Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in...Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in approximately 40% of people with type 1 diabetesmellitus(T1DM) and with less frequency in T2 DM.Though the aetiology of HU is multifactorial,possible mechanisms include chronic exposure to low blood glucose,antecedent hypoglycaemia,recurrent severe hypoglycaemia and the failure of counter-regulatory hormones.Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms,but the mechanisms and mediators remain largely unknown.Prevention and management of HU is complex,and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team.Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes.Several medications are thought to worsen or promote HU,whereas others may have an attenuating effect on the problem.This article reviews recent advances in how the brain senses and responds to hypoglycaemia,novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses.The consequences that HU has on the person with diabetes and their family are also described.Finally,it examines the evidence for prevention and treatment of HU,and summarizes the effects of medications that may influence it.展开更多
目的分析低血糖察觉意识受损(IAH)相关研究的现状、热点及前沿。方法采用CiteSpace5.7.R5软件对Web of Science(WOS)核心集、PubMed和Scopus数据库1991年1月1日—2021年3月15日收录的关于IAH文献进行可视化分析。结果共检索IAH相关文献...目的分析低血糖察觉意识受损(IAH)相关研究的现状、热点及前沿。方法采用CiteSpace5.7.R5软件对Web of Science(WOS)核心集、PubMed和Scopus数据库1991年1月1日—2021年3月15日收录的关于IAH文献进行可视化分析。结果共检索IAH相关文献593篇,最终共纳入209篇文献进行可视化分析。发文量表现为缓慢、平稳和快速增长共3个阶段;英美国家、学者奠定了该领域研究的基础;各研究机构之间合作密切;国际间合作频率呈现不平衡现象。研究内容主要集中在IAH不良影响、IAH技术干预及结构化教育的研究与探讨。结论国外IAH相关研究开展较早且相对成熟,国内在该领域尚处于起步阶段,建议中国临床科研人员加强IAH相关研究,实施有效干预措施,改善低血糖患者不良结局。展开更多
文摘Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in approximately 40% of people with type 1 diabetesmellitus(T1DM) and with less frequency in T2 DM.Though the aetiology of HU is multifactorial,possible mechanisms include chronic exposure to low blood glucose,antecedent hypoglycaemia,recurrent severe hypoglycaemia and the failure of counter-regulatory hormones.Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms,but the mechanisms and mediators remain largely unknown.Prevention and management of HU is complex,and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team.Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes.Several medications are thought to worsen or promote HU,whereas others may have an attenuating effect on the problem.This article reviews recent advances in how the brain senses and responds to hypoglycaemia,novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses.The consequences that HU has on the person with diabetes and their family are also described.Finally,it examines the evidence for prevention and treatment of HU,and summarizes the effects of medications that may influence it.
文摘目的分析低血糖察觉意识受损(IAH)相关研究的现状、热点及前沿。方法采用CiteSpace5.7.R5软件对Web of Science(WOS)核心集、PubMed和Scopus数据库1991年1月1日—2021年3月15日收录的关于IAH文献进行可视化分析。结果共检索IAH相关文献593篇,最终共纳入209篇文献进行可视化分析。发文量表现为缓慢、平稳和快速增长共3个阶段;英美国家、学者奠定了该领域研究的基础;各研究机构之间合作密切;国际间合作频率呈现不平衡现象。研究内容主要集中在IAH不良影响、IAH技术干预及结构化教育的研究与探讨。结论国外IAH相关研究开展较早且相对成熟,国内在该领域尚处于起步阶段,建议中国临床科研人员加强IAH相关研究,实施有效干预措施,改善低血糖患者不良结局。
