Hypoglycaemia in Clinical Diabetes

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Figure 10.2 Example of home blood glucose monitoring chart used in the combined antenatal diabetic clinic at Aberdeen Maternity Hospital, Scotland
226 HYPOGLYCAEMIA IN PREGNANCYFigure 10.3 Ultrasound scan of at 32 weeks gestation demonstrating measurement of abdominalcircumference (AC)Optimising Insulin RegimensData is limited with regard to studies of different insulin regimens during pregnancy andmany studies are small and observational in nature. The effects of conventional versusintensive insulin therapy were studied in the women participating in the DCCT (The DiabetesControl and Complications Trial Research Group, 1996). In women who had initially been
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Hypoglycaemia in Clinical DiabetesS
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Hypoglycaemia in Clinical DiabetesS
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ToEmily, Ben and Marc
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viiiCONTENTS13 Long-term Effects of
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ContributorsProfessor Stephanie A.
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1 Normal Glucose Metabolismand Resp
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NORMAL GLUCOSE HOMEOSTASIS 3Box 1.2
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Fed state (Figure 1.1b)EFFECTS OF G
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COUNTERREGULATION DURING HYPOGLYCAE
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COUNTERREGULATION DURING HYPOGLYCAE
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HORMONAL CHANGES DURING HYPOGLYCAEM
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HORMONAL CHANGES DURING HYPOGLYCAEM
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PHYSIOLOGICAL RESPONSES 15hormones.
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PHYSIOLOGICAL RESPONSES 17Figure 1.
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PHYSIOLOGICAL RESPONSES 19We do not
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REFERENCES 21NORMAL GLUCOSE HOMEOST
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REFERENCES 23Hamilton-Wessler M, Be
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2 Symptoms of Hypoglycaemiaand Effe
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SYMPTOMS OF HYPOGLYCAEMIA 27appeare
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SYMPTOMS OF HYPOGLYCAEMIA 29aware o
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SYMPTOMS OF HYPOGLYCAEMIA 31Table 2
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SYMPTOMS OF HYPOGLYCAEMIA 33frequen
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SYMPTOMS OF HYPOGLYCAEMIA 35Figure
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ACUTE HYPOGLYCAEMIA AND COGNITIVE F
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ACUTE HYPOGLYCAEMIA AND EMOTIONS 43
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REFERENCES 45Bremer JP, Baron M, Pe
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REFERENCES 47McAulay V, Deary IJ, F
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3 Frequency, Causes and RiskFactors
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FREQUENCY OF HYPOGLYCAEMIA 51Box 3.
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Table 3.1 Frequency of mild hypogly
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FREQUENCY OF HYPOGLYCAEMIA 55some i
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FREQUENCY OF HYPOGLYCAEMIA 57Jansse
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Table 3.2 Frequency of severe hypog
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CAUSES OF HYPOGLYCAEMIACAUSES OF HY
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RISK FACTORS FOR SEVERE HYPOGLYCAEM
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CONCLUSIONS 75Other Risk FactorsThe
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REFERENCES 77Bott S, Bott U, Berger
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REFERENCES 79Leckie AM, Graham MK,
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REFERENCES 81Vervoort G, Goldschmid
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Table 4.1 Frequency of nocturnal hy
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86 NOCTURNAL HYPOGLYCAEMIACAUSES OF
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88 NOCTURNAL HYPOGLYCAEMIAPlasma Ep
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90 NOCTURNAL HYPOGLYCAEMIACAN NOCTU
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92 NOCTURNAL HYPOGLYCAEMIABox 4.2 C
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94 NOCTURNAL HYPOGLYCAEMIAconflicti
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96 NOCTURNAL HYPOGLYCAEMIA• Noctu
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98 NOCTURNAL HYPOGLYCAEMIAHolleman
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5 Moderators, Monitoring andManagem
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LIFESTYLE MODERATORS 103• absolut
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LIFESTYLE MODERATORS 10520 22 24 2
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LIFESTYLE MODERATORS 107Growthhormo
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LIFESTYLE MODERATORS 109mean change
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MONITORING 111flow) while simultane
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MONITORING 113• It is unclear whe
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MANAGEMENT OF HYPOGLYCAEMIA 115MANA
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REFERENCES 117CONCLUSIONS• Hypogl
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REFERENCES 119MacDonald MJ (1987).
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6 Counterregulatory Deficienciesin
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NORMAL GLUCOSE COUNTERREGULATION 12
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NORMAL GLUCOSE COUNTERREGULATION 12
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DEFECTIVE HORMONAL GLUCOSE COUNTERR
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DEFECTIVE HORMONAL GLUCOSE COUNTERR
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MECHANISMS OF COUNTERREGULATORY FAI
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AGE, OBESITY AND GLUCOSE COUNTERREG
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TREATMENT OF COUNTERREGULATORY FAIL
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REFERENCES 137Bingham EM, Dunn JT,
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REFERENCES 139McCall AL, Fixman LB,
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7 Impaired Awareness ofHypoglycaemi
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NORMAL RESPONSES TO HYPOGLYCAEMIA 1
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IMPAIRED AWARENESS OF HYPOGLYCAEMIA
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PREVALENCE OF IMPAIRED AWARENESS OF
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PATHOGENESIS OF IMPAIRED AWARENESS
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Table 7.3 Studies of antecedent hyp
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IMPAIRED AWARENESS OF HYPOGLYCAEMIA
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TREATMENT STRATEGIES 163or unexplai
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CONCLUSIONS 165Box 7.5 Treatment st
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REFERENCES 167Boyle PJ (1997). Alte
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REFERENCES 169Kerr D, Sherwin RS, P
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8 Risks of Strict GlycaemicControlS
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CONTRIBUTORS TO INCREASED RISK OF S
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Page 190 and 191: CEREBRAL ADAPTATION 177severe, are
Page 192 and 193: CEREBRAL ADAPTATION 179hypoglycaemi
Page 194 and 195: THERAPEUTIC MANIPULATION 181Figure
Page 196 and 197: PATIENTS UNSUITABLE FOR STRICT CONT
Page 198 and 199: REFERENCES 185It is the patient who
Page 200 and 201: REFERENCES 187Egger M, Davey Smith
Page 202: REFERENCES 189Simonson DC, Tamborla
Page 205 and 206: 192 HYPOGLYCAEMIA IN CHILDREN WITH
Page 207 and 208: Table 9.2 Summary of studies examin
Page 230 and 231: 10 Hypoglycaemia in PregnancyAnn E.
Page 232 and 233: FREQUENCY OF HYPOGLYCAEMIA IN DIABE
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Page 236 and 237: CLINICAL MANAGEMENT BEFORE AND DURI
Page 244 and 245: MATERNAL COMPLICATIONS OF DIABETES
Page 246 and 247: COMPLICATIONS IN THE INFANT OF THE
Page 248 and 249: REFERENCES 235Akazawa M, Akazawa S,
Page 250: REFERENCES 237Ray JG, O’Brien TE,
Page 253 and 254: 240 HYPOGLYCAEMIA IN TYPE 2 DIABETE
Page 261 and 262: Table 11.2a Prevalence of severe hy
Page 279 and 280: 266 MORTALITY, CARDIOVASCULAR MORBI
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276 MORTALITY, CARDIOVASCULAR MORBI
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13 Long-term Effects ofHypoglycaemi
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COGNITIVE FUNCTION AND HYPOGLYCAEMI
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FUNCTIONAL EFFECTS OF HYPOGLYCAEMIA
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STRUCTURAL AND FUNCTIONAL CHANGES I
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REFERENCES 303disease (Fisher and F
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REFERENCES 305Fisher M, Frier BM (1
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REFERENCES 307Seidl R, Birnbacher R
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310 LIVING WITH HYPOGLYCAEMIAPSYCHO
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312 LIVING WITH HYPOGLYCAEMIABox 14
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314 LIVING WITH HYPOGLYCAEMIAprophy
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316 LIVING WITH HYPOGLYCAEMIAMost t
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318 LIVING WITH HYPOGLYCAEMIAfor pu
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320 LIVING WITH HYPOGLYCAEMIAVocati
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322 LIVING WITH HYPOGLYCAEMIAif the
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324 LIVING WITH HYPOGLYCAEMIAestabl
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326 LIVING WITH HYPOGLYCAEMIAwith g
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328 LIVING WITH HYPOGLYCAEMIAalcoho
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330 LIVING WITH HYPOGLYCAEMIAChante
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332 LIVING WITH HYPOGLYCAEMIASonger
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334 INDEXanterior pituitary gland,
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336 INDEXcomplications due to diabe
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338 INDEXemployment aspects, 323-32
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340 INDEXhypopituitarism, 74, 102,
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342 INDEXmood changes due to hypogl
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344 INDEXpsychological factors, and
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346 INDEXtrain drivers, 323, 324tra
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Hypoglycaemia in Clinical Diabetes

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