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Year 2018, Volume: 10 Issue: 3, 24 - 27, 26.05.2018

Abstract

Abstract

In recent years, diabetes prevalence is increasing in Turkey and in the World. Aggressive therapies with insulin-based regimens have an important place in the management of this disease which causes  morbidity and mortality by its complications. However, hypoglycaemia, which occurs during these treatments and causes morbidity and evenmortality in itself, is a serious question. Recent studies show that the cause of hypoglycemia is not only ınsulin use but is based on many versatile etiology and pathophysiology. The aim of this article is to examine the work done on hypoglycemia during diabetes treatment and to present improved ideas on their results.

References

  • Kaynaklar 1.Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag Net al.Twelve year trends in the prevalence and risk factors ofdiabetes and prediabetes in Turkish adults. Eur JEpidemiol.2013;28:169-180 .2.International Diabetes Federation. IDF Diabetes Atlas. (6thed). Brussels, Belgium: International Diabetes Federation;2013;153. 3.The Diabetes Control and Complications Trial Research Gro-up. The effect of intensive treatment of diabetes on the develop-ment and progression of long-term complications in insulin-de-pendent diabetes mellitus. N Engl J Med 1993; 329:977-986. 4.UK Prospective Diabetes Study (UKPDS) Group. Intensiveblood-glucose control with sulphonylureas or insulin compa-red with conventional treatment and risk of complications inpatients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-853. 5.The Diabetes Control and Complications Trial/Epidemiologyof Diabetes Interventions and Complications (DCCT/EDIC)Study Research Group, Nathan DM, Cleary PA, Backlund JY,Genuth SM, Lachin JM, Orchard TJ et al. Intensive diabetestreatment and cardiovascular disease in patients with type 1diabetes. N Engl J Med 2005; 353:2643-2653. 6.Workgroup on Hypoglycemia. American Diabetes Associati-on. Defining and reporting hypoglycemia in diabetes. Diabe-tes Care 2005; 28:1245-1249. 7.Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S,Fish L,et al. Hypoglycemia and diabetes: a report of a workg-roup of the American Diabetes Association and the Endocri-ne Society. Diabetes Care 2013; 36:1384-1395. 8.ACCORD Study Group, Gerstein HC, Miller ME, ByingtonRP, Goff DC, Jr., Bigger JT, Buse JB,et al. Effects of inten-sive glucose lowering in type 2 diabetes. N Engl J Med 2008;358:2545-2559. 9.Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V,etal. Intensive versus conventional glucose control in criticallyill patients. N Engl J Med 2009; 360:1283-1297. 10.Mellbin LG, Ryden L, Riddle MC, Probstfield J, RosenstockJ, Diaz R, et al.Does hypoglycaemia increase the risk of car-diovascular events? A report from the ORIGIN trial. Eur He-art J 2013; 34:3137-3144. 11.Cryer PE. The barrier of hypoglycemia in diabetes. Diabetes2008; 57:3169-3176. 12.Cryer PE. Hypoglycemia in Diabetes: Pathophysiology,Prevalence and Prevention. 2nd Ed. Alexandria, VA, Ameri-can Diabetes Association, 2013. 13.Matschinsky FM. Regulation of pancreatic beta-cell glucoki-nase: from basics to therapeutics. Diabetes. 2002;51(Suppl3):S394–404. 14.Berson SA, Yalow RS, Bauman A, Rothschild MA, Newerly K.Insulin-I131 metabolism in human subjects: demonstration ofinsulin binding globulin in the circulation of insulin treatedsubjects. The Journal of Clinical Investigation.1956;35:170–190. 15.Yalow RS, Berson SA. Dynamics of Insulin Secretion inHypoglycemia. Diabetes. 1965;14:341–349. 16.Meissner T, Wendel U, Burgard P, Schaetzle S, Mayatepek E.Long-term follow-up of 114 patients with congenital hyperin-sulinism. Eur J Endocrinol (2003) 149(1):43–51.10.1530/eje.0.1490043 17.Rossetti P, Porcellati F, Bolli GB, Fanelli CG. Prevention ofhypoglycemia while achieving good glycemic control in type1 diabetes. Diabetes Care 2008; 31 (Suppl 2):S113-S120. 18.Siebenhofer A, Plank J, Berghold A, Jeitler K, Horvath K, Na-rath M, et al. Short acting insulin analogues versus regularhuman insulin in patients with diabetes mellitus. Cochrane Da-tabase Syst Rev 2006; CD003287. 19.Horvath K, Jeitler K, Berghold A, Ebrahim SH, Gratzer TW,Plank J,et al.Long-acting insulin analogues versus NPH in-sulin (human isophane insulin) for type 2 diabetes mellitus.Cochrane Database Syst Rev 2007; CD005613. 20.Pedersen-Bjergaard U, Kristensen PL, Beck-Nielsen H, Norga-ard K, Perrild H, Christiansen JS,et al. Effect of insulin analo-gues on risk of severe hypoglycaemia in patients with type 1 dia-betes prone to recurrent severe hypoglycaemia (HypoAna Tri-al): a prospective, randomised, open-label, blinded-endpoint cros-sover trial. Lancet Diabetes Endocrinol 2014; 2:553-561. 21.Bay C, Kristensen PL, Pedersen-Bjergaard U, Tarnow L,Thorsteinsson B. Nocturnal continuous glucose monitoring:accuracy and reliability of hypoglycemia detection in patientswith type 1 diabetes at high risk of severe hypoglycemia. Dia-betes Technol Ther 2013; 15:371-377. 22.Polonsky KS, Given BD, Van Cauter E. Twentyfourhour pro-files and pulsatile patterns of insulin secretion in normal andobese subjects. J Clin Invest 1988; 81: 442–448. 23.Brunner GA, Hirschberger S, Sendlhofer G, Wutte A, Ellme-rer M, Balent B, et al Postprandial administration of the in-sulin analogue insulin aspart in patients with type 1 diabetesmellitus. Diabet Med 2000; 17: 371–375. 24.Ratner R, Wynne A, Nakhle S, Brusco O, Vlajnic A, RendellM. Influence of preprandial vs. postprandial insulin glulisi-ne on weight and glycaemic control in patients initiatingbasalbolus regimen for type 2 diabetes: a multicenter, ran-domized, parallel, openlabel study. Diabetes Obes Metab 2011;13: 1142–1148. 25.Slattery D, Amiel SA, Choudhary P.Optimal prandial timingof bolus insulin in diabetes management: a review. Diabet Med.2018 Mar;35(3):306-316. doi: 10.1111/dme.13525. Epub 2017Nov 6.

İnsülin Tedavisi ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış

Year 2018, Volume: 10 Issue: 3, 24 - 27, 26.05.2018

Abstract

Öz

Son yıllarda Türkiye’de ve dünyada diyabet prevelansı artmaktadır. Komplikasyonları ile morbidite ve mortaliteye sebep olan bu hastalığın yönetiminde özellikle insülin bazlı rejimlerle agresif tedaviler önemli bir yer tutar. Fakat bu tedaviler sırasında ortaya çıkan  ve kendisi de morbidite ve hatta mortaliteye sebep olan hipoglisemi ciddi birsorundur. Yapılan çalışmalar hipoglisemi sebebinin sadece insülin uygulamaktan ziyade çok yönlü etiyoloji ve patofizyolojiye dayandığını göstermektedir. Bu makalede amaç  diyabet tedavisi sırasında gelişen hipoglisemi konusunda yapılan çalışmaların incelenmesi ve bunların sonuçlarına dair geliştirilmiş olan fikirleri sunmaktır.

References

  • Kaynaklar 1.Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag Net al.Twelve year trends in the prevalence and risk factors ofdiabetes and prediabetes in Turkish adults. Eur JEpidemiol.2013;28:169-180 .2.International Diabetes Federation. IDF Diabetes Atlas. (6thed). Brussels, Belgium: International Diabetes Federation;2013;153. 3.The Diabetes Control and Complications Trial Research Gro-up. The effect of intensive treatment of diabetes on the develop-ment and progression of long-term complications in insulin-de-pendent diabetes mellitus. N Engl J Med 1993; 329:977-986. 4.UK Prospective Diabetes Study (UKPDS) Group. Intensiveblood-glucose control with sulphonylureas or insulin compa-red with conventional treatment and risk of complications inpatients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-853. 5.The Diabetes Control and Complications Trial/Epidemiologyof Diabetes Interventions and Complications (DCCT/EDIC)Study Research Group, Nathan DM, Cleary PA, Backlund JY,Genuth SM, Lachin JM, Orchard TJ et al. Intensive diabetestreatment and cardiovascular disease in patients with type 1diabetes. N Engl J Med 2005; 353:2643-2653. 6.Workgroup on Hypoglycemia. American Diabetes Associati-on. Defining and reporting hypoglycemia in diabetes. Diabe-tes Care 2005; 28:1245-1249. 7.Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S,Fish L,et al. Hypoglycemia and diabetes: a report of a workg-roup of the American Diabetes Association and the Endocri-ne Society. Diabetes Care 2013; 36:1384-1395. 8.ACCORD Study Group, Gerstein HC, Miller ME, ByingtonRP, Goff DC, Jr., Bigger JT, Buse JB,et al. Effects of inten-sive glucose lowering in type 2 diabetes. N Engl J Med 2008;358:2545-2559. 9.Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V,etal. Intensive versus conventional glucose control in criticallyill patients. N Engl J Med 2009; 360:1283-1297. 10.Mellbin LG, Ryden L, Riddle MC, Probstfield J, RosenstockJ, Diaz R, et al.Does hypoglycaemia increase the risk of car-diovascular events? A report from the ORIGIN trial. Eur He-art J 2013; 34:3137-3144. 11.Cryer PE. The barrier of hypoglycemia in diabetes. Diabetes2008; 57:3169-3176. 12.Cryer PE. Hypoglycemia in Diabetes: Pathophysiology,Prevalence and Prevention. 2nd Ed. Alexandria, VA, Ameri-can Diabetes Association, 2013. 13.Matschinsky FM. Regulation of pancreatic beta-cell glucoki-nase: from basics to therapeutics. Diabetes. 2002;51(Suppl3):S394–404. 14.Berson SA, Yalow RS, Bauman A, Rothschild MA, Newerly K.Insulin-I131 metabolism in human subjects: demonstration ofinsulin binding globulin in the circulation of insulin treatedsubjects. The Journal of Clinical Investigation.1956;35:170–190. 15.Yalow RS, Berson SA. Dynamics of Insulin Secretion inHypoglycemia. Diabetes. 1965;14:341–349. 16.Meissner T, Wendel U, Burgard P, Schaetzle S, Mayatepek E.Long-term follow-up of 114 patients with congenital hyperin-sulinism. Eur J Endocrinol (2003) 149(1):43–51.10.1530/eje.0.1490043 17.Rossetti P, Porcellati F, Bolli GB, Fanelli CG. Prevention ofhypoglycemia while achieving good glycemic control in type1 diabetes. Diabetes Care 2008; 31 (Suppl 2):S113-S120. 18.Siebenhofer A, Plank J, Berghold A, Jeitler K, Horvath K, Na-rath M, et al. Short acting insulin analogues versus regularhuman insulin in patients with diabetes mellitus. Cochrane Da-tabase Syst Rev 2006; CD003287. 19.Horvath K, Jeitler K, Berghold A, Ebrahim SH, Gratzer TW,Plank J,et al.Long-acting insulin analogues versus NPH in-sulin (human isophane insulin) for type 2 diabetes mellitus.Cochrane Database Syst Rev 2007; CD005613. 20.Pedersen-Bjergaard U, Kristensen PL, Beck-Nielsen H, Norga-ard K, Perrild H, Christiansen JS,et al. Effect of insulin analo-gues on risk of severe hypoglycaemia in patients with type 1 dia-betes prone to recurrent severe hypoglycaemia (HypoAna Tri-al): a prospective, randomised, open-label, blinded-endpoint cros-sover trial. Lancet Diabetes Endocrinol 2014; 2:553-561. 21.Bay C, Kristensen PL, Pedersen-Bjergaard U, Tarnow L,Thorsteinsson B. Nocturnal continuous glucose monitoring:accuracy and reliability of hypoglycemia detection in patientswith type 1 diabetes at high risk of severe hypoglycemia. Dia-betes Technol Ther 2013; 15:371-377. 22.Polonsky KS, Given BD, Van Cauter E. Twentyfourhour pro-files and pulsatile patterns of insulin secretion in normal andobese subjects. J Clin Invest 1988; 81: 442–448. 23.Brunner GA, Hirschberger S, Sendlhofer G, Wutte A, Ellme-rer M, Balent B, et al Postprandial administration of the in-sulin analogue insulin aspart in patients with type 1 diabetesmellitus. Diabet Med 2000; 17: 371–375. 24.Ratner R, Wynne A, Nakhle S, Brusco O, Vlajnic A, RendellM. Influence of preprandial vs. postprandial insulin glulisi-ne on weight and glycaemic control in patients initiatingbasalbolus regimen for type 2 diabetes: a multicenter, ran-domized, parallel, openlabel study. Diabetes Obes Metab 2011;13: 1142–1148. 25.Slattery D, Amiel SA, Choudhary P.Optimal prandial timingof bolus insulin in diabetes management: a review. Diabet Med.2018 Mar;35(3):306-316. doi: 10.1111/dme.13525. Epub 2017Nov 6.
There are 1 citations in total.

Details

Primary Language Turkish
Journal Section makaleler
Authors

Özlem Özdemir

Publication Date May 26, 2018
Published in Issue Year 2018 Volume: 10 Issue: 3

Cite

APA Özdemir, Ö. (2018). İnsülin Tedavisi ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış. Klinik Tıp Aile Hekimliği, 10(3), 24-27.
AMA Özdemir Ö. İnsülin Tedavisi ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış. Aile Hekimliği. May 2018;10(3):24-27.
Chicago Özdemir, Özlem. “İnsülin Tedavisi Ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış”. Klinik Tıp Aile Hekimliği 10, no. 3 (May 2018): 24-27.
EndNote Özdemir Ö (May 1, 2018) İnsülin Tedavisi ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış. Klinik Tıp Aile Hekimliği 10 3 24–27.
IEEE Ö. Özdemir, “İnsülin Tedavisi ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış”, Aile Hekimliği, vol. 10, no. 3, pp. 24–27, 2018.
ISNAD Özdemir, Özlem. “İnsülin Tedavisi Ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış”. Klinik Tıp Aile Hekimliği 10/3 (May 2018), 24-27.
JAMA Özdemir Ö. İnsülin Tedavisi ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış. Aile Hekimliği. 2018;10:24–27.
MLA Özdemir, Özlem. “İnsülin Tedavisi Ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış”. Klinik Tıp Aile Hekimliği, vol. 10, no. 3, 2018, pp. 24-27.
Vancouver Özdemir Ö. İnsülin Tedavisi ve Hipoglisemi Üzerine Yapılan Çalışmalara Güncel Bakış. Aile Hekimliği. 2018;10(3):24-7.