HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hvidberg, A. Articles by Cryer, P. E. Search for Related Content PubMed PubMed Citation Articles by Hvidberg, A. Articles by Cryer, P. E. Social Bookmarking                What's this?

Impact of recent antecedent hypoglycemia on hypoglycemic cognitive dysfunction in nondiabetic humans

To test the hypothesis that glycemic thresholds for hypoglycemic cognitive dysfunction, like those for neuroendocrine responses to and symptoms of hypoglycemia, shift to lower plasma glucose concentrations after recent antecedent hypoglycemia, 16 healthy young adult subjects (7 women and 9 men) were studied on two separate occasions in random sequence, once with hyperinsulinemic hypoglycemia (2.6 +/- 0.1 mmol/l, 47 +/- 1 mg/dl) and once with otherwise identical hyperinsulinemic euglycemia (4.8 +/- 0.1 mmol/l, 86 +/- 5 mg/dl) between 1430 and 1630. Neuroendocrine, symptomatic, and cognitive responses to hyperinsulinemic stepped hypoglycemic (4.7, 4.2, 3.6, 3.0, 2.8, 2.5, and 2.2 mmol/l; 85, 75, 65, 55, 50, 45, and 40 mg/dl) clamps were quantitated the following morning on both occasions. Cognitive function tests included measures of information processing (Serial Addition), attention (Stroop Arrow Word), pattern recognition and memory (Delayed Non-Match to Sample), and declarative memory (Paragraph Recall). As expected, plasma glucagon (P = 0.0094), epinephrine (P = 0.0063), and pancreatic polypeptide (P = 0.0046) responses to stepped hypoglycemia were reduced significantly, and symptomatic responses tended to be reduced after afternoon hypoglycemia. Performance on the cognitive function tests deteriorated (P < 0.0001) during stepped hypoglycemic clamps, but there were no significant overall effects of antecedent hypoglycemia on hypoglycemic cognitive dysfunction. Although deterioration was reduced (P < 0.05) from the 2.8 mmol/l (50 mg/dl) to the 2.5 mmol/l (45 mg/dl) steps on the Serial Addition and Delayed Non-Match to Sample tasks after afternoon hypoglycemia, comparable differences were not found on the Stroop Arrow Word or Paragraph Recall tasks. Thus, glycemic thresholds for hypoglycemic cognitive dysfunction, unlike those for neuroendocrine responses to and symptoms of hypoglycemia, do not seem to shift to substantially lower plasma glucose concentrations after recent antecedent hypoglycemia in nondiabetic humans.

CiteULike

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				E. C. McNay, A. Williamson, R. J. McCrimmon, and R. S. Sherwin Cognitive and neural hippocampal effects of long-term moderate recurrent hypoglycemia. Diabetes, April 1, 2006; 55(4): 1088 - 1095. [Abstract] [Full Text] [PDF]

				K. E. Inouye, J. T. Y. Yue, O. Chan, T. Kim, E. M. Akirav, E. Park, M. C. Riddell, E. Burdett, S. G. Matthews, and M. Vranic Effects of Insulin Treatment without and with Recurrent Hypoglycemia on Hypoglycemic Counterregulation and Adrenal Catecholamine-Synthesizing Enzymes in Diabetic Rats Endocrinology, April 1, 2006; 147(4): 1860 - 1870. [Abstract] [Full Text] [PDF]

				E. C. McNay and R. S. Sherwin Effect of Recurrent Hypoglycemia on Spatial Cognition and Cognitive Metabolism in Normal and Diabetic Rats Diabetes, February 1, 2004; 53(2): 418 - 425. [Abstract] [Full Text]

				K. Inouye, K. Shum, O. Chan, J. Mathoo, S. G. Matthews, and M. Vranic Effects of recurrent hyperinsulinemia with and without hypoglycemia on counterregulation in diabetic rats Am J Physiol Endocrinol Metab, June 1, 2002; 282(6): E1369 - E1379. [Abstract] [Full Text] [PDF]

				T. Sakurai, B. Yang, T. Takata, and K. Yokono Synaptic Adaptation to Repeated Hypoglycemia Depends on the Utilization of Monocarboxylates in Guinea Pig Hippocampal Slices Diabetes, February 1, 2002; 51(2): 430 - 438. [Abstract] [Full Text] [PDF]

				K. Shum, K. Inouye, O. Chan, J. Mathoo, D. Bilinski, S. G. Matthews, and M. Vranic Effects of antecedent hypoglycemia, hyperinsulinemia, and excess corticosterone on hypoglycemic counterregulation Am J Physiol Endocrinol Metab, September 1, 2001; 281(3): E455 - E465. [Abstract] [Full Text] [PDF]