Key result
Hypoglycemia remains the key barrier in diabetes care, emphasizing better insulin replacement and counterregulation strategies.
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Hypoglycemia is the limiting factor, both conceptually and in practice, in the management of diabetes mellitus. While the long-term goal of diabetes research must remain the cure and the prevention of the disease and reasonable near-term goals might include perfect insulin replacement or prevention of complications despite ongoing hyperglycemia, the most pressing short-term goal for people with diabetes would seem to be insight leading to strategies that effectively minimize the risk of hypoglycemia and thus permit low-risk glycemic control. Having reviewed the field in detail recently, the author offers his personal views of the key questions - concerning the physiology of glucose counterregulation, its pathophysiology in diabetes, and hypoglycemia in diabetes - that, if answered, might lead to a reduced risk of iatrogenic hypoglycemia in people with diabetes. The overriding question is: How can we learn to replace insulin more perfectly, prevent, correct or compensate for compromised glucose counterregulation, or both?
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Philip E. Cryer (1999) conducted a review in diabetes mellitus. Strategies to minimize hypoglycemia risk was evaluated. Hypoglycemia is the primary limiting factor in diabetes management, highlighting the need for strategies to perfectly replace insulin and address compromised glucose counterregulation.
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