Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus

Anne-Sophie Sejling; Troels W Kjaer; Ulrik Pedersen-Bjergaard; Line S Remvig; Christian S Frandsen; Linda Hilsted; Jens Faber; Jens Juul Holst; Lise Tarnow; Jakob Skadkær Møller; Martin N Nielsen; Birger Thorsteinsson; Claus B Juhl

doi:10.1089/dia.2016.0331

Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus

Anne-Sophie Sejling, Troels W Kjaer, Ulrik Pedersen-Bjergaard, Line S Remvig, Christian S Frandsen, Linda Hilsted, Jens Faber, Jens Juul Holst, Lise Tarnow, Jakob Skadkær Møller, Martin N Nielsen, Birger Thorsteinsson, Claus B Juhl

Institut for Klinisk Medicin

10 Citationer (Scopus)

Abstract

BACKGROUND: Recurrent hypoglycemia has been shown to blunt hypoglycemia symptom scores and counterregulatory hormonal responses during subsequent hypoglycemia. We therefore studied whether hypoglycemia-associated electroencephalogram (EEG) changes are affected by an antecedent episode of hypoglycemia.

METHODS: Twenty-four patients with type 1 diabetes mellitus (10 with normal hypoglycemia awareness, 14 with hypoglycemia unawareness) were studied on 2 consecutive days by hyperinsulinemic glucose clamp at hypoglycemia (2.0-2.5 mmol/L) during a 1-h period. EEG was recorded, cognitive function assessed, and hypoglycemia symptom scores and counterregulatory hormonal responses were obtained.

RESULTS: Twenty-one patients completed the study. Hypoglycemia-associated EEG changes were identified on both days with no differences in power or frequency distribution in the theta, alpha, or the combined theta-alpha band during hypoglycemia on the 2 days. Similar degree of cognitive dysfunction was also present during hypoglycemia on both days. When comparing the aware and unaware group, there were no differences in the hypoglycemia-associated EEG changes. There were very subtle differences in cognitive function between the two groups on day 2. The symptom response was higher in the aware group on both days, while only subtle differences were seen in the counterregulatory hormonal response.

CONCLUSION: Antecedent hypoglycemia does not affect hypoglycemia-associated EEG changes in patients with type 1 diabetes mellitus.

Originalsprog	Engelsk
Tidsskrift	Diabetes Technology & Therapeutics
Vol/bind	19
Udgave nummer	2
Sider (fra-til)	85-90
Antal sider	6
ISSN	1520-9156
DOI	https://doi.org/10.1089/dia.2016.0331
Status	Udgivet - 1 feb. 2017

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Sejling, A.-S., Kjaer, T. W., Pedersen-Bjergaard, U., Remvig, L. S., Frandsen, C. S., Hilsted, L., Faber, J., Holst, J. J., Tarnow, L., Møller, J. S., Nielsen, M. N., Thorsteinsson, B., & Juhl, C. B. (2017). Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus. Diabetes Technology & Therapeutics, 19(2), 85-90. https://doi.org/10.1089/dia.2016.0331

Sejling, A-S, Kjaer, TW, Pedersen-Bjergaard, U, Remvig, LS, Frandsen, CS, Hilsted, L, Faber, J, Holst, JJ, Tarnow, L, Møller, JS, Nielsen, MN, Thorsteinsson, B & Juhl, CB 2017, 'Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus', Diabetes Technology & Therapeutics, bind 19, nr. 2, s. 85-90. https://doi.org/10.1089/dia.2016.0331

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abstract = "BACKGROUND: Recurrent hypoglycemia has been shown to blunt hypoglycemia symptom scores and counterregulatory hormonal responses during subsequent hypoglycemia. We therefore studied whether hypoglycemia-associated electroencephalogram (EEG) changes are affected by an antecedent episode of hypoglycemia.METHODS: Twenty-four patients with type 1 diabetes mellitus (10 with normal hypoglycemia awareness, 14 with hypoglycemia unawareness) were studied on 2 consecutive days by hyperinsulinemic glucose clamp at hypoglycemia (2.0-2.5 mmol/L) during a 1-h period. EEG was recorded, cognitive function assessed, and hypoglycemia symptom scores and counterregulatory hormonal responses were obtained.RESULTS: Twenty-one patients completed the study. Hypoglycemia-associated EEG changes were identified on both days with no differences in power or frequency distribution in the theta, alpha, or the combined theta-alpha band during hypoglycemia on the 2 days. Similar degree of cognitive dysfunction was also present during hypoglycemia on both days. When comparing the aware and unaware group, there were no differences in the hypoglycemia-associated EEG changes. There were very subtle differences in cognitive function between the two groups on day 2. The symptom response was higher in the aware group on both days, while only subtle differences were seen in the counterregulatory hormonal response.CONCLUSION: Antecedent hypoglycemia does not affect hypoglycemia-associated EEG changes in patients with type 1 diabetes mellitus.",

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author = "Anne-Sophie Sejling and Kjaer, {Troels W} and Ulrik Pedersen-Bjergaard and Remvig, {Line S} and Frandsen, {Christian S} and Linda Hilsted and Jens Faber and Holst, {Jens Juul} and Lise Tarnow and M{\o}ller, {Jakob Skadk{\ae}r} and Nielsen, {Martin N} and Birger Thorsteinsson and Juhl, {Claus B}",

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T1 - Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus

AU - Sejling, Anne-Sophie

AU - Kjaer, Troels W

AU - Pedersen-Bjergaard, Ulrik

AU - Remvig, Line S

AU - Frandsen, Christian S

AU - Hilsted, Linda

AU - Faber, Jens

AU - Holst, Jens Juul

AU - Tarnow, Lise

AU - Møller, Jakob Skadkær

AU - Nielsen, Martin N

AU - Thorsteinsson, Birger

AU - Juhl, Claus B

PY - 2017/2/1

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N2 - BACKGROUND: Recurrent hypoglycemia has been shown to blunt hypoglycemia symptom scores and counterregulatory hormonal responses during subsequent hypoglycemia. We therefore studied whether hypoglycemia-associated electroencephalogram (EEG) changes are affected by an antecedent episode of hypoglycemia.METHODS: Twenty-four patients with type 1 diabetes mellitus (10 with normal hypoglycemia awareness, 14 with hypoglycemia unawareness) were studied on 2 consecutive days by hyperinsulinemic glucose clamp at hypoglycemia (2.0-2.5 mmol/L) during a 1-h period. EEG was recorded, cognitive function assessed, and hypoglycemia symptom scores and counterregulatory hormonal responses were obtained.RESULTS: Twenty-one patients completed the study. Hypoglycemia-associated EEG changes were identified on both days with no differences in power or frequency distribution in the theta, alpha, or the combined theta-alpha band during hypoglycemia on the 2 days. Similar degree of cognitive dysfunction was also present during hypoglycemia on both days. When comparing the aware and unaware group, there were no differences in the hypoglycemia-associated EEG changes. There were very subtle differences in cognitive function between the two groups on day 2. The symptom response was higher in the aware group on both days, while only subtle differences were seen in the counterregulatory hormonal response.CONCLUSION: Antecedent hypoglycemia does not affect hypoglycemia-associated EEG changes in patients with type 1 diabetes mellitus.

AB - BACKGROUND: Recurrent hypoglycemia has been shown to blunt hypoglycemia symptom scores and counterregulatory hormonal responses during subsequent hypoglycemia. We therefore studied whether hypoglycemia-associated electroencephalogram (EEG) changes are affected by an antecedent episode of hypoglycemia.METHODS: Twenty-four patients with type 1 diabetes mellitus (10 with normal hypoglycemia awareness, 14 with hypoglycemia unawareness) were studied on 2 consecutive days by hyperinsulinemic glucose clamp at hypoglycemia (2.0-2.5 mmol/L) during a 1-h period. EEG was recorded, cognitive function assessed, and hypoglycemia symptom scores and counterregulatory hormonal responses were obtained.RESULTS: Twenty-one patients completed the study. Hypoglycemia-associated EEG changes were identified on both days with no differences in power or frequency distribution in the theta, alpha, or the combined theta-alpha band during hypoglycemia on the 2 days. Similar degree of cognitive dysfunction was also present during hypoglycemia on both days. When comparing the aware and unaware group, there were no differences in the hypoglycemia-associated EEG changes. There were very subtle differences in cognitive function between the two groups on day 2. The symptom response was higher in the aware group on both days, while only subtle differences were seen in the counterregulatory hormonal response.CONCLUSION: Antecedent hypoglycemia does not affect hypoglycemia-associated EEG changes in patients with type 1 diabetes mellitus.

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Hypoglycemia-Associated EEG Changes Following Antecedent Hypoglycemia in Type 1 Diabetes Mellitus

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