. Searches for “hypoglycemia” and “symptomatic hypoglycemia risk of death association” found no such analysis in our copy. (LLM, conf=0.77)

  cites [62] 62. Hayward RA, Reaven PD, Wiitala WL, et al. Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2015;372:2197- 206. sourceExperimental — accuracy not yet measured
• Partly supported

  The Discussion (p. 6) clearly reports an association between severe hypoglycemia and increased mortality. But the Study Population section (p. 3) includes patients with microvascular disease or just one other cardiovascular risk factor, so it does not establish that all participants had established CVD or were at very high CVD risk. The symptomatic-hypoglycemia part is attributed to citation 64, not this paper. (LLM, conf=0.82)

  cites [63] 63. Zoungas S, Patel A, Chalmers J, et al. Severe hypoglycemia and risks of vascular events and death. N Engl J Med 2010;363:1410-18. sourceExperimental — accuracy not yet measured
• Supported

  The Abstract reports that symptomatic, severe hypoglycaemia was associated with an increased risk of death within each ACCORD study arm. Its Participants section describes people with type 2 diabetes and established cardiovascular disease or substantial cardiovascular risk. The cited paper supports the severe-hypoglycaemia portion of the sentence; the separate citation (64) is attached to symptomatic hypoglycaemia. (LLM, conf=0.93)

  cites [64] 64. Bonds DE, Miller ME, Bergenstal RM, et al. The association between symptom- atic, severe hypoglycaemia and mortality in type 2 diabetes: Retrospective epi- demiological analysis of the ACCORD study. BMJ 2010;340:b4909. source

In the paper

“Risk factors for hypoglycemia in people with type 2 diabetes include advancing age (18), severe cognitive impairment (19), poor health literacy (20), food insecurity (21), increased A1C (18,22), hypoglycemia unawareness (23), duration of insulin therapy, renal impairment and neuropathy (22).”

What the sources say

• Partly supported

  The Principal findings section reports increased risk with peripheral neuropathy and markers of renal dysfunction. It also reports an association with higher baseline A1C, but after adjustment this was seen only in the standard-treatment group. The paper identifies insulin use and longer duration of diabetes as risk factors, not duration of insulin therapy; the other factors in the sentence are assigned to different citations. (LLM, conf=0.88)

  cites [18] 18. Miller ME, Bonds DE, Gerstein HC, et al. The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: Post hoc epidemiological analysis of the ACCORD study. BMJ 2010;340:b5444. sourceExperimental — accuracy not yet measured
• Supported

  Citation (19) is attached specifically to severe cognitive impairment, not to the sentence’s other listed risk factors. The Discussion (p. 7) reports that patients with severe cognitive dysfunction had twice the risk of severe hypoglycaemia compared with patients with normal cognitive function. (LLM, conf=0.95)

  cites [19] 19. de Galan BE, Zoungas S, Chalmers J, et al. Cognitive function and risks of car- diovascular disease and hypoglycaemia in patients with type 2 diabetes: The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Diabetologia 2009;52:2328-36. source
• Supported

  Citation (20) is attached specifically to poor health literacy, not to the other risk factors in the sentence. The paper’s Results report that three measures of limited health literacy were independently associated with significant hypoglycemia after adjustment (page not specified in our copy). (LLM, conf=0.94)

  cites [20] 20. Sarkar U, Karter AJ, Liu JY, et al. Hypoglycemia is more common among type 2 diabetes patients with limited health literacy: The Diabetes Study of Northern California (DISTANCE). J Gen Intern Med 2010;25:962-8. source

In the paper

“Islet cell transplantation, which has been shown to reduce hypoglycemia (48) and restore glucose counter-regulation (49), should be considered for people with type 1 diabetes who experience recurrent severe hypoglycemia (50)”

What the sources say

• ?Not checked — no full text of the sourcecites [48] 48. Hering BJ, Clarke WR, Bridges ND, et al. Phase 3 trial of transplantation of human islets in type 1 diabetes complicated by severe hypoglycemia. Diabetes Care 2016;39:1230-40. source
• Supported

  Citation (49) is attached to the claim that islet transplantation restores glucose counter-regulation. In the section ‘Recovery of glucose counterregulation by islet transplantation’ (page unavailable), the paper reports recovery of hormonal responses and normalized counterregulatory thresholds, while noting that glucagon recovery is partial. The separate hypoglycemia-reduction claim is attached to citation (48). (LLM, conf=0.90)

  cites [49] 49. Rickels MR. Recovery of endocrine function after islet and pancreas transplan- tation. Curr Diab Rep 2012;12:587-96. source

In the paper

“Acute hypoglycemia is proinflammatory, increases platelet activation and decreases fibrinolysis, leading to a prothrombotic state (65,66).”

What the sources say

• Partly supported

  The Results and Conclusions (page unavailable) report increased inflammatory markers and platelet activation after acute hypoglycemia, and discuss possible adverse vascular consequences. They do not establish decreased fibrinolysis or demonstrate that these changes led to a prothrombotic state; tPA antigen was reported as rising nonsignificantly in nondiabetic participants during hypoglycemia. (LLM, conf=0.87)

  cites [65] 65. Wright RJ, Newby DE, Stirling D, et al. Effects of acute insulin-induced hypo- glycemia on indices of inflammation: Putative mechanism for aggravating vas- cular disease in diabetes. Diabetes Care 2010;33:1591-7. sourceExperimental — accuracy not yet measured
• Supported

  The Conclusions report that acute moderate hypoglycemia activated proinflammatory mechanisms, increased a marker of platelet activation, and decreased fibrinolytic balance in people with type 1 diabetes and healthy controls. The paper describes these changes as activating prothrombotic mechanisms; it does not establish a long-term thrombotic outcome. (LLM, conf=0.94)

  cites [66] 66. Gogitidze Joy N, Hedrington MS, Briscoe VJ, et al. Effects of acute hypoglyce- mia on inflammatory and pro-atherothrombotic biomarkers in individuals with type 1 diabetes and healthy individuals. Diabetes Care 2010;33:1529- 35. source

In the paper

“Hypoglycemia is associated with increased heart rate, systolic blood pressure (BP), myocardial contractility, stroke volume and cardiac output, and can induce ST-and T-wave changes with a lengthening of the QT interval (slower repolarization), which may increase the risk of arrhythmias (67)(68)(69)(70)(71).”

What the sources say

• Partly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  cites [67] 67. Koivikko ML, Karsikas M, Salmela PI, et al. Effects of controlled hypoglycaemia on cardiac repolarisation in patients with type 1 diabetes. Diabetologia 2008;51:426-35. sourceExperimental — accuracy not yet measured
• ?Not checked — no full text of the sourcecites [68] 68. Kubiak T, Wittig A, Koll C, et al. Continuous glucose monitoring reveals asso- ciations of glucose levels with QT interval length. Diabetes Technol Ther 2010;12:283-6. source
• ?Not checked — no full text of the sourcecites [69] 69. Wright RJ, Frier BM. Vascular disease and diabetes: Is hypoglycaemia an aggravating factor? Diabetes Metab Res Rev 2008;24:353-63. source
• Supported

  Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  cites [70] 70. Frier BM, Schernthaner G, Heller SR. Hypoglycemia and cardiovascular risks. Dia- betes Care 2011;34(Suppl. 2):S132-7. source
• ?Not checked — no full text of the sourcecites [71] 71. Stahn A, Pistrosch F, Ganz X, et al. Relationship between hypoglycemic epi- sodes and ventricular arrhythmias in patients with type 2 diabetes and cardio- vascular diseases: Silent hypoglycemias and silent arrhythmias. Diabetes Care 2014;37:516-20. source

In the paper

“Similarly, pancreas transplantation has been shown to reduce hypoglycemia and restore glucose counter-regulation (43,(51)(52)(53).”

What the sources say

• ?Not checked — no full text of the sourcecites [43] 43. van Dellen D, Worthington J, Mitu-Pretorian OM, et al. Mortality in diabetes: Pancreas transplantation is associated with significant survival benefit. Nephrol Dial Transplant 2013;28:1315-22. source
• ?Not checked — no full text of the sourcecites [51] 51. Kendall DM, Rooney DP, Smets YF, et al. Pancreas transplantation restores epi- nephrine response and symptom recognition during hypoglycemia in patients with long-standing type I diabetes and autonomic neuropathy. Diabetes 1997;46:249-57. source
• ?Not checked — no full text of the sourcecites [52] 52. Paty BW, Lanz K, Kendall DM, et al. Restored hypoglycemic counterregulation is stable in successful pancreas transplant recipients for up to 19 years after trans- plantation. Transplantation 2001;72:1103-7. source
• ?Not checked — no full text of the sourcecites [53] 53. Barrou Z, Seaquist ER, Robertson RP. Pancreas transplantation in diabetic humans normalizes hepatic glucose production during hypoglycemia. Diabetes 1994;43:661-6. source

In the paper

“Structured educational and psycho-behavioural programs (e.g.BG awareness training) may help improve detection of hypoglycemia and reduce the frequency of severe hypoglycemia (40)(41)(42)(43).”

What the sources say

• ?Not checked — no full text of the sourcecites [40] 40. Kinsley BT, Weinger K, Bajaj M, et al. Blood glucose awareness training and epi- nephrine responses to hypoglycemia during intensive treatment in type 1 dia- betes. Diabetes Care 1999;22:1022-8. source
• ?Not checked — no full text of the sourcecites [41] 41. Schachinger H, Hegar K, Hermanns N, et al. Randomized controlled clinical trial of Blood Glucose Awareness Training (BGAT III) in Switzerland and Germany. J Behav Med 2005;28:587-94. source
• ?Not checked — no full text of the sourcecites [42] 42. Yeoh E, Choudhary P, Nwokolo M, et al. Interventions that restore awareness of hypoglycemia in adults with type 1 diabetes: A systematic review and meta- analysis. Diabetes Care 2015;38:1592-609. source
• ?Not checked — no full text of the sourcecites [43] 43. van Dellen D, Worthington J, Mitu-Pretorian OM, et al. Mortality in diabetes: Pancreas transplantation is associated with significant survival benefit. Nephrol Dial Transplant 2013;28:1315-22. source

In the paper

“Frequent hypoglycemia can decrease normal responses to hypoglycemia (12) and lead to defective glucose counter-regulation and hypoglycemia unawareness.”

What the sources say

• ?Not checked — no full text of the sourcecites [12] 12. Davis EA, Keating B, Byrne GC, et al. Hypoglycemia: Incidence and clinical pre- dictors in a large population-based sample of children and adolescents with IDDM. Diabetes Care 1997;20:22-5. source

In the paper

“People with diabetes who continue to have frequent and severe hypoglycemia and/or impaired awareness of hypoglycemia, despite educational interventions, may benefit from continuous subcutaneous insulin infusion (CSII) therapy or continuous glucose monitoring (CGM) or both (i.e. a sensor augmented pump), to reduce the risk of severe hypoglycemia (44)(45)(46)(47).”

What the sources say

• ?Not checked — no full text of the sourcecites [44] 44. Ly TT, Nicholas JA, Retterath A, et al. Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: A randomized clinical trial. JAMA 2013;310:1240-7. source
• ?Not checked — no full text of the sourcecites [45] 45. Little SA, Leelarathna L, Walkinshaw E, et al. Recovery of hypoglycemia aware- ness in long-standing type 1 diabetes: A multicenter 2 x 2 factorial random- ized controlled trial comparing insulin pump with multiple daily injections and continuous with conventional glucose self-monitoring (HypoCOMPaSS). Diabetes Care 2014;37:2114-22. source
• ?Not checked — no full text of the sourcecites [46] 46. Bergenstal RM, Klonoff DC, Garg SK, et al. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med 2013;369:224- 32. source
• ?Not checked — no full text of the sourcecites [47] 47. van Beers CAJ, DeVries JH, Kleijer SJ, et al. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): A randomised, open-label, crossover trial. Lancet Diabetes Endocrinol 2016;4:893-902. source

In the paper

“Glucose gel is quite slow (<1.0 mmol/L increase at 20 minutes) and must be swallowed to have a significant effect (73)(74)(75)(76)(77)(78).”

What the sources say

• ?Not checked — no full text of the sourcecites [73] 73. Slama G, Traynard PY, Desplanque N, et al. The search for an optimized treatment of hypoglycemia. carbohydrates in tablets, solutin, or gel for the correction of insulin reactions. Arch Intern Med 1990;150:589-93. source
• ?Not checked — no full text of the sourcecites [74] 74. Wiethop BV, Cryer PE. Alanine and terbutaline in treatment of hypoglycemia in IDDM. Diabetes Care 1993;16:1131-6. source
• ?Not checked — no full text of the sourcecites [75] 75. Brodows RG, Williams C, Amatruda JM. Treatment of insulin reactions in dia- betics. JAMA 1984;252:3378-81. source
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [76] 76. Skyler JS (Ed.): Medical Management of Type 1 Diabetes. 3rd ed. Alexandria, VA, American Diabetes Association, 1998. pg. 134-43.
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [77] 77. Canadian Diabetes Association. The role of dietary sugars in diabetes mellitus. Beta Release 1991;15:117-23.
• ?Not checked — no full text of the sourcecites [78] 78. Gunning RR, Garber AJ. Bioactivity of instant glucose. Failure of absorption through oral mucosa. JAMA 1978;240:1611-12. source

In the paper

“Other choices, such as milk and orange juice, are slower to increase BG levels and provide symptom relief (74,75).”

What the sources say

• ?Not checked — no full text of the sourcecites [74] 74. Wiethop BV, Cryer PE. Alanine and terbutaline in treatment of hypoglycemia in IDDM. Diabetes Care 1993;16:1131-6. source
• ?Not checked — no full text of the sourcecites [75] 75. Brodows RG, Williams C, Amatruda JM. Treatment of insulin reactions in dia- betics. JAMA 1984;252:3378-81. source

In the paper

“People taking an alpha glucosidase inhibitor (acarbose) must use glucose (dextrose) tablets (79) or, if unavailable, milk or honey to treat hypoglycemia.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [79] 79. Glucobay® (acarbose) [product monograph]. Toronto: Bayer Inc, 2007.

In the paper

“The effectiveness of glucagon is reduced in individuals who have consumed more than 2 standard alcoholic drinks in the previous few hours, after prolonged fasting, or in those who have advanced hepatic disease (81,82).”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [81] 81. Glucagon [product monograph]. Toronto: Eli Lilly Canada, Inc, 2007.
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [82] 82. GlucaGen® (glucagon) [product monograph]. Bagsvaerd: Novo Nordisk, 2002.