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Your search term(s) "hypoglycemia" returned 234 results.

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Diabetes Sourcebook. 3rd ed. Detroit, MI: Omnigraphics. 2003. 621 p.

This book provides information for people seeking to understand the risk factors, complications, and management of type 1 diabetes, type 2 diabetes, and gestational diabetes. The book offers 67 chapters in seven sections: diabetes types and diagnosis; lifestyle and related diabetes management concerns; exercise and nutrition for diabetes management; medication management of diabetes; complications of diabetes; treatment of end stage renal disease (ESRD); and diabetes-related research and statistics. Specific topics include risk factors, impaired glucose tolerance (IGT), insulin resistance, HbA1c (glycosylated hemoglobin) testing, blood glucose testing, urine testing, SMBG (self monitoring of blood glucose), non-invasive blood glucose monitors, preventing complications, how stress affect diabetes, alternative therapies for diabetes, exercise, exchange lists, carbohydrate counting, eating at restaurants, insulin administration and dosage, oral medications, amputation, kidney disease (diabetic nephropathy), diabetic retinopathy (eye disease), diabetic neuropathy (nerve disease), gastroparesis (reduced motility of stomach contents), hypoglycemia (low blood glucose levels), hyperglycemia (high blood glucose levels), erectile dysfunction (ED formerly called impotence), research advances in diabetes, and diabetes in ethnic and racial groups. The book includes a glossary of related terms, information about locating financial help for diabetes care, and a list of resources, including organizations, recipes and cookbooks.

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Do All Prepubertal Years of Diabetes Duration Contribute Equally to Diabetes Complications?. Diabetes Care. 26(4): 1224-1229. April 2003.

This article reports on a study that explored the timeline of protection against complications in prepubertal children with diabetes, in particular the effects of diabetes duration before age 5 years. In the study, 193 adolescents with prepubertal diabetes onset were followed longitudinally for retinopathy (eye disease) and microalbuminuria (protein in the urine). Results showed that prepubertal duration improved the prediction for retinopathy over postpubertal duration alone in the young adults. The survival-free period of retinopathy and microalbuminuria was significantly longer (2 to 4 years) for those diagnosed before age 5 years compared with those diagnosed after 5 years. Time to onset of all complications increased progressively with longer diabetes duration before puberty. Higher HbA1c (glycosylated hemoglobin, a measure of blood glucose over time) during adolescence had an independent effect on the risk of retinopathy and microalbuminuria. The authors conclude that the effect of time on the risk of retinopathy and microalbuminuria is nonuniform, with an increasing delay in the onset of complications in those with longer prepubertal duration. These findings are of major clinical importance when setting targets of glycemic control in young children who are at greatest risk of hypoglycemia (low blood glucose levels). 2 figures. 1 table. 28 references.

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Factors Associated with Academic Achievement in Children with Type 1 Diabetes. Diabetes Care. 26(1): 112-117. January 2003.

This article reports on a study that examined academic achievement in children with diabetes and that identified predictors of academic achievement. Participants were 244 children, ages 8 to 18 years, with type 1 diabetes. Results showed that reading scores and grade point averages (GPA) were lower for children with poor metabolic control than for children with average control. Children with hospitalizations for hyperglycemia (high blood glucose levels) had lower overall achievement scores than children with better metabolic control and fewer hospitalizations for hyperglycemia. The authors conclude that, for most children with diabetes, medical variables are not as strongly associated with academic achievement as are factors such as socioeconomic status and behavioral factors. Poor metabolic control and serious hypoglycemia, however, are a potential concern for a subset of these children. 3 tables. 31 references.

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Gastroparesis: A Case of Unexplained Lows. Diabetes Forecast. 56(9): 69-72. September 2003.

Gastroparesis is a form of nerve damage that affects the stomach, resulting in a slowed motility (movement) of gastric contents. Gastroparesis develops in 40 to 50 percent of people who have had type 1 diabetes for more than 20 years and in 30 to 40 percent of those with long-standing type 2 diabetes. This article shares the experience of one person with diabetes who developed gastroparesis. Topics include how gastroparesis is diagnosed, a typical symptom questionnaire, blood glucose (sugar) target ranges, adjusting insulin dosage to carbohydrate intake, diet suggestions for people with gastroparesis, suggested insulin regimens, and strategies for patients using insulin pumps. 3 figures.

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Handbook of Diagnostic Endocrinology. Totowa, NJ: The Humana Press, Inc. 2003. 360 p.

With the rapid development of new and more reliable diagnostic tests, and aided by the molecular and genetic approaches that continue to deepen the understanding of these diseases, the ability to diagnose patients with endocrine disease has dramatically increased. In this book, physicians concisely explain the pathophysiology and clinical manifestations of these disorders and survey all the latest laboratory tests used in their diagnosis. Topics range widely from an overview of the diagnosis of diabetes and the long-term monitoring of its complications to the evaluation of menstrual dysfunction. Other topics include the diagnosis of pituitary tumors, Cushing's syndrome, thyroid disease, and hypoglycemia; the evaluation of endocrine-induced hypertension; the assessment of dyslipidemia and obesity; new approaches to diagnosing hypercalcemia and hypocalcemia, osteoporosis, hypogonadism and erectile dysfunction, and hyperandrogenism in women. The authors review the complex physiological basis of the relevant endocrine processes and provide recommendations for the follow up and long term management of patients. Each chapter concludes with references and the text concludes with a subject index.

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Hypoglycemia in Diabetes. Diabetes Care. 26(6): 1902-1912. June 2003.

Iatrogenic (treatment induced) hypoglycemia (low blood glucose levels) causes recurrent morbidity in most people with type 1 diabetes and in many with type 2 diabetes, and it is sometimes fatal. The barrier of hypoglycemic generally precludes maintenance of euglycemia (best levels of blood glucose) over a lifetime of diabetes and thus precludes full realization of euglycemia's long-term benefits. This article reviews hypoglycemia, notably iatrogenic hypoglycemia. The authors note that iatrogenic hypoglycemia is typically the result of the interplay of absolute or relative insulin excess and compromised glucose counterregulation in type 1 and advanced type 2 diabetes. Reduced sympathoadrenal responses cause hypoglycemia unawareness. Short-term avoidance of hypoglycemia reverses hypoglycemia unawareness in most affected patients. The clinical approach to minimizing hypoglycemia while improving glycemic control includes addressing the issue; applying the principles of aggressive glycemic therapy, including flexible and individualized drug regimens; and considering the risk factors for iatrogenic hypoglycemia. The authors conclude that, pending the prevention and cure of diabetes or the development of methods that provide glucose-regulated insulin replacement or secretion, physicians and patients must learn to replace insulin in a much more physiological fashion to prevent, correct, or compensate for compromised glucose counterregulation. 1 figure. 85 references.

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Hypoglycemia in Type I Diabetes. In: Sperling, M.A. Type 1 Diabetes: Etiology and Treatment. Totowa, NJ: Humana Press Inc. 2003. p. 321-343.

Although the introduction of insulin therapy was life-saving for patients with type 1 diabetes, problems of iatrogenic (caused by the medical therapy) hypoglycemia (low blood glucose levels) were noticeable from the outset. Episodes of hypoglycemia continue to be a daily threat to all patients with type 1 diabetes and can lead to a significant reduction in quality of life. This chapter on hypoglycemia in type 1 diabetes is from a book in which well-recognized physicians and researchers review the latest thinking about the causes of type 1 diabetes and the best approaches to treating both its acute and chronic complications. Topics include the prevalence of hypoglycemia, glucose homeostasis, clinical features, risk factors, nocturnal hypoglycemia, and prevention strategies. The authors conclude that there are many unresolved questions regarding the etiology, sequelae, and prevention of this common acute complication of the treatment of type 1 diabetes. The benefits of long-term good glycemic control cannot be denied, but further progress in the application of intensified diabetes therapy needs to be made before it can be safely applied to all patients with type 1 diabetes. 3 figures. 1 table. 161 references.

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Hypoglycemia. In: Franz, M.J., et al., eds. Core Curriculum for Diabetes Education. 5th ed. (Volume 2) Diabetes Management Therapies. Chicago, IL: American Association of Diabetes Educators (AADE). 2003. p. 277-310.

It is extremely difficult to duplicate normal blood glucose metabolism with insulin therapies. Therefore, blood glucose levels in patients taking insulin tend to fluctuate between abnormally high (hyperglycemia) and abnormally low (hypoglycemia) levels due to under-and over-insulinization relative to food intake, physical activity, and metabolic needs. This chapter on hypoglycemia is from a handbook of the CORE Curriculum, a publication that helps educators prepare for the Certified Diabetes Educators (CDE) exam, serves as a key reference for the Advanced Diabetes Management credential exam, and provides an authoritative source of information for diabetes education, training, and management. This chapter covers mild and severe hypoglycemic episodes, including the symptoms associated with varying levels of severity; the physiological changes that occur with hypoglycemia; the symptoms of hypoglycemia, the effects of hypoglycemia on emotions and behavior, and factors underlying symptoms idiosyncrasy; the causes of hypoglycemia and possible risk factors for individual patients; the treatment for different levels of hypoglycemia, including guidelines for when the person with diabetes is unable to self-treat due to a severe hypoglycemic episode; psychosocial sequelae of hypoglycemia; and general education plans for teaching patients about hypoglycemia as well as more specific assessment and intervention plans for patients experiencing frequent or severe hypoglycemia episodes. The chapter includes an introduction, a list of learning objectives, key definitions (glossary), key educational considerations, self review questions, references, and a post-test (including an answer key). 2 figures. 7 tables. 47 references.

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Hypoglycemic Disorders. In: Hall, J.E.; Nieman, L.K., eds. Handbook of Diagnostic Endocrinology. Totowa, NJ: The Humana Press, Inc. 2003. p. 193-211.

With the rapid development of new and more reliable diagnostic tests, and aided by the molecular and genetic approaches that continue to deepen the understanding of these diseases, the ability to diagnose patients with endocrine disease has dramatically increased. This chapter on hypoglycemic (low blood glucose) disorders is from a book that explains the pathophysiology and clinical manifestations of endocrine disorders and surveys all the latest laboratory tests used in their diagnosis. The author discusses classification of hypoglycemic disorders, and then considers the tests available for their diagnostic evaluation. The author notes that a healthy-appearing patient with no coexisting disease who has a history of neuroglycopenic spells requires an approach quite different from that taken for a patient with concurrent illness or a hospitalized patient with acute hypoglycemia (low levels of blood glucose). Tests discussed include serum glucose levels, the prolonged (72 hour) fast, the mixed meal test, the C-peptide suppression test, insulin antibodies, glycated hemoglobin, and imaging studies. 6 figures. 4 tables. 84 references.

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Impact of Bedtime Snack Composition on Prevention of Nocturnal Hypoglycemia in Adults with Type 1 Diabetes Undergoing Intensive Insulin Management Using Lispro Insulin Before Meals. Diabetes Care. 26(1): 9-15. January 2003.

This article reports on a study undertaken to determine the impact of four bedtime (HS) snack compositions on nocturnal glycemic control, including frequency of hypoglycemia and morning hyperglycemia, in adults with type 1 diabetes using lispro insulin before meals and NPH insulin at bedtime. Substitutions of 15 grams carbohydrate (one starch exchange) for an equivalent amount of uncooked cornstarch or pure protein were compared to a standard snack (control: two starch and one protein exchange) and to no snack (placebo) in 15 adults using a randomized, crossover design. The glycemic level at bedtime mediated the effects observed. A total of 14 hypoglycemic episodes, in 60 percent of patients, and 23 morning hyperglycemic episodes occurred over 50 nights. Most hypoglycemic episodes (10 of 14, 71 percent) occurred with no snack compared to any snack. The standard and protein snacks resulted in no nocturnal hypoglycemia at all HS glucose levels. The authors conclude that the need for and composition of an HS snack depends on the HS glucose such that no snack is necessary at greater than 10 mmol per liter. At levels between 7 and 10 mmol per liter, any snack is advised, and at less than 7 mmol per liter, a standard or protein snack is recommended. 1 figure. 3 tables. 38 references.

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