Diabetic Autonomic Neuropathy

Aaron I. Vinik, MD, PhD.; Roy Freeman, MB, ChB.; Tomris Erbas, MD


Semin Neurol. 2003;23(4) 

In This Article

Hypoglycemic Autonomic Failure

The spectrum of reduced counterregulatory hormone responses (in particular epinephrine) and decreased symptom perception of hypoglycemia due to decreased ANS activation after recent antecedent hypoglycemia has been termed "hypoglycemia-induced autonomic failure."45 Hypoglycemia-induced autonomic failure leads to a vicious cycle of hypoglycemia unawareness that induces a further decrease in counterregulatory hormone responses to hypoglycemia. This vicious cycle occurs commonly in individuals with diabetes who are in strict glycemic control.


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