en POLSKI
eISSN: 2083-8441
ISSN: 2081-237X
Pediatric Endocrinology Diabetes and Metabolism
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
Editorial Policies
Sarajevo Declaration on Integrity and Visibility of Scholarly Publications

Open access

without publication fees

Journal integrated with

integrated with publons
3/2018
vol. 24
 
Share:
Send email
Share:
abstract:
Review paper

Hypoglycaemia unawareness in patients with type 1 diabetes

Agnieszka Szadkowska
1
,
Katarzyna Czyżewska
1
,
Iwona Pietrzak
1
,
Beata Mianowska
2
,
Przemysława Jarosz-Chobot
3
,
Małgorzata Myśliwiec
4

  1. Department of Preservative Nursing, Medical University of Lodz, Poland
  2. Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland
  3. Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical University of Silesia, Poland
  4. Chair and Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Poland
Pediatr Endocrinol Diabetes Metab 2018; 24 (3): 126-134
DOI: https://doi.org/10.5114/pedm.2018.80994
Online publish date: 2018/12/23
View full text Get citation
 
PlumX metrics:
Hypoglycaemia unawareness, defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms, is an serious problem in type 1 diabetes mellitus. It is often caused by recurrent or severe hypoglycaemia, which leads to the failure of the autonomic nervous system (hypoglycaemia-associated autonomic failure – HAAF). The hypoglycaemia awareness can be restored by avoiding episodes of hypoglycaemia. Management of hypoglycaemia unawareness is complex, and can only be achieved by a multifactorial intervention of clinical care and structured patient education. In patients in whom functional intensive insulin therapy with insulin analogue, continuous subcutaneous insulin infusion using insulin pumps are ineffective in the prevention of hypoglycaemia the implementation of continuous glucose monitoring (CGM) is advisable. CGM systems equipped with low glucose alarms and prediction alarms not only significantly reduce the risk of severe hypoglycaemia, but also significantly reduce the fear of hypoglycaemia and improve the quality of life of patients and their families. The insulin pumps integrated with CGM automatically suspending insulin infusion when glucose is predicted to soon be low (PLGS) should be preferred in patient with hypoglycaemia unawareness. Hypoglycaemia management is complex and should also include structural education. Particular attention should be paid to the management of hypoglycaemia and appropriate use of modern therapy.

The hypoglycaemia unawareness is very common among children under the age of 6 years who are unable to observe the early symptoms of hypoglycemia by themselves. This induces a high risk of frequent and severe hypoglycaemia, which can lead to structural changes in the brain, cognitive dysfunctions, poor mental abilities and behavioral disorders later in life.
keywords:

type 1 diabetes, hypoglycaemia unawareness, continuous glucose monitoring, insulin pump

Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2024 Termedia Sp. z o.o.
Developed by Bentus.