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Title: Insulin-induced hypoglycaemia in humans
Author: Strachan, Mark William John
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2001
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Acute hypoglycaemia was induced in 16 non-diabetic subjects using a modified hyperinsulinaemic glucose clamp technique and caused predictable decrements in cognitive performance. However, acute hypoglycaemia had no effect on the function of the peripheral nervous system, as assessed by nerve conduction studies performed on the dominant median and common peroneal nerves. This lack of effect of acute hypoglycaemia on peripheral nerve function suggests that peripheral neurones do not have the same obligate for glucose as a metabolic fuel as neurones of the central nervous system. The temporal changes in mood states and cognitive functions following a single, spontaneous episode of severe hypoglycaemia in 20 people with insulin-treated diabetes were examined. Recovery from any acute cognitive decrement following severe hypoglycaemia was complete by 1.5 days, although decreased levels of 'happiness' and 'energy' appeared to take longer to recover. Compared to 'control' subjects who had not experienced severe hypoglycaemia for over one year, the 'hypo' subjects had persistent cognitive decrements and altered mood states which may have been a consequence of previous exposure to recurrent episodes of severe hypoglycaemia. The identification of serum markers that could predict the degree of neuronal damage and prognosis of patients after severe hypoglycaemia would have considerable clinical value. Neurone-Specific Enolase (NSE) and Protein S-100 (S-100) are markers of acute neuronal damage in various neurological disorders. Serum concentrations of these markers did not rise in 16 diabetic subjects who experienced an episode of severe hypoglycaemia and who made a complete neurological recovery. However, serum concentrations of the markers did rise in two of three patients who died following an episode of severe hypoglycaemia. These preliminary results suggest that measurement of serum concentrations of NSE and S-100 may have a future role in evaluating clinical outcome following an episode of severe hypoglycaemia which is associated with neurological damage.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available