Clinical approaches to treat impaired awareness of hypoglycaemia

Farrell, Catriona M.; McCrimmon, Rory J.

doi:10.1177/20420188211000248

Cited by 31Diabetes Management and ResearchDiabetes Management and EducationPatient Safety and Medication Errors

Clinical approaches to treat impaired awareness of hypoglycaemia

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Farrell, Catriona M., McCrimmon, Rory J.·2021·Therapeutic Advances in Endocrinology and Metabolism

DOI 10.1177/20420188211000248PMC PMC7968015

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Abstract

Impaired awareness of hypoglycaemia (IAH) affects between 25% and 30% of all people with type 1 diabetes (T1D) and markedly increases risk of severe hypoglycaemia. This greatly feared complication of T1D impairs quality of life and has a recognised morbidity. People with T1D have an increased propensity to hypoglycaemia as a result of fundamental physiological defects in their ability to respond appropriately to a fall in blood glucose levels. With repeated exposure to low glucose, many then develop a condition referred to as IAH, where there is a reduced ability to perceive the onset of hypoglycaemia and take appropriate corrective action. The management of individuals with IAH relies initially on its identification in the clinic through a detailed exploration of the frequency of hypoglycaemia and an assessment of the individual's ability to recognise these episodes. In this review article, we will address the clinical strategies that may help in the management of the patient with IAH once identified, who may or may not also suffer from problematic hypoglycaemia. The initial focus is on how to identify such patients and then on the variety of approaches involving educational programmes and technological approaches that may be taken to minimise hypoglycaemia risk. No single approach can be advocated for all patients, and it is the role of the health care professional to identify the clinical strategy that best enables their patient to achieve this goal.

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Teaching people with diabetes to balance insulin use and carbohydrate intake and physical activity are necessary, but these strategies are not always sufficient for prevention.
“Teaching people with diabetes to balance insulin use and carbohydrate intake and physical activity are necessary, but these strategies are not always sufficient for prevention (77,(103)(104)(105).”
From 6. Glycemic Targets: Standards of Care in Diabetes—2023 (2023) · cites this paper as [104]

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Wu, C., Wang, W., Cheng, S., Zhang, H., Li, L., Tian, C., Zhang, L., Chen, N., Du, J., Ren, L., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04698-9 · Cited by 12 · see citing works
Automated detection of hypoglycemia-induced EEG changes recorded by subcutaneous electrodes in subjects with type 1 diabetes—The brain as a biosensor
Juhl, C. B., Højlund, K., Madsen, R. E., Poulsen, M. K., Selmar, P. E., Holst, J. J., Christiansen, C., & Beck‐Nielsen, H. (2010) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2010.01.007 · Cited by 53 · see citing works
Management of hypoglycemia
Kapoor, N., Jagan, J., & Thomas, N. (2017) · Current Medical Issues · doi:10.4103/cmi.cmi_66_17

Authors: Farrell, C. M., & McCrimmon, R. J.
Affiliations: University of Dundee (GB)
Corresponding author: McCrimmon, Rory J.
ORCID: Farrell, Catriona M.
McCrimmon, Rory J.
Venue: Therapeutic Advances in Endocrinology and Metabolism
Publisher: SAGE Publications
Published: 2021-01
Volume: 12
Pages: 20420188211000248-20420188211000248
ISSN: 2042-0188 (ISSN-L)
2042-0196
DOI: 10.1177/20420188211000248
PMC: PMC7968015
OpenAlex: W3138296315
Cited by: 31
References: 69
Citations by year: 2026: 1 · 2025: 8 · 2024: 8 · 2023: 4 · 2022: 6 · 2021: 4
FWCI: 0.84
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/4.0/ (unspecified)
Locations: Therapeutic Advances in Endocrinology and Metabolism (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Discovery Research Portal (University of Dundee) (submittedVersion, cc-by-nc)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Diabetes UK (17/0005591)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords: impaired awareness of hypoglycaemia, type 1 diabetes, hypoglycemia, hypoglycemia risk

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Clinical approaches to treat impaired awareness of hypoglycaemia

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