You are not logged in.

Severe hypoglycaemia in type 1 diabetes mellitus: underlying drivers and potential strategies for successful prevention

Little,SA, Leelarathna,L, Barendse,SM, Walkinshaw,E, Tan,HK, Lubina Solomon,A, de Zoysa,N, Rogers,H, Choudhary,P, Amiel,SA, Heller,SR, Evans,M, Flanagan,D, Speight,J and Shaw,JA 2014, Severe hypoglycaemia in type 1 diabetes mellitus: underlying drivers and potential strategies for successful prevention, Diabetes/metabolism research and reviews, vol. 30, no. 3, pp. 175-190, doi: 10.1002/dmrr.2492.

Attached Files
Name Description MIMEType Size Downloads

Title Severe hypoglycaemia in type 1 diabetes mellitus: underlying drivers and potential strategies for successful prevention
Author(s) Little,SA
Leelarathna,L
Barendse,SM
Walkinshaw,E
Tan,HK
Lubina Solomon,A
de Zoysa,N
Rogers,H
Choudhary,P
Amiel,SA
Heller,SR
Evans,M
Flanagan,D
Speight,JORCID iD for Speight,J orcid.org/0000-0002-1204-6896
Shaw,JA
Journal name Diabetes/metabolism research and reviews
Volume number 30
Issue number 3
Start page 175
End page 190
Publisher John Wiley & Sons
Place of publication Chichester, England
Publication date 2014-03
ISSN 1520-7560
Keyword(s) hypoglycaemia
impaired awareness of hypoglycaemia
type 1 diabetes
Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
INTENSIVE INSULIN THERAPY
TREAT-TO-TARGET
BASAL-BOLUS REGIMEN
NEUTRAL PROTAMINE HAGEDORN
GLUCOSE MONITORING-SYSTEM
IMPROVED GLYCEMIC CONTROL
AUGMENTED PUMP THERAPY
AUTONOMIC NEUROPATHY
NPH INSULIN
NOCTURNAL HYPOGLYCEMIA
Summary Hypoglycaemia remains an over-riding factor limiting optimal glycaemic control in type 1 diabetes. Severe hypoglycaemia is prevalent in almost half of those with long-duration diabetes and is one of the most feared diabetes-related complications. In this review, we present an overview of the increasing body of literature seeking to elucidate the underlying pathophysiology of severe hypoglycaemia and the limited evidence behind the strategies employed to prevent episodes. Drivers of severe hypoglycaemia including impaired counter-regulation, hypoglycaemia-associated autonomic failure, psychosocial and behavioural factors and neuroimaging correlates are discussed. Treatment strategies encompassing structured education, insulin analogue regimens, continuous subcutaneous insulin infusion pumps, continuous glucose sensing and beta-cell replacement therapies have been employed, yet there is little randomized controlled trial evidence demonstrating effectiveness of new technologies in reducing severe hypoglycaemia. Optimally designed interventional trials evaluating these existing technologies and using modern methods of teaching patients flexible insulin use within structured education programmes with the specific goal of preventing severe hypoglycaemia are required. Individuals at high risk need to be monitored with meticulous collection of data on awareness, as well as frequency and severity of all hypoglycaemic episodes.
Language eng
DOI 10.1002/dmrr.2492
Field of Research 170106 Health, Clinical and Counselling Psychology
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, John Wiley & Sons
Persistent URL http://hdl.handle.net/10536/DRO/DU:30069561

Document type: Journal Article
Collection: School of Psychology
Connect to link resolver
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 11 times in TR Web of Science
Scopus Citation Count Cited 10 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 146 Abstract Views, 1 File Downloads  -  Detailed Statistics
Created: Tue, 10 Feb 2015, 14:24:48 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.