New Issue Of Diabetic Hypoglycaemia Discusses Effects Of Poor Metabolic Control On The Brain And Central Nervous System
Professor Ryan's editorial focuses on the interesting point that, although hypoglycaemia has previously been seen as a primary cause of brain damage in children and adults with diabetes, it now appears likely that most episodes of hypoglycaemia have no, or very little, permanent effect on the CNS. He highlights that diabetic patients may manifest cognitive dysfunction, regardless of whether they have had previous exposure to severe hypoglycaemia. Professor Ryan points out that a long history of poor metabolic control markedly increases the risk of damage to the brain, and therefore hyperglycaemia may be far more damaging to the patient. His accompanying feature article reviews the risks of CNS damage associated with recurrent hypoglycaemia, concluding that "recurrent episodes of moderate or severe hypoglycaemia do not appear to have long-term adverse effects on the CNS of adults with diabetes."
Glycaemic control and the reduction of hyperglycaemia are crucial factors in the treatment of diabetes, and this was re-emphasised in the recent release of a statement by the American Diabetes Association (ADA), the American Heart Association (AHA), and the American College of Cardiology (ACC), highlighting the need for clinicians to continue to pursue a strategy of intensive glycaemic control to reduce the risk of vascular events (Circulation, January 2009). Professor Ryan's article and editorial provide the important message that poor glycaemic control can also have deleterious effects on the brain and CNS - this has also been recently confirmed in the MIND sub-study of the ACCORD trial (Diabetes Care, February 2009).
This issue of Diabetic Hypoglycaemia also contains highlights of the 44th Annual
Meeting of the European Association for the Study of Diabetes (EASD) and the 34th Annual Meeting of the International Society for Pediatric and Adolescent Diabetes (ISPAD), plus an interview with one of the foremost investigators on hypoglycaemia, Professor Robert Sherwin, who is currently studying how blood glucose is sensed in the CNS and how hypoglycaemia affects the brain.
Diabetic Hypoglycaemia is created with and run by an Editorial Board of hypoglycaemia experts led by Professor Brian Frier (Edinburgh, UK) with Associate Editors: Professor Simon Heller (Sheffield, UK), Professor Christopher Ryan (Pittsburgh, USA) and Dr Rory McCrimmon (Yale, USA). The journal is published three times per year, providing an interactive forum for readers to share practical knowledge and opinions on the rapidly evolving field of hypoglycaemia. To explore the Diabetic Hypoglycaemia website and its key features, our guided tour can be activated by clicking the following link: http://www.hypodiab.com/Teaser/hypodiab.html.
Initial support of the journal is provided by an unrestricted educational grant from Novo Nordisk A/S (Bagsvaerd, Denmark).
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