Hypoglycemia in type 2 diabetes mellitus patients — cerebral, cognitive, psychosocial and clinical aspects
https://doi.org/10.14341/DM12840
Abstract
The review article describes modern approaches to hypoglycemia in diabetes mellitus (DM) patients, its clinical and laboratory diagnostics, and its current classification. Hypoglycemia has the highest impact on cardiovascular morbidity and mortality, including stroke. Cerebral damage in neuroglycopenia, as well as neurological aspects in this group of patients, are discussed. The authors describe glycopenia’s influence on cerebral metabolism, counter-regulatory response, and impaired hypoglycemia recognition, as well as modern neuroimaging techniques that may enhance differential diagnostics in complex cases. The epidemiology of neurocognitive disorders in DM patients and their association with hypoglycemic conditions is outlined, together with psychosocial aspects of its consequences — both for the patient and relatives and for the medical professionals. The search for ways to reduce the burden of hypoglycemia from the standpoint of an effective and safe strategy for treating patients with type 2 diabetes does not lose its relevance, and therefore data on the prevalence of hypoglycemic conditions of varying severity when using certain classes of hypoglycemic drugs are presented. A therapeutic approach that maximizes metabolic control while reducing hypoglycemia to a minimum may determine further possibilities for personalized DM management.
About the Authors
K. V. Antonova
Research center of neurology
Russian Federation
Russian Federation
Ksenia V. Antonova, MD, PhD, leading research associate
80, Volokolamskoe highway, Moscow, 125367
Researcher ID: J-9971-2016;
Scopus Author ID: 7004672742;
eLibrary SPIN: 7737-4712
O. V. Lagoda
Research center of neurology
Russian Federation
Russian Federation
Olga V. Lagoda, MD, PhD, senior research associate
Moscow
Researcher ID: C-5395-2012;
Scopus Author ID: 6507370001;
eLibrary SPIN: 1789-4735
M. M. Tanashyan
Research center of neurology
Marine M. Tanashyan, MD, PhD, Professor
Moscow
Researcher ID: F-8483-2014;
Scopus Author ID: 6506228066;
eLibrary SPIN: 7191-1163
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1. Рисунок 1. Потенциальные механизмы церебральной адаптации к повторной гипогликемии. Адаптировано по Rory J. McCrimmon, 2021. Примечания: βAdR — β-адренорецептор; EphA5 — рецептор эфрина A5; TRP — каналы транзиторного рецепторного потенциала; ГАМК — гамма-аминомасляная кислота; KATФ — АТФ-зависимые калиевые каналы | |
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2. Рисунок 2. Данные МРТ. Тяжелая гипогликемия у 42-летней женщины. Визуализируется гиперинтенсивность в базальных ганглиях и валике мозолистого тела (стрелки a, c) без признаков острого ишемического повреждения в режиме ДВИ (b) и значимых изменений интракраниальных артерий (МР-ангиография) (d). Приводится по Adam G и соавт. [49]. | |
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For citations:
Antonova K.V., Lagoda O.V., Tanashyan M.M. Hypoglycemia in type 2 diabetes mellitus patients — cerebral, cognitive, psychosocial and clinical aspects. Diabetes mellitus. 2022;25(3):288-298. (In Russ.) https://doi.org/10.14341/DM12840
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