ReviewDiabetologia2021
Consequences of recurrent hypoglycaemia on brain function in diabetes.
Review in Diabetologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 80 citations in OpenAlex.
- The Impact of Free and Added Sugars on Cognitive Function: A Systematic Review and Meta-Analysis.Nutrients · 2023Pooled it
- A novel glucose beta-hydroxybutyrate combination improves hypoglycaemia recovery and patient-reported outcomes in type 1 diabetes.Diabetes, obesity & metabolism · 2026Trial
- Symptomatic reactive hypoglycemia is highly prevalent post-esophagectomy.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Regulation and clinical manifestations of gluconeogenesis dysfunction.npj metabolic health and disease · 2026Review
- Paroxysmal sympathetic hyperactivity secondary to hypoglycemic encephalopathy: A case report.Journal of diabetes investigation · 2026Article
- Quality of Life and Humanistic Burden of Adults with Type 1 Diabetes with Recurrent Severe Hypoglycemic Events and Impaired Awareness of Hypoglycemia Using a Continuous Glucose Monitor.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Article
- Lipid-lowering and glucose-lowering drug targets differentially modulate antipsychotic treatment efficacy in schizophrenia.Cell reports. Medicine · 2026Article
- Article
- [Recurrent hypoglycemia and the structure of the choroid plexus of the lateral ventricles of the rat brain].Problemy endokrinologii · 2026Article
- Cognitive Assessment in Adults With Adrenal Cortisol Insufficiency: Challenges and Opportunities.Endocrine reviews · 2026Review
- Atypical Hypoglycemia-Induced Stroke Mimic: A Case Report and Literature Review.Clinical medicine insights. Endocrinology and diabetes · 2026Article
- Hypoglycemia induces brain metabolic reprogramming and neurodegeneration via serum response factor and myocardin-related transcription factor-A.Signal transduction and targeted therapy · 2025Article
- HbA1c Variability as a Predictor of Neurocognitive Decline in Children With Type 1 Diabetes.Cureus · 2025Article
- Targeted proteomics analysis in type 1 diabetes identifies lower agouti-related protein levels in individuals with impaired hypoglycaemia awareness.Scientific reports · 2025Article
- Strategies for optimization of hypoglycemia rat models.Animal models and experimental medicine · 2025Review
- Movement Disorder Following Hypoglycemic Encephalopathy in Mitochondrial 3-Hydroxy-3-methylglutaryl-CoA Synthase-2 (mHS) Deficiency.Annals of internal medicine. Clinical cases · 2025Article
- Impact of level 2 hypoglycaemia on neuroaxonal damage biomarker in individuals with type 2 diabetes: A stepwise hypoglycaemic clamp study.Diabetes, obesity & metabolism · 2025Article
- Glucose Extremes and Cognitive Function: A Review of the Neurological Impacts of Hypoglycemia and Hyperglycemia in Type 1 Diabetes.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Towards a decision support system for post bariatric hypoglycaemia: development of forecasting algorithms in unrestricted daily-life conditions.BMC medical informatics and decision making · 2025Article
- Management of acute ischemic stroke in the emergency department: optimizing the brain.International journal of emergency medicine · 2025Review
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
The discovery of insulin and its subsequent mass manufacture transformed the lives of people with type 1 and 2 diabetes. Insulin, however, was a drug with a 'dark side'. It brought with it the risk of iatrogenic hypoglycaemia. In this short review, the cellular consequences of recurrent hypoglycaemia, with a particular focus on the brain, are discussed. Using the ventromedial hypothalamus as an exemplar, this review highlights how recurrent hypoglycaemia has an impact on the specialised cells in the brain that are critical to the regulation of glucose homeostasis and the counterregulatory response to hypoglycaemia. In these cells, recurrent hypoglycaemia initiates a series of adaptations that ensure that they are more resilient to subsequent hypoglycaemia, but this leads to impaired hypoglycaemia awareness and a paradoxical increased risk of severe hypoglycaemia. This review also highlights how hypoglycaemia, as an oxidative stressor, may also exacerbate chronic hyperglycaemia-induced increases in oxidative stress and inflammation, leading to damage to vulnerable brain regions (and other end organs) and accelerating cognitive decline. Pre-clinical research indicates that glucose recovery following hypoglycaemia is considered a period where reactive oxygen species generation and oxidative stress are pronounced and can exacerbate the longer-term consequence of chronic hypoglycaemia. It is proposed that prior glycaemic control, hypoglycaemia and the degree of rebound hyperglycaemia interact synergistically to accelerate oxidative stress and inflammation, which may explain why increased glycaemic variability is now increasingly considered a risk factor for the complications of diabetes.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.