The DOI matches its Crossref record; 76 of the 76 references it cites were found in a registry or an index.
Hypoglycemia-associated autonomic failure in diabetes
Abstract
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 reducing the autonomic and the resulting neurogenic symptom responses) and thus a vicious cycle of recurrent hypoglycemia. Perhaps the most compelling support for HAAF is the finding that as little as 2-3 wk of scrupulous avoidance of hypoglycemia reverses hypoglycemia unawareness and improves the reduced epinephrine component of defective glucose counterregulation in most affected individuals. Insight into this pathophysiology has led to a broader view of the clinical risk factors for hypoglycemia to include indexes of compromised glucose counterregulation and provided a framework for the study of the mechanisms of iatrogenic hypoglycemia and, ultimately, its elimination from the lives of people with diabetes.
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“However, recent antecedent hypoglycemic episodes do not increase these mechanisms with a higher blood-to-brain glucose transport.”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [18]
In the citing paper
“Dysfunction in these processes can lead to altered brain glucose sensing, which has far-reaching consequences on neuronal activity and overall brain physiology and can contribute to hypoglycemia unawareness syndrome [ 10 , 18 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [18]
In the citing paper
“Consequently, a vicious cycle of recurrent hypoglycemia with the potential for serious complications can occur [ 18 , 19 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [18]
In the citing paper
“Hypoglycemia unawareness syndrome is commonly observed in individuals with recurrent hypoglycemic episodes disrupting the normal release of counterregulatory hormones, such as glucagon, growth hormone (GH), and epinephrine.”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [18]
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Metadata
- Authors
- Cryer, P. E.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Cryer, Philip E.
- Venue
- American Journal of Physiology-Endocrinology and Metabolism
- Publisher
- American Physiological Society
- Published
- 2001-12-01
- Volume
- 281
- Issue
- 6
- Pages
- E1115-E1121
- ISSN
- 0193-1849 (ISSN-L)
- 1522-1555
- OpenAlex
- W1931223844
- Cited by
- 152
- References
- 76
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 8 · 2020: 10 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 5 · 2015: 10 · 2014: 10 · 2013: 9 · 2012: 8
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p60dk020579-35)
- National Institute of Diabetes and Digestive and Kidney Diseases (R37DK027085, P60-DK20579, R37-DK27085, T32 DK07120, T32DK007120)
- National Center for Research Resources (M01-RR00036, M01RR000036)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- hypoglycemia-associated autonomic failure, iatrogenic hypoglycemia, diabetes mellitus, glucose counterregulation, hypoglycemia unawareness, epinephrine response, glucagon response, neurogenic symptoms, glycemic control, hypoglycemia risk factors
- MeSH terms
- Animals, Autonomic Nervous System Diseases, Diabetes Mellitus, Glucose, Humans, Hypoglycemia, Diabetes Complications
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