Hypoglycemia unawareness slide share

Hypoglycemia-Associated Autonomic Failure HAAF Pr Dr Mohamed A. BADR Diabetes and Metabolic Unit Alex Faculty of medicine

HYPOGLYCEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Hypoglycemia is brain specific

Since 1921 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Plz Think with me ,[object Object],[object Object]

WHERE IS THE GLUCOSE SENSOR WHAT MECHANISMS DOES IT USE TO ACTIVATE WHY DOES HYPOGLYCEMIA BEGET HYPOGLYCEMIA

WHERE IS THE GLUCOSE SENSOR central ,[object Object],[object Object],[object Object]

peripheral ,[object Object],[object Object],[object Object]

Not only VMH ,[object Object],[object Object],[object Object],[object Object]

Brain (central) PERIPHERAL ,[object Object],[object Object]

What mechanism VMH use to activate counterregulation SENSOR OF TWO TYPES ,[object Object],[object Object]

Hypoglycemic stress ,[object Object],[object Object],[object Object]

WHY WOULD BRAIN ADAPT TO RECURRENT HYP0GLYCEMIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hypoglycemia-Associated Autonomic Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hypoglycemia-Associated Autonomic Failure

Half Severe Hypo in DCCT occurred patient sleep

Hypoglycemia-Associated Autonomic Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The Systemic Mediator Hypothesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EUGLYCEMIC HYPERINSULINEMIC CLAMP ,[object Object],[object Object],[object Object],[object Object],[object Object]

The Brain Fuel Transport Hypothesis

The Brain Metabolism Hypothesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CNS Responses to Hypoglycemia in Humans ,[object Object],[object Object],[object Object],[object Object],[object Object],Teves D, et al. Proc Natl Acad Sci USA 101:6217, 2004

Decreased Synaptic Activity During Hypoglycemia

CNS Responses to Hypoglycemia in Humans cont ,[object Object],[object Object],[object Object],Teves D, et al. Proc Natl Acad Sci USA 101:6217, 2004

Hypothesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Teves D, et al. Proc Natl Acad Sci USA 101:6217, 2004

Interval hypoglycemia ,[object Object],[object Object],[object Object],1Arbelaez AM, et al. Diabetes 57:470, 2008. 2Segel S, et al. Diabetes 50:1911, 2001

Synaptic Activity Interval hypoglycemia

Challenge ,[object Object],[object Object],[object Object],[object Object]

Fruit fly ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object]

Hypoglycemia Risk Reduction in Diabetes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hypoglycemia Risk Reduction in Diabetes ,[object Object],[object Object],[object Object],[object Object]

Approaches to the Problem of Nocturnal Hypoglycemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hypoglycemia Prevention Strategies ,[object Object],[object Object],[object Object],[object Object]

A Big Part of the Problem CPOE Documentation

Change the scientific scope, widening it, inclusion of other domain don’t limit your mind in the same tract, sure researches must be redirected. ,[object Object]

Hypoglycemia unawareness slide share

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Hypoglycemia unawareness slide share