[1]王雅静,方彭华,张真稳.2型糖尿病患者低血糖感知受损的研究进展[J].国际内分泌代谢杂志,2023,43(02):132-135.[doi:10.3760/cma.j.cn121383-20211206-12012]
 Wang Yajing,Fang Penghua,Zhang Zhenwen..Research progress of impaired perception of hypoglycemia in patients with type 2 diabetes[J].International Journal of Endocrinology and Metabolism,2023,43(02):132-135.[doi:10.3760/cma.j.cn121383-20211206-12012]
点击复制

2型糖尿病患者低血糖感知受损的研究进展()
分享到:

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
43
期数:
2023年02期
页码:
132-135
栏目:
综述
出版日期:
2023-03-20

文章信息/Info

Title:
Research progress of impaired perception of hypoglycemia in patients with type 2 diabetes
作者:
王雅静1方彭华2张真稳1
1扬州大学临床医学院内分泌科,扬州 225001; 2南京中医药大学第一临床医学院临床医学实验研究中心,南京 210023
Author(s):
Wang Yajing1 Fang Penghua2 Zhang Zhenwen1.
1Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou 225001, China; 2The Experimental Research Center of Clinical Medicine, the First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
关键词:
2型糖尿病 低血糖感知受损 严重低血糖
Keywords:
Type 2 diabetes mellitus Impaired awareness of hypoglycaemia Severe hypoglycaemia
DOI:
10.3760/cma.j.cn121383-20211206-12012
摘要:
低血糖感知受损指患者对低血糖的感知能力减弱或缺失的一种现象。目前,低血糖感知受损的评估主要为葡萄糖钳夹实验及问卷法,近年研究发现负反馈调节异常、中枢及周围神经系统调节异常均可能参与了低血糖感知受损的发生。连续血糖监测等手段也为低血糖感知受损的缓解提供新的方向。现对2型糖尿病患者的低血糖感知受损的评估、发生机制等研究进展进行综述。
Abstract:
Impaired awareness of hypoglycaemia is a phenomenon among patients with diabetes mellitus who weaken or lost their ability to perceive hypoglycemia symptoms. At present, the assessment of impaired awareness of hypoglycaemia mainly based on hyperinsulinemic-euglycemic clamp study and questionnaire. Recent studies have found that abnormal negative feedback regulation, abnormal central and peripheral nervous system regulation are probably involved in impaired awareness of hypoglycaemia, and continuous glucose monitoring also provide new directions for its treatment. This paper reviews the new progress of the assessment and pathogenetic mechanism of impaired awareness of hypoglycemia in patients with type 2 diabetes mellitus.

参考文献/References:

[1] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,13(4):315-409.DOI:10.3760/cma.j.cn115791-20210221-00095.
[2] Gold AE,MacLeod KM,Frier BM.Frequency of severe hypoglycemia in patients with type I diabetes with impaired awareness of hypoglycemia[J].Diabetes Care,1994,17(7):697-703.DOI:10.2337/diacare.17.7.697.
[3] American Diabetes Association.2.Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021[J].Diabetes Care,2021,44(Suppl 1):S15-S33.DOI:10.2337/dc21-S002.
[4] Leelarathna L,Little SA,Walkinshaw E,et al.Restoration of self-awareness of hypoglycemia in adults with long-standing type 1 diabetes: hyperinsulinemic-hypoglycemic clamp substudy results from the HypoCOMPaSS trial[J].Diabetes Care,2013,36(12):4063-4070.DOI:10.2337/dc13-1004.
[5] Clarke WL,Cox DJ,Gonder-Frederick LA,et al.Reduced awareness of hypoglycemia in adults with IDDM.A prospective study of hypoglycemic frequency and associated symptoms[J].Diabetes Care,1995,18(4):517-522.DOI:10.2337/diacare.18.4.517.
[6] Pedersen-Bjergaard U,Agerholm-Larsen B,Pramming S,et al.Activity of angiotensin-converting enzyme and risk of severe hypoglycaemia in type 1 diabetes mellitus[J].Lancet,2001,357(9264):1248-1253.DOI:10.1016/S0140-6736(00)04405-6.
[7] Ghandi K,Pieri B,Dornhorst A,et al.A comparison of validated methods used to assess impaired awareness of hypoglycaemia in type 1 diabetes: an observational study[J].Diabetes Ther,2021,12(1):441-451.DOI:10.1007/s13300-020-00965-0.
[8] Alkhatatbeh MJ,Abdalqader NA,Alqudah MAY.Impaired awareness of hypoglycaemia in insulin-treated type 2 diabetes mellitus[J].Curr Diabetes Rev,2019,15(5):407-413.DOI:10.2174/1573399814666180806144937.
[9] Peene B,D'Hooge D,Vandebrouck T,et al.Patient-reported frequency,awareness and patient-physician communication of hypoglycaemia in Belgium[J].Acta Clin Belg,2014,69(6):439-445.DOI:10.1179/2295333714Y.0000000050.
[10] 包頔,余杭青,程正楠,等.2型糖尿病患者低血糖感知受损现况及影响因素分析[J].天津护理,2021,29(1):33-37.DOI:10.3969/j.issn.1006-9143.2021.01.009.
[11] 包頔,余杭青,程正楠,等.老年糖尿病患者低血糖恐惧感发生情况及其影响因素研究[J].中国全科医学,2020,23(30):3775-3780.DOI:10.12114/j.issn.1007-9572.2020.00.484.
[12] Nwokolo M,Amiel SA,O'Daly O,et al.Impaired awareness of hypoglycemia disrupts blood flow to brain regions involved in arousal and decision making in type 1 diabetes[J].Diabetes Care,2019,42(11):2127-2135.DOI:10.2337/dc19-0337.
[13] Farrell CM,McCrimmon RJ.Clinical approaches to treat impaired awareness of hypoglycaemia[J].Ther Adv Endocrinol Metab,2021,12:1869597768.DOI:10.1177/20420188211000248.
[14] Jezequel C,de Kerdanet M,Girre MA.Hypoglycemia provoked by clandestine injections of insulin in the diabetic child[J].Ann Pediatr(Paris),1993,40(1):32-36.
[15] Long C,Dungan K.Hypoglycemia awareness and burden among hospitalized patients at high risk for hypoglycemia[J].J Diabetes Complications,2020,34(4):107521.DOI:10.1016/j.jdiacomp.2019.107521.
[16] Ma Y,Wang Q,Joe D,et al.Recurrent hypoglycemia inhibits the counterregulatory response by suppressing adrenal activity[J].J Clin Invest,2018,128(9):3866-3871.DOI:10.1172/JCI91921.
[17] Stantonyonge N,Sampedro F,Méndez J,et al.Structural gray and white matter differences in patients with type 1 diabetes and impaired awareness of hypoglycemia[J].J Clin Endocrinol Metab,2021,106(2):450-458.DOI:10.1210/clinem/dgaa832.
[18] Sampedro F,Stantonyonge N,Martinez-Horta S,et al.Increased cerebral FDG-PET uptake in type 1 diabetes patients with impaired awareness of hypoglycaemia[J].J Neuroendocrinol,2021,33(1):e12910.DOI:10.1111/jne.12910.
[19] 中华医学会糖尿病学分会.中国持续葡萄糖监测临床应用指南(2017年版)[J].中华糖尿病杂志,2017,9(11):667-675.DOI:10.3760/cma.j.issn.1674-5809.2017.11.002.
[20] Blissett DB,Attvall S,Hellmund RA.Analysis estimating the potential cost Impact of utilizing flash glucose monitoring with optional alarms in Swedish adults with diabetes with impaired awareness of hypoglycaemia,using intensive insulin[J].Diabetes Ther,2021,12(8):2179-2193.DOI:10.1007/s13300-021-01099-7.
[21] Hvidberg A,Rasmussen MH,Christensen NJ,et al.Theophylline enhances glucose recovery after hypoglycemia in healthy man and in type I diabetic patients[J].Metabolism,1994,43(6):776-781.DOI:10.1016/0026-0495(94)90130-9.
[22] Watson JM,Sherwin RS,Deary IJ,et al.Dissociation of augmented physiological,hormonal and cognitive responses to hypoglycaemia with sustained caffeine use[J].Clin Sci(Lond),2003,104(4):447-454.
[23] de Galan BE,Schouwenberg BJ,Tack CJ,et al.Pathophysiology and management of recurrent hypoglycaemia and hypoglycaemia unawareness in diabetes[J]. Neth J Med,2006,64(8):269-279.
[24] Farhat R,Su G,Sejling AS,et al.Carvedilol prevents counterregulatory failure and impaired hypoglycaemia awareness in non-diabetic recurrently hypoglycaemic rats[J].Diabetologia,2019,62(4):676-686.DOI:10.1007/s00125-018-4802-0.

相似文献/References:

[1]曾静波,王姮.2型糖尿病与自身免疫反应[J].国际内分泌代谢杂志,2007,(04):259.
[2]朱素君,谢锦桃,刘军,等.二甲双胍:2型糖尿病治疗的基础药[J].国际内分泌代谢杂志,2007,(04):280.
[3]刘艳清 易秋艳 邵加庆.肠道菌群与肥胖和糖尿病的关系[J].国际内分泌代谢杂志,2015,(01):31.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.01.007]
 Liu Yanqing,Yi Qiuyan,Shao Jiaqing..Relationship between gut microbiota, obesity and diabetes[J].International Journal of Endocrinology and Metabolism,2015,(02):31.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.01.007]
[4]姚旻 赵爱源 张宏.肠道菌群与2型糖尿病[J].国际内分泌代谢杂志,2015,(01):35.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.01.008]
 Yao Min*,Zhao Aiyuan,Zhang Hong..Relationship between gut microbiota and type 2 diabetes[J].International Journal of Endocrinology and Metabolism,2015,(02):35.[doi:DOI:10.3760/cma.j.issn.1673-4157.2015.01.008]
[5]赵丽娟,徐宽枫,杨涛,等.SLC30A8和PTPRD基因多态性与南京地区中老年人群2型糖尿病的相关性研究[J].国际内分泌代谢杂志,2015,(03):145.[doi:10.3760/cma.j.issn.1673-4157.2015.03.001]
 Zhao Lijuan*,Xu Kuanfeng,Yang Tao,et al.Relationship between SLC30A8 and PTPRD gene polymorphisms and type 2 diabetes in middle aged and elderly people in Nanjing area[J].International Journal of Endocrinology and Metabolism,2015,(02):145.[doi:10.3760/cma.j.issn.1673-4157.2015.03.001]
[6]王洁,何媛,于珮.糖尿病肾病的相关危险因素分析[J].国际内分泌代谢杂志,2015,(03):153.[doi:10.3760/cma.j.issn.1673-4157.2015.03.003]
 Wang Jie*,He Yuan,Yu Pei..Risk factors of diabetic nephropathy[J].International Journal of Endocrinology and Metabolism,2015,(02):153.[doi:10.3760/cma.j.issn.1673-4157.2015.03.003]
[7]刘帅,张萍,方毅,等.2型糖尿病合并无症状冠状动脉钙化的相关危险因素分析[J].国际内分泌代谢杂志,2015,(03):158.[doi:10.3760/cma.j.issn.1673-4157.2015.03.004]
 Liu Shuai*,Zhang Ping,Fang Yi,et al.Analysis of the risk factors related with asymptomatic coronary calcification for type 2 diabetic patients[J].International Journal of Endocrinology and Metabolism,2015,(02):158.[doi:10.3760/cma.j.issn.1673-4157.2015.03.004]
[8]徐庆海,马颖,李铁马.2型糖尿病患者高甘油三酯血症-腰围表型与甲状腺功能异常的关系[J].国际内分泌代谢杂志,2015,(04):222.[doi:10.3760/cma.j.issn.1673-4157.2015.04.002]
 Xu Qinghai,Ma Ying,Li Tiema..Association of hypertriglyceridaemic-waist phenotype with thyroid dysfunction in patients with type 2 diabetes mellitus[J].International Journal of Endocrinology and Metabolism,2015,(02):222.[doi:10.3760/cma.j.issn.1673-4157.2015.04.002]
[9]潘道延,沈洁,朱筱,等.利格列汀对2型糖尿病大鼠代谢性内毒素血症的影响[J].国际内分泌代谢杂志,2015,(04):230.[doi:10.3760/cma.j.issn.1673-4157.2015.04.004]
 Pan Daoyan,Shen Jie,Zhu Xiao,et al.Effects of linagliptin on metabolic endotoxemia in type 2 diabetic rats[J].International Journal of Endocrinology and Metabolism,2015,(02):230.[doi:10.3760/cma.j.issn.1673-4157.2015.04.004]
[10]黄桥,白洁,杜洪泉.一种新的脂肪细胞因子——cartonectin[J].国际内分泌代谢杂志,2015,(04):265.[doi:10.3760/cma.j.issn.1673-4157.2015.04.014]
 Huang Qiao*,Bai Jie,Du Hongquan..A novel adipokine--cartonectin[J].International Journal of Endocrinology and Metabolism,2015,(02):265.[doi:10.3760/cma.j.issn.1673-4157.2015.04.014]

备注/Memo

备注/Memo:
基金项目:江苏省中医药科技发展计划项目(YB2020087); 国家自然科学基金(81803792)
通信作者:张真稳,Email:yzdxzzw@163.com
更新日期/Last Update: 2023-04-15