Hypoglycemia-dependent beta2-adrenoceptor downregulation: a contributing
factor to hypoglycemia unawareness in patients with Type-1 diabetes?
K. Schwab, U. Menche, G. Schmeisl, and M. Lohse. Horm Res, 62 (3):
137-41(2004)Schwab, K O Menche, U Schmeisl, G Lohse, M J Research Support, Non-U.S.
Gov't Switzerland Hormone research Horm Res. 2004;62(3):137-41. Epub
2004 Aug 3..
Abstract
To evaluate the influence of the incidence and unawareness of hypoglycemia
on lymphocyte beta2-adrenoceptor densities, we measured beta2-adrenoceptor
density using 125I-iodocyanopindolol and CGP 12177 before and after
1 week of treatment optimization in 33 adults with type-1 diabetes
mellitus. Diabetes treatment of all patients was modified to improve
their glycemic control. During this week, all patients had to complete
a protocol with 7 daily glucose measurements, one of which was at
night. The subjective symptoms were evaluated in case of hypoglycemia.
A significant correlation between a hypoglycemia incidence below
(but not above) the threshold of 2.75 mmol/l (50 mg/dl) and beta2-adrenoceptor
densities on lymphocytes was found after the study week (r = -0.72,
p < 0.00001). Nine patients suffering from hypoglycemia unawareness
had a significantly higher incidence of hypoglycemia (p < 0.002)
and lower beta2-adrenoceptor densities on lymphocytes compared to
24 patients who recognized all of their hypoglycemic episodes (p
< 0.004). We conclude that downregulation of beta2-adrenoceptor densities
on lymphocytes occurs as a result of recurrent hypoglycemia defined
as glucose levels of < 2.75 mmol/l. Beta2-adrenoceptor densities
are decreased in patients with subjective hypoglycemia unawareness
and might contribute to the reduced beta-adrenergic sensitivity in
this subgroup of patients.
Schwab, K O Menche, U Schmeisl, G Lohse, M J Research Support, Non-U.S.
Gov't Switzerland Hormone research Horm Res. 2004;62(3):137-41. Epub
2004 Aug 3.
%0 Journal Article
%1 Schwab2004
%A Schwab, K. O.
%A Menche, U.
%A Schmeisl, G.
%A Lohse, M. J.
%D 2004
%J Horm Res
%K 1/*metabolism/psychology Adolescent Adult Aged Awareness/*physiology Diabetes Down-Regulation Female Humans Hypoglycemia/*metabolism/psychology Male Mellitus, Middle Nervous Signal Sympathetic System/physiology Transduction Type beta-2/*metabolism Receptor Adrenergic
%N 3
%P 137-41
%T Hypoglycemia-dependent beta2-adrenoceptor downregulation: a contributing
factor to hypoglycemia unawareness in patients with Type-1 diabetes?
%U http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15297801
%V 62
%X To evaluate the influence of the incidence and unawareness of hypoglycemia
on lymphocyte beta2-adrenoceptor densities, we measured beta2-adrenoceptor
density using 125I-iodocyanopindolol and CGP 12177 before and after
1 week of treatment optimization in 33 adults with type-1 diabetes
mellitus. Diabetes treatment of all patients was modified to improve
their glycemic control. During this week, all patients had to complete
a protocol with 7 daily glucose measurements, one of which was at
night. The subjective symptoms were evaluated in case of hypoglycemia.
A significant correlation between a hypoglycemia incidence below
(but not above) the threshold of 2.75 mmol/l (50 mg/dl) and beta2-adrenoceptor
densities on lymphocytes was found after the study week (r = -0.72,
p < 0.00001). Nine patients suffering from hypoglycemia unawareness
had a significantly higher incidence of hypoglycemia (p < 0.002)
and lower beta2-adrenoceptor densities on lymphocytes compared to
24 patients who recognized all of their hypoglycemic episodes (p
< 0.004). We conclude that downregulation of beta2-adrenoceptor densities
on lymphocytes occurs as a result of recurrent hypoglycemia defined
as glucose levels of < 2.75 mmol/l. Beta2-adrenoceptor densities
are decreased in patients with subjective hypoglycemia unawareness
and might contribute to the reduced beta-adrenergic sensitivity in
this subgroup of patients.
@article{Schwab2004,
abstract = {To evaluate the influence of the incidence and unawareness of hypoglycemia
on lymphocyte beta2-adrenoceptor densities, we measured beta2-adrenoceptor
density using [125I]-iodocyanopindolol and CGP 12177 before and after
1 week of treatment optimization in 33 adults with type-1 diabetes
mellitus. Diabetes treatment of all patients was modified to improve
their glycemic control. During this week, all patients had to complete
a protocol with 7 daily glucose measurements, one of which was at
night. The subjective symptoms were evaluated in case of hypoglycemia.
A significant correlation between a hypoglycemia incidence below
(but not above) the threshold of 2.75 mmol/l (50 mg/dl) and beta2-adrenoceptor
densities on lymphocytes was found after the study week (r = -0.72,
p < 0.00001). Nine patients suffering from hypoglycemia unawareness
had a significantly higher incidence of hypoglycemia (p < 0.002)
and lower beta2-adrenoceptor densities on lymphocytes compared to
24 patients who recognized all of their hypoglycemic episodes (p
< 0.004). We conclude that downregulation of beta2-adrenoceptor densities
on lymphocytes occurs as a result of recurrent hypoglycemia defined
as glucose levels of < 2.75 mmol/l. Beta2-adrenoceptor densities
are decreased in patients with subjective hypoglycemia unawareness
and might contribute to the reduced beta-adrenergic sensitivity in
this subgroup of patients.},
added-at = {2010-12-14T18:12:02.000+0100},
author = {Schwab, K. O. and Menche, U. and Schmeisl, G. and Lohse, M. J.},
biburl = {https://www.bibsonomy.org/bibtex/2af72ea756310831e71015dada356bc7c/pharmawuerz},
endnotereftype = {Journal Article},
interhash = {cea10bdbdafb2a29973b8fab0eadb9df},
intrahash = {af72ea756310831e71015dada356bc7c},
issn = {0301-0163 (Print) 0301-0163 (Linking)},
journal = {Horm Res},
keywords = {1/*metabolism/psychology Adolescent Adult Aged Awareness/*physiology Diabetes Down-Regulation Female Humans Hypoglycemia/*metabolism/psychology Male Mellitus, Middle Nervous Signal Sympathetic System/physiology Transduction Type beta-2/*metabolism Receptor Adrenergic},
note = {Schwab, K O Menche, U Schmeisl, G Lohse, M J Research Support, Non-U.S.
Gov't Switzerland Hormone research Horm Res. 2004;62(3):137-41. Epub
2004 Aug 3.},
number = 3,
pages = {137-41},
shorttitle = {Hypoglycemia-dependent beta2-adrenoceptor downregulation: a contributing
factor to hypoglycemia unawareness in patients with Type-1 diabetes?},
timestamp = {2010-12-14T18:22:42.000+0100},
title = {Hypoglycemia-dependent beta2-adrenoceptor downregulation: a contributing
factor to hypoglycemia unawareness in patients with Type-1 diabetes?},
url = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15297801},
volume = 62,
year = 2004
}