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Adaptation of cognitive function to hypoglycemia in healthy men.

  1. B Fruehwald-Schultes,
  2. J Born,
  3. W Kern,
  4. A Peters and
  5. H L Fehm
  1. Department of Internal Medicine, University of Luebeck, Germany. fruehwal@kfg.mu-luebeck.de
    Diabetes Care 2000 Aug; 23(8): 1059-1066. https://doi.org/10.2337/diacare.23.8.1059
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    Abstract

    OBJECTIVE: Antecedent hypoglycemia reduces hypoglycemic counterregulation and symptoms, thereby provoking the hypoglycemia unawareness syndrome. The effects of antecedent hypoglycemia on hypoglycemia-induced cognitive dysfunction are less well established. RESEARCH DESIGN AND METHODS: To determine whether antecedent hypoglycemia also reduces hypoglycemic cognitive dysfunction, we performed stepwise hypoglycemic clamp experiments (4.1, 3.6, 3.1, and 2.6 mmol/l) during a 6-h period in 30 young healthy men. A total of 15 subjects additionally received a 2.5-h antecedent hypoglycemic clamp (3.1 mmol/l) on the preceding day (prior-hypo group), whereas the other 15 subjects did not (control group). Cognitive function was assessed by auditory-evoked brain potentials (AEBPs) and reaction time during a vigilance task and short-term memory recall. Tests were performed during the stepwise hypoglycemic clamp at baseline and at each hypoglycemic plateau. RESULTS: In both groups, performance on all measures of cognitive function deteriorated during stepwise hypoglycemia (all P < 0.01). However, after antecedent hypoglycemia, the hypoglycemia-induced decrease in the amplitude of the P3 of the AEBP was distinctly reduced compared with the control condition (P < 0.05). Also, short-term memory performance was less impaired in the prior-hypo group than in the control group (P < 0.005), and a minor hypoglycemic impairment of reaction time (P < 0.05) was evident in the prior-hypo group. CONCLUSIONS: Data provide evidence that a single episode of mild antecedent hypoglycemia (3.1 mmol/l) attenuates several aspects of cognitive dysfunction during subsequent hypoglycemia 18-24 h later.

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    August 2000, 23(8)
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    Adaptation of cognitive function to hypoglycemia in healthy men.
    B Fruehwald-Schultes, J Born, W Kern, A Peters, H L Fehm
    Diabetes Care Aug 2000, 23 (8) 1059-1066; DOI: 10.2337/diacare.23.8.1059

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    Adaptation of cognitive function to hypoglycemia in healthy men.
    B Fruehwald-Schultes, J Born, W Kern, A Peters, H L Fehm
    Diabetes Care Aug 2000, 23 (8) 1059-1066; DOI: 10.2337/diacare.23.8.1059
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