Hypoglycaemia in Clinical Diabetes

INDEX 343oral antidiabetic agents, see alsoalpha-glucosidase inhibitors; metformin,frequency of hypoglycaemia;sulphonylureas; thiazolidinedioneshypoglycaemic effects, 247–252compared with insulin therapy, 251–253oxytocin, changes during hypoglycaemia, 13,14–15pallor (clinical sign), 17palpitations (symptom), 30, 31, 36, 196difficulty in interpreting, 37pancreas, hormonal changes duringhypoglycaemia, 13, 15, 21pancreatic polypeptide, changes duringhypoglycaemia, 13, 15parasympathetic nervous system, 10, 11activation during hypoglycaemia, 12, 143passenger carrying vehicle (PCV) licences,320, 324patient ‘error’, as ‘cause’ of hypoglycaemia, 62,103peripheral autonomic neuropathyand impaired awareness of hypoglycaemia,152–153and severe hypoglycaemia, 73–74, 110pessimism during hypoglycaemia, 43, 312phobia about hypoglycaemia, 43, 312physical activity (children)management of, 208–209as risk factor, 200–201physical exhaustion, and hypoglycaemia, 317physically demanding jobs, and strict glycaemiccontrol, 185physiological responses to hypoglycaemia,15–20, 142, 143pituitary failure, 130pituitary function, effect of hypoglycaemia, 13pituitary gland, hormonal changes duringhypoglycaemia, 13–15, 21, 124placenta, in mother with diabetes, 218police custody, hypoglycaemia while in,327–329positron emission tomography (PET), brainmetabolism studies, 6, 132, 161, 177post-mortem diagnosis, 266–269posterior pituitary gland, hormonal changesduring hypoglycaemia, 13, 14–15postprandial metabolic pathways, 3, 4posture, counterregulatory responses affectedby, 87potassium levels, fall due to hypoglycaemia,273, 276‘pounding’ heart (symptom), 26, 29, 31, 142,143children, 32older people, 240in pregnancy, 221prandial glucose regulators, 249pregnancy, see also diabetic pregnancyaverage age of mothers with diabetes, 217frequency of hypoglycaemia, 219–222lifestyle management in, 229maternal complications due to diabetes,230–231metabolic changes during, 217–219organisation of clinical care, 223–226pre-conception care/counselling, 223prevalence of hypoglycaemiamild hypoglycaemia, 54, 246nocturnal hypoglycaemia, 83, 193, 196severe hypoglycaemia, 121, 198in pregnancy, 220, 227in type 2 diabetes, 253, 256previous history of hypoglycaemia, see alsoantecedent hypoglycaemiaas risk factor, 64, 68, 69, 102, 157–160in pregnancy, 221and worry, 44prison, management of diabetes in, 330–331prison officer, as restricted occupation, 326profound hypoglycaemiacounterregulatory responses, 134hepatic autoregulation in, 9increased cerebral blood flow in, 123prolactin, changes during hypoglycaemia, 13, 14prospective studiescompared with retrospective studies, 51–52,172mild hypoglycaemia, 53, 54–55severe hypoglycaemia, 57, 58, 59children, 194 195, 286type 2 diabetes, 248−249,253, 254protein snack, and nocturnal hypoglycaemia, 93psychiatric disturbance/illnesseffect of hypoglycaemia, 295as risk factor for death, 58, 269treatment of, 281psychological consequences of hypoglycaemia,311