Severe hypoglycemia in type I diabetic patients with impaired kidney function.

Abstract:

OBJECTIVE:To assess the frequency and possible risk indicators of severe hypoglycemia in insulin-dependent (type I) diabetic patients with impaired kidney function. RESEARCH DESIGN AND METHODS:Retrospective follow-up examination of case subjects and control subjects with mean follow-up periods of 2.9 and 1.3 yr, respectively. The setting was the diabetes center at the Düsseldorf University hospital. Subjects were consecutive type I diabetic patients. Case subjects consisted of 44 patients with initial serum creatinine levels of greater than or equal to 133 microM and pathological proteinuria. Control subjects consisted of 46 patients with normal serum creatinine levels matched for age, duration of diabetes, and hypertension; 57% of case subjects and 67% of control subjects were being treated with beta-blockers. Incidence of severe hypoglycemia (cases/patient-yr) was assessed through an interviewer-administered questionnaire. RESULTS:At comparable levels of HbA1c (7.9 +/- 1.8 vs. 7.6 +/- 1.1%), case subjects had a fivefold higher incidence of severe hypoglycemic episodes (1.28 vs. 0.25 cases/patient-yr, P less than 0.02) than control subjects. Within the group with impaired kidney function, patients with severe hypoglycemic episodes had lower HbA1c levels (7.4 +/- 1.6 vs. 8.7 +/- 2.0%, P less than 0.03) and a lower body mass index (22.0 +/- 3.4 vs. 24.4 +/- 3.8 kg/m2, P less than 0.04) than those without severe hypoglycemic episodes, whereas serum creatinine levels, body weight-related insulin dosage (U x kg-1 x day-1), prevalence of blindness, autonomic neuropathy, and treatment with beta-blockers were comparable. CONCLUSIONS:Type I diabetic patients with impaired kidney function are at an excessively high risk of severe hypoglycemia. In addition to low HbA1c levels, a low body mass index appears to be a risk indicator for this adverse effect of insulin therapy.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Mühlhauser I,Toth G,Sawicki PT,Berger M

doi

10.2337/diacare.14.4.344

subject

Has Abstract

pub_date

1991-04-01 00:00:00

pages

344-6

issue

4

eissn

0149-5992

issn

1935-5548

journal_volume

14

pub_type

杂志文章
  • Novel Protein Glycan-Derived Markers of Systemic Inflammation and C-Reactive Protein in Relation to Glycemia, Insulin Resistance, and Insulin Secretion.

    abstract:OBJECTIVE:N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB) moieties of glycosylated serum proteins are nonspecific measures of inflammation, but conclusive data on their relationship with insulin resistance or insulin secretion are missing. Therefore, we aimed to examine the relation of GlycA, GlycB, a...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc16-1569

    authors: Lorenzo C,Festa A,Hanley AJ,Rewers MJ,Escalante A,Haffner SM

    更新日期:2017-03-01 00:00:00

  • The midregional fragment of pro-A-type natriuretic peptide, blood pressure, and mortality in a prospective cohort study of patients with type 2 diabetes (ZODIAC-25).

    abstract:OBJECTIVE:Evidence that midregional fragment of pro-A-type natriuretic peptide (MR-proANP) is a marker of mortality in patients with type 2 diabetes is limited. Therefore, we aimed to investigate the capabilities of MR-proANP in predicting mortality. We also investigated whether MR-proANP influences the relationship be...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-0428

    authors: van Hateren KJ,Landman GW,Kleefstra N,Groenier KH,Struck J,Navis GJ,Bakker SJ,Houweling ST,van der Meer K,Bilo HJ

    更新日期:2013-05-01 00:00:00

  • Eating fish and risk of type 2 diabetes: A population-based, prospective follow-up study.

    abstract:OBJECTIVE:To investigate the relation between total fish, type of fish (lean and fatty), and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake and risk of type 2 diabetes in a population-based cohort. RESEARCH DESIGN AND METHODS:The analysis included 4,472 Dutch participants aged >or=55 years without d...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-1042

    authors: van Woudenbergh GJ,van Ballegooijen AJ,Kuijsten A,Sijbrands EJ,van Rooij FJ,Geleijnse JM,Hofman A,Witteman JC,Feskens EJ

    更新日期:2009-11-01 00:00:00

  • Asymptomatic bacteriuria and hemoglobin A1.

    abstract::We measured hemoglobin A1 (HbA1) and performed clean-catch urine cultures in 752 patients (411 men and 341 women) with non-insulin-dependent diabetes mellitus (NIDDM) attending an outpatient diabetes clinic. Prevalence of bacteriuria was significantly greater in diabetic women than in controls (9.1 vs. 5.0%, P less th...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.9.5.518

    authors: Schmitt JK,Fawcett CJ,Gullickson G

    更新日期:1986-09-01 00:00:00

  • Clinical and genetic determinants of progression of type 2 diabetes: a DIRECT study.

    abstract:OBJECTIVE:To identify the clinical and genetic factors that explain why the rate of diabetes progression is highly variable between individuals following diagnosis of type 2 diabetes. RESEARCH DESIGN AND METHODS:We studied 5,250 patients with type 2 diabetes using comprehensive electronic medical records in Tayside, S...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-1995

    authors: Zhou K,Donnelly LA,Morris AD,Franks PW,Jennison C,Palmer CN,Pearson ER

    更新日期:2014-01-01 00:00:00

  • Remembering Statins: Do Statins Have Adverse Cognitive Effects?

    abstract::The issue of statin-associated cognitive impairment has been a hot topic among both patients and health care providers, especially since the U.S. Food and Drug Administration (FDA) issued a statement regarding rare postmarketing reports of ill-defined cognitive impairment associated with statin use. This statement was...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/dcS15-3022

    authors: Bitzur R

    更新日期:2016-08-01 00:00:00

  • Sodium-Glucose Cotransporter 2 Inhibitors and the Risk of Below-Knee Amputation: A Multicenter Observational Study.

    abstract:OBJECTIVE:Reports of amputations associated with sodium-glucose cotransporter 2 (SGLT2) inhibitors have been inconsistent. We aimed to compare the risk of below-knee amputation with SGLT2 inhibitors versus dipeptidyl peptidase 4 (DPP-4) inhibitors among patients with type 2 diabetes. RESEARCH DESIGN AND METHODS:This m...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc20-0267

    authors: Yu OHY,Dell'Aniello S,Shah BR,Brunetti VC,Daigle JM,Fralick M,Douros A,Hu N,Alessi-Severini S,Fisher A,Bugden SC,Ronksley PE,Filion KB,Ernst P,Lix LM,Canadian Network for Observational Drug Effect Studies (CNODES) Investiga

    更新日期:2020-10-01 00:00:00

  • Alanine aminotransferase and directly measured insulin sensitivity in a multiethnic cohort: the Insulin Resistance Atherosclerosis Study.

    abstract:OBJECTIVE:The objective of the present analysis was to evaluate the association of alanine aminotransferase (ALT) with directly measured insulin sensitivity (S(i)) in a large, multiethnic cohort of U.S. adults and to determine whether ALT adds to existing metabolic risk definitions in identifying subjects with insulin ...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/dc07-0086

    authors: Hanley AJ,Wagenknecht LE,Festa A,D'Agostino RB Jr,Haffner SM

    更新日期:2007-07-01 00:00:00

  • Fish oil and glycemic control in diabetes. A meta-analysis.

    abstract:OBJECTIVE:Hypertriglyceridemia is associated with cardiovascular disease in diabetes. Fibrates effectively lower, but do not always normalize, serum triglyceride levels. Fish oil supplements may then be added to lower serum triglyceride levels. Doubt remains whether the net effect of fish oil intake on glycemic control...

    journal_title:Diabetes care

    pub_type: 杂志文章,meta分析

    doi:10.2337/diacare.21.4.494

    authors: Friedberg CE,Janssen MJ,Heine RJ,Grobbee DE

    更新日期:1998-04-01 00:00:00

  • Effect of chronic intermittent intravenous insulin therapy on antihypertensive medication requirements in IDDM subjects with hypertension and nephropathy.

    abstract:OBJECTIVE:The prevalence of systemic hypertension is increased in patients with diabetes. In this prospective, randomized, crossover clinical trial, we assessed antihypertensive effects of chronic intermittent intravenous insulin therapy (CIIIT) on insulin-dependent diabetes mellitus (IDDM) subjects with hypertension a...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.18.9.1260

    authors: Aoki TT,Grecu EO,Prendergast JJ,Arcangeli MA,Meisenheimer R

    更新日期:1995-09-01 00:00:00

  • Lifestyle Counseling and Long-term Clinical Outcomes in Patients With Diabetes.

    abstract:OBJECTIVE:To investigate the relationship between lifestyle counseling in primary care settings and clinical outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS:We retrospectively studied hyperglycemic adults with diabetes treated at primary care practices between 2000 and 2014. We analyzed the relationshi...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc19-0629

    authors: Zhang H,Goldberg SI,Hosomura N,Shubina M,Simonson DC,Testa MA,Turchin A

    更新日期:2019-09-01 00:00:00

  • Plasma copeptin and renal outcomes in patients with type 2 diabetes and albuminuria.

    abstract:OBJECTIVE:Plasma copeptin, a surrogate for vasopressin, was associated with albuminuria in population-based studies. These associations are consistent with the effect of vasopressin on albuminuria observed in humans and rodents. The objective of this study was to determine whether plasma copeptin is an independent mark...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-0683

    authors: Velho G,Bouby N,Hadjadj S,Matallah N,Mohammedi K,Fumeron F,Potier L,Bellili-Munoz N,Taveau C,Alhenc-Gelas F,Bankir L,Marre M,Roussel R

    更新日期:2013-11-01 00:00:00

  • Epidemiology of Diabetes Interventions and Complications (EDIC). Design, implementation, and preliminary results of a long-term follow-up of the Diabetes Control and Complications Trial cohort.

    abstract:OBJECTIVE:The Diabetes Control and Complications Trial (DCCT) demonstrated the powerful impact of glycemic control on the early manifestations of microvascular complications. Contemporary prospective data on the evolution of macrovascular and late microvascular complications of type 1 diabetes are limited. The Epidemio...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/diacare.22.1.99

    authors:

    更新日期:1999-01-01 00:00:00

  • A New Zealand linkage study examining the associations between A1C concentration and mortality.

    abstract:OBJECTIVE:To examine associations between A1C concentration and mortality in a New Zealand population. RESEARCH DESIGN AND METHODS:During a Hepatitis Foundation screening campaign for hepatitis B (1999-2001), participants were offered A1C testing. The participants were anonymously linked to the national mortality coll...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc07-2374

    authors: Brewer N,Wright CS,Travier N,Cunningham CW,Hornell J,Pearce N,Jeffreys M

    更新日期:2008-06-01 00:00:00

  • Exercise therapy in type 2 diabetes: is daily exercise required to optimize glycemic control?

    abstract:OBJECTIVE:Given the transient nature of exercise-induced improvements in insulin sensitivity, it has been speculated that daily exercise is preferred to maximize the benefits of exercise for glycemic control. The current study investigates the impact of daily exercise versus exercise performed every other day on glycem...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc11-2112

    authors: van Dijk JW,Tummers K,Stehouwer CD,Hartgens F,van Loon LJ

    更新日期:2012-05-01 00:00:00

  • The effect of ruboxistaurin on nephropathy in type 2 diabetes.

    abstract:OBJECTIVE:Ruboxistaurin selectively inhibits protein kinase C-beta and ameliorates kidney disease in animal models of diabetes. The purpose of this study was to evaluate the effects of ruboxistaurin on diabetic nephropathy in humans. RESEARCH DESIGN AND METHODS:A randomized, double-blind, placebo-controlled, multicent...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.2337/diacare.28.11.2686

    authors: Tuttle KR,Bakris GL,Toto RD,McGill JB,Hu K,Anderson PW

    更新日期:2005-11-01 00:00:00

  • More impact of microalbuminuria on retinopathy than moderately reduced GFR among type 2 diabetic patients.

    abstract:OBJECTIVE:The current study aimed to investigate whether microalbuminuria or moderately decreased glomerular filtration rate (GFR) is a better predictor for the development and progression of retinopathy in type 2 diabetic patients. RESEARCH DESIGN AND METHODS:Type 2 diabetic patients without cardiovascular diseases, ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-1955

    authors: Chen YH,Chen HS,Tarng DC

    更新日期:2012-04-01 00:00:00

  • Assessment of diabetic retinopathy using nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) compared with ETDRS 7-field stereo photography.

    abstract:OBJECTIVE:To compare the diagnostic properties of a nonmydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) versus mydriatic Early Treatment of Diabetic Retinopathy Study (ETDRS) 7-field photography for diabetic retinopathy (DR) screening. RESEARCH DESIGN AND METHODS:A consecutive series of 212 eyes of 1...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-0346

    authors: Kernt M,Hadi I,Pinter F,Seidensticker F,Hirneiss C,Haritoglou C,Kampik A,Ulbig MW,Neubauer AS

    更新日期:2012-12-01 00:00:00

  • Elevation of N-(carboxymethyl)valine residue in hemoglobin of diabetic patients. Its role in the development of diabetic nephropathy.

    abstract:OBJECTIVE:Advanced glycation end products (AGEs) are a risk factor for diabetic complications. We have developed an assay method for N-(carboxymethyl)valine (CMV) of the hemoglobin (CMV-Hb), which is an AGE generated from HbA1c. Herein we describe the clinical utility of CMV-Hb measurement for the diagnosis of diabetic...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.24.5.891

    authors: Uchimura T,Nakano K,Hashiguchi T,Iwamoto H,Miura K,Yoshimura Y,Hanyu N,Hirata K,Imakuma M,Motomiya Y,Maruyama I

    更新日期:2001-05-01 00:00:00

  • One-year outcome of a combination of weight loss therapies for subjects with type 2 diabetes: a randomized trial.

    abstract:OBJECTIVE:The purpose of this study was to evaluate the effects of a combination weight loss program using intermittent low-calorie diets, energy-controlled meal replacement products, and sibutramine on weight loss, diabetes control, and cardiovascular risk factors in overweight or obese subjects with type 2 diabetes. ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.26.9.2505

    authors: Redmon JB,Raatz SK,Reck KP,Swanson JE,Kwong CA,Fan Q,Thomas W,Bantle JP

    更新日期:2003-09-01 00:00:00

  • Effect of diabetes on renal medullary oxygenation during water diuresis.

    abstract:OBJECTIVES:To study the effect of water diuresis on renal medullary and cortical oxygenation in patients with diabetes using blood oxygenation level--dependent magnetic resonance imaging (BOLD MRI). RESEARCH DESIGN AND METHODS:Nine mild diabetic subjects (48 +/- 2.7 years of age, six women) and nine nondiabetic subjec...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.25.3.575

    authors: Epstein FH,Veves A,Prasad PV

    更新日期:2002-03-01 00:00:00

  • Depression and diabetes: a large population-based study of sociodemographic, lifestyle, and clinical factors associated with depression in type 1 and type 2 diabetes.

    abstract:OBJECTIVE:The purpose of this study was to investigate factors associated with depression in type 1 and type 2 diabetes and test whether these differ from factors associated with depression in the nondiabetic population. RESEARCH DESIGN AND METHODS:In an unselected population study comprising 60,869 individuals, poten...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.28.8.1904

    authors: Engum A,Mykletun A,Midthjell K,Holen A,Dahl AA

    更新日期:2005-08-01 00:00:00

  • Effects of pramlintide on postprandial glucose excursions and measures of oxidative stress in patients with type 1 diabetes.

    abstract:OBJECTIVE:Oxidative stress has been shown to be increased in the postprandial period in patients with diabetes and has been implicated in the pathogenesis of micro- and macrovascular complications. The aim of this post hoc analysis was to assess the effects of pramlintide, an amylin analog shown to reduce postprandial ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.28.3.632

    authors: Ceriello A,Piconi L,Quagliaro L,Wang Y,Schnabel CA,Ruggles JA,Gloster MA,Maggs DG,Weyer C

    更新日期:2005-03-01 00:00:00

  • Clinical trials of cyclosporin in IDDM.

    abstract::The results of uncontrolled trials in immunomodulation of insulin-dependent diabetes mellitus (IDDM) led to randomized controlled trials in Canada and Europe. In the Canadian open study, the rate of clinical remissions (target control of glycemia maintained with less than or equal to 0.15 U.kg-1.day-1 insulin) was une...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章

    doi:

    authors: Dupré J,Stiller CR,Gent M,Donner A,von Graffenried B,Heinrichs D,Jenner M,Keown P,Mahon J,Martell R

    更新日期:1988-11-01 00:00:00

  • Sex hormone-binding globulin levels predict insulin sensitivity, disposition index, and cardiovascular risk during puberty.

    abstract:OBJECTIVE:Early puberty is associated with increased risk of subsequent cardiovascular disease. Low sex hormone-binding globulin (SHBG) levels are a feature of early puberty and of conditions associated with increased cardiovascular risk. The aim of the present study was to evaluate SHBG as a predictor of glucose metab...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-1618

    authors: Sørensen K,Aksglaede L,Munch-Andersen T,Aachmann-Andersen NJ,Petersen JH,Hilsted L,Helge JW,Juul A

    更新日期:2009-05-01 00:00:00

  • The Impact of Liraglutide on Diabetes-Related Foot Ulceration and Associated Complications in Patients With Type 2 Diabetes at High Risk for Cardiovascular Events: Results From the LEADER Trial.

    abstract:OBJECTIVE:Diabetes-related foot ulcers (DFUs) and their sequelae result in large patient and societal burdens. Long-term data determining the efficacy of individual glucose-lowering agents on DFUs are lacking. Using existing data from the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome R...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.2337/dc18-1094

    authors: Dhatariya K,Bain SC,Buse JB,Simpson R,Tarnow L,Kaltoft MS,Stellfeld M,Tornøe K,Pratley RE,LEADER Publication Committee on behalf of the LEADER Trial Investigators.

    更新日期:2018-10-01 00:00:00

  • Diabetes and impaired fasting glycemia in the tribes of Khagrachari hill tracts of Bangladesh.

    abstract:OBJECTIVE:To determine the prevalence of type 2 diabetes and impaired fasting glycemia (IFG) in a tribal population of Bangladesh. RESEARCH DESIGN AND METHODS:A cluster sampling of 1,287 tribal subjects of age > or =20 years was investigated. They live in a hilly area of Khagrachari in the far northeast of Bangladesh....

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.27.5.1054

    authors: Abu Sayeed M,Mahtab H,Akter Khanam P,Abul Ahsan K,Banu A,Rashid AN,Azad Khan AK

    更新日期:2004-05-01 00:00:00

  • Malfunction of continuous subcutaneous insulin infusion systems: a one-year prospective study of 127 patients.

    abstract::Malfunction of portable continuous subcutaneous insulin infusion (CSII) systems may result in either ketoacidosis or serious hypoglycemia. To determine the types and frequencies of infusion system failure and the resulting clinical consequences, we recorded their occurrences in a 1-yr prospective study of 127 patients...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.9.4.351

    authors: Mecklenburg RS,Guinn TS,Sannar CA,Blumenstein BA

    更新日期:1986-07-01 00:00:00

  • Early childhood gut microbiomes show strong geographic differences among subjects at high risk for type 1 diabetes.

    abstract:OBJECTIVE:Gut microbiome dysbiosis is associated with numerous diseases, including type 1 diabetes. This pilot study determines how geographical location affects the microbiome of infants at high risk for type 1 diabetes in a population of homogenous HLA class II genotypes. RESEARCH DESIGN AND METHODS:High-throughput ...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/dc14-0850

    authors: Kemppainen KM,Ardissone AN,Davis-Richardson AG,Fagen JR,Gano KA,León-Novelo LG,Vehik K,Casella G,Simell O,Ziegler AG,Rewers MJ,Lernmark Å,Hagopian W,She JX,Krischer JP,Akolkar B,Schatz DA,Atkinson MA,Triplett EW,TED

    更新日期:2015-02-01 00:00:00

  • Reconciliation of Type 2 Diabetes Remission Rates in Studies of Roux-en-Y Gastric Bypass.

    abstract:OBJECTIVE:Bariatric surgery may induce remission of type 2 diabetes in obese patients. However, estimates of remission rates reported in the literature range from 25 to 81%, contributing to the uncertainty patients and physicians both face as they assess treatment options. This analysis attempts to reconcile the seemin...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc16-0954

    authors: Isaman DJ,Rothberg AE,Herman WH

    更新日期:2016-12-01 00:00:00