Identification of type I diabetic patients at increased risk for hypoglycemia during intensive therapy
NH White, DA Skor, PE Cryer… - … England Journal of …, 1983 - Mass Medical Soc
NH White, DA Skor, PE Cryer, LA Levandoski, DM Bier, JV Santiago
New England Journal of Medicine, 1983•Mass Medical SocDuring intravenous insulin infusions (40 mU per kilogram of body weight per hour for up to
100 minutes), 9 of 22 patients with insulin-requiring diabetes mellitus had neurologic signs
or symptoms of hypoglycemia, plasma glucose concentrations that were below 35 mg per
deciliter (1.9 mmol per liter) and continued to decline, or both. This inadequate glucose
counterregulation resulted from the combined effect of deficient glucagon and epinephrine
responses. In 8 of the 9 patients with inadequate counterregulation severe hypoglycemia …
100 minutes), 9 of 22 patients with insulin-requiring diabetes mellitus had neurologic signs
or symptoms of hypoglycemia, plasma glucose concentrations that were below 35 mg per
deciliter (1.9 mmol per liter) and continued to decline, or both. This inadequate glucose
counterregulation resulted from the combined effect of deficient glucagon and epinephrine
responses. In 8 of the 9 patients with inadequate counterregulation severe hypoglycemia …
Abstract
During intravenous insulin infusions (40 mU per kilogram of body weight per hour for up to 100 minutes), 9 of 22 patients with insulin-requiring diabetes mellitus had neurologic signs or symptoms of hypoglycemia, plasma glucose concentrations that were below 35 mg per deciliter (1.9 mmol per liter) and continued to decline, or both. This inadequate glucose counterregulation resulted from the combined effect of deficient glucagon and epinephrine responses.
In 8 of the 9 patients with inadequate counterregulation severe hypoglycemia developed during subsequent intensive therapy, whereas such episodes occurred in only 1 of 13 patients with adequate counterregulation. Thus, an intravenous insulin-infusion test can prospectively identify patients who are at increased risk for recurrent severe hypoglycemia during intensive therapy for diabetes. (N Engl J Med. 1983; 308:485–91.)
The New England Journal Of Medicine