Fasting Hypoglycaemia and Postprandial Hyperglycaemia as a Prodrome of Type 1 Diabetes Mellitus
Abstract
The pathophysiology of type 1 diabetes mellitus (DM) involves the selective autoimmune destruction of the pancreatic beta-cells [Pihoker et al.: Diabetes 2005;54(suppl 2):S52-S61]. The onset of type 1 DM is characterised by hyperglycaemia. Islet cell antibody (ICA), anti-insulin, anti-glutamic acid decarboxylase and the antibody against tyrosine phosphatase-like protein known as ICA-512 (IA-2) usually appear before the clinical onset of DM and are markers of the autoimmune process. Hypoglycaemia in type 1 DM is a common complication and a result of the interaction between excess insulin administration and a compromised glucose counterregulatory hormonal response [Cryer: Endocrinol Metab Clin North Am 2010;39:641-654]. Spontaneous fasting hypoglycaemia alternating with hyperglycaemia prior to the onset of antibody-positive type 1 DM has not been described before.
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Presymptomatic stage 1 and 2 T1D-associated hypoglycemia has been more frequently reported in children, where predominantly postprandial and transient episodes appeared associated with preserved endogenous insulin secretion before progression to overt diabetes.
“In contrast, presymptomatic stage 1 and 2 T1D-associated hypoglycemia has been more frequently reported in children, where predominantly postprandial and transient episodes appeared associated with preserved endogenous insulin secretion before progression to overt diabetes (3,4).”
From Reactive Hypoglycemia as a Transient Metabolic Phenotype of Stage 1 and 2 Type 1 Diabetes (2026) · cites this paper as [3]
Cites
Hypoglycemia in Type 1 Diabetes Mellitus
Cryer, P. E. (2010) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2010.05.003 · Cited by 205 · see citing works
Bolli, G., De Feo, P., Perriello, G., De Cosmo, S., Compagnucci, P., Santeusanio, F., Brunetti, P., & Unger, R. H. (1984) · Journal of Clinical Investigation · doi:10.1172/jci111315 · Cited by 64 · see citing works
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Reactive Hypoglycemia as a Transient Metabolic Phenotype of Stage 1 and 2 Type 1 Diabetes
Dreves, B., & Joubert, M. (2026) · Diabetes Care · doi:10.2337/dc26-0921
- Authors
- Rafeullah, N., Cackett, N., & Hussain, K.
- Affiliations
- Great Ormond Street Hospital (GB)
- Colchester Hospital (GB)
- ORCID
- Hussain, Khalid
- Venue
- Hormone Research in Paediatrics
- Publisher
- S. Karger AG
- Published
- 2012
- Volume
- 78
- Issue
- 5-6
- Pages
- 332-335
- ISSN
- 1663-2818 (ISSN-L)
- 1663-2826
- OpenAlex
- W2062644254
- Cited by
- 7
- References
- 2
- Citations by year
- 2026: 2 · 2025: 1 · 2021: 1 · 2018: 2 · 2016: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hormone Research in Paediatrics (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- type 1 diabetes, fasting hypoglycaemia, postprandial hyperglycemia, islet autoimmunity, islet cell antibodies, IA-2 autoantibodies, glucose counterregulation, insulin therapy complications
- MeSH terms
- Blood Glucose, Child, Child, Preschool, Diabetes Mellitus, Type 1, Fasting, Glucose Tolerance Test, Humans, Hyperglycemia, Hypoglycemia, Male, Insulin, Long-Acting
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