Glycemic control and neuropsychologic function during hypoglycemia in patients with insulin-dependent diabetes mellitus

Article Abstract:

Insulin is a naturally occurring hormone secreted by the pancreas in response to increased levels of glucose in the blood. Insulin interacts with proteins on cell surfaces called receptors that allow cells to use glucose as food. Diabetes mellitus is a complex disorder resulting primarily from a lack of insulin secretion or a defect in insulin receptors and leads to elevated levels of glucose in the blood. Insulin is used to treat diabetes mellitus by lowering blood glucose levels to normal. However, intensive insulin therapy can lead to a severe lowering of blood glucose levels or coma. When this occurs, a regulatory mechanism is activated and hormones such as epinephrine, growth hormone, and cortisol are released by the body to reestablish normal glucose levels. Additionally, very low blood glucose levels are associated with mental impairment resulting in slowing of task response speeds and information processing, and fine motor coordination and memory impairment. A recent study examined nine patients with poorly controlled diabetes, eight patients with well controlled diabetes and 10 healthy persons. Observations included the blood glucose level at which mental dysfunction occurred and regulatory hormone secretion began, and symptoms of low blood glucose were noted. In patients with well controlled diabetes, a significantly lower blood glucose level was required to elicit an increase in growth hormone, epinephrine, and cortisol and symptoms that result from these imbalances. No differences in the blood glucose levels accompanied mental impairment. This study indicates that patients with well controlled diabetes may have undetected very low blood glucose levels, thus allowing them to decrease even further. Frequent home monitoring of blood glucose levels are of paramount importance for these individuals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Control, Reasoning, Glucose, Hypoglycemia

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Exogenous insulin administration and cardiovascular risk in non-insulin-dependent and insulin-dependent diabetes mellitus

Article Abstract:

Current research may be inadequate to conclusively determine the effects of intense insulin treatment on heart disease. A researcher analyzed the research methods of two studies designed to determine the effects on heart disease of varying insulin treatments in patients with non-insulin dependent diabetes mellitus (NIDDM) and insulin dependent diabetes mellitus (IDDM). Both studies showed trends toward improvements in the risk for heart disease by more tightly controlling blood glucose levels. Flaws in the study on patients with NIDDM include choosing too few study patients, poor monitoring of study patients, choosing many patients with already advanced heart disease, and no documentation of smoking history. The IDDM study included patients that were too young to expect major heart disease events and compared insulin doses that were too similar.

Health aspects, Heart diseases, Type 2 diabetes, Insulin

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Incidence of postpartum thyroid dysfunction in patients with type I diabetes mellitus

Article Abstract:

Pregnant women with type I diabetes mellitus may have a high risk of developing thyroid gland dysfunction after giving birth than other individuals. Among 40 women with type I diabetes mellitus who were not being treated with thyroid medication or thyroactive or immunosuppressive medication, 10 (25%) developed thyroid gland dysfunction following delivery. Nine women developed thyroiditis, and one patient developed Graves disease within the first six months postpartum. Different types of thyroiditis developed by the women included transient thyrotoxicosis, hypothyroidism or transient thyrotoxicosis followed by hypothyroidism. Thyroid dysfunction did not adversely affect blood glucose levels in any of the women. Thyroid dysfunction may be caused by thyroid damage by the immune system at the time of delivery.

Diabetes in pregnancy, Gestational diabetes, Thyroid diseases

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