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Perspectives in Diabetes

Mechanisms of Hypoglycemia-Associated Autonomic Failure and Its Component Syndromes in Diabetes

  1. Philip E. Cryer
  1. From the Division of Endocrinology, Metabolism and Lipid Research and the General Clinical Research Center and Diabetes Research and Training Center, Washington University School of Medicine, St. Louis, Missouri
  1. Address correspondence and reprint requests to Philip E. Cryer, MD, Campus Box 8127, Washington University School of Medicine, 660 South Euclid Ave., St. Louis, MO 63110. E-mail: pcryer{at}wustl.edu
Diabetes 2005 Dec; 54(12): 3592-3601. https://doi.org/10.2337/diabetes.54.12.3592
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    Hypoglycemia-associated autonomic failure in type 1 diabetes. Modified from ref. 1. © 2004 by the MA Medical Society.

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    Mechanisms of the fundamental components of hypoglycemia-associated autonomic failure in diabetes

    Loss of the glucagon response: the intraislet insulin hypothesis
    Reduced awareness: the sympathetic neural hypothesis
    Reduced sympathoadrenal responses
        The central nervous system premise
        The systemic mediator hypothesis
        The brain fuel transport hypothesis
        The brain metabolism hypothesis
        The brain glycogen supercompensation hypothesis
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December 2005, 54(12)
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Mechanisms of Hypoglycemia-Associated Autonomic Failure and Its Component Syndromes in Diabetes
Philip E. Cryer
Diabetes Dec 2005, 54 (12) 3592-3601; DOI: 10.2337/diabetes.54.12.3592

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Mechanisms of Hypoglycemia-Associated Autonomic Failure and Its Component Syndromes in Diabetes
Philip E. Cryer
Diabetes Dec 2005, 54 (12) 3592-3601; DOI: 10.2337/diabetes.54.12.3592
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  • Article
    • Abstract
    • THE CLINICAL PROBLEM
    • THE PATHOPHYSIOLOGY OF GLUCOSE COUNTERREGULATION IN DIABETES
    • HAAF IN DIABETES
    • THE MECHANISM OF THE LOSS OF THE GLUCAGON RESPONSE TO HYPOGLYCEMIA IN INSULIN-DEFICIENT DIABETES: THE INTRAISLET INSULIN HYPOTHESIS
    • THE MECHANISM OF HYPOGLYCEMIA UNAWARENESS IN DIABETES: THE SYMPATHETIC NEURAL HYPOTHESIS
    • THE MECHANISM OF THE SHIFT OF THE GLYCEMIC THRESHOLDS FOR SYMPATHOADRENAL ACTIVATION TO LOWER PLASMA GLUCOSE CONCENTRATIONS BY RECENT ANTECEDENT HYPOGLYCEMIA
    • The CNS premise.
    • The systemic mediator hypothesis.
    • The brain fuel transport hypothesis.
    • The brain metabolism hypothesis.
    • The brain glycogen supercompensation hypothesis.
    • DIVERSE CAUSES OF HAAF IN DIABETES
    • COMMENT
    • Acknowledgments
    • Footnotes
    • REFERENCES
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