Long-Term Intensive Therapy of IDDM Patients With Clinically Overt Autonomic Neuropathy: Effects on Hypoglycemia Awareness and Counterregulation

36 subjects: 21 IDDM patients (8 without diabetic autonomic neuropathy [DAN-], 13 with DAN [7 with orthostatic hypotension, 6 without]) and 15 nondiabetic subjects.

Meticulous prevention of hypoglycemia (intensive therapy) for 6 months

Baseline (before prevention of hypoglycemia)

Hypoglycemia awareness and counterregulation (adrenaline responses, glycemic thresholds, autonomic symptoms, cognitive function) during stepped hypoglycemia (plateau plasma glucose decrements from 5.0 to 2.2 mmol/l)surrogate