Frier Brian M
Department of Diabetes, Royal Infirmary, 51 Little France Crescent, Edinburgh EH16 4SA, Scotland, UK.
Diabetes Res Clin Pract. 2004 Sep;65 Suppl 1:S47-52. doi: 10.1016/j.diabres.2004.07.008.
Hypoglycemia is a common side effect of intensive insulin therapy in patients with type 1 diabetes. Mild hypoglycemia is any episode that can be self-treated, while a severe episode requires external help for recovery. Acute hypoglycemia produces autonomic and neuroglycopenic symptoms, including cognitive impairment and mood changes, while sympathoadrenal stimulation can provoke acute hemodynamic changes with alterations in regional vascular perfusion and a risk of cardiac dysrhythmias. Neurological manifestations include coma, convulsions and focal abnormalities. Long-term morbidities associated with hypoglycemia include impaired awareness of hypoglycemia, counterregulatory hormonal deficiencies, hypoglycemia-associated autonomic failure, and, in rare cases, permanent cognitive impairment. Hypoglycemia affects all aspects of life for the person with type 1 diabetes, including employment, social interactions, driving, sport and leisure activities, and sleep. Appreciation of the potential morbidities of hypoglycemia should encourage physicians to utilize therapeutic regimens that decrease the risk of severe hypoglycemia.
低血糖是1型糖尿病患者强化胰岛素治疗的常见副作用。轻度低血糖是指任何可自行处理的发作，而严重发作则需要外部帮助才能恢复。急性低血糖会产生自主神经和神经低血糖症状，包括认知障碍和情绪变化，而交感肾上腺刺激可引发急性血流动力学变化，伴有局部血管灌注改变和心律失常风险。神经学表现包括昏迷、抽搐和局灶性异常。与低血糖相关的长期并发症包括低血糖意识受损、反调节激素缺乏、低血糖相关自主神经功能衰竭，以及罕见的永久性认知障碍。低血糖影响1型糖尿病患者生活的方方面面，包括就业、社交互动、驾驶、运动和休闲活动以及睡眠。认识到低血糖的潜在并发症应促使医生采用降低严重低血糖风险的治疗方案。
