Blog About Health & Medicine

The DCCT investigators-concluded that intensive management of type 1 diabetes, with a goal of normal or near-normal levels of glycemia, is associated with an increased risk of severe hypoglycemia. Individualization of therapeutic goals and methods was encouraged. In particular, future development of intensive treatment methods that afford the benefits of improved glucose control with reduced risks of hypoglycemia was advocated.

Hypoglycemia unawarerfess is frequently seen in type 1 diabetics after-prolonged periods of intensive glucose regulation and recurrent hypoglycemic attacks. This issue has received extensive study. It has been postulated that in hypoglycemia-aware type 1 patients, beta-adrenergic sensitivity is increased to compensate for impaired catecholamine response. With repeated episodes of hypoglycemia, this increased sensitivity is lost. The end result is hypoglycemia unawareness with reduced catecholamine response and reduced beta-adrenergic sensitivity. Recent studies have shown that this sensitivity may be restored in type 1 diabetes by avoiding hypoglycemia with less stringent blood glucose control. Thus, in patients with hypoglycemia unawareness, it is appropriate to modify the stringent HbA1 c and plasma glucose control goals to avoid recurrent hypoglycemia and hypoglycemic unawareness.

*38\357\8*