Severe hypoglycaemia unawareness is associated with an early decrease in vigilance during hypoglycaemia

Howorka, Kinga; Heger, G.; Schabmann, Alfred; Anderer, P.; Tribl, Gotthard G.; Zeitlhofer, J.

doi:10.1016/0306-4530(95)00034-8

Cited by 34 publications

(29 citation statements)

References 40 publications

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“…This is in accordance with other studies investigating hypoglycemia-associated EEG changes (11,22,23). Increased amplitude in the u band is not unique to hypoglycemia but is seen during a number of conditions including drowsiness, encephalopathy, or depression (24)(25)(26).…”

Section: Discussionsupporting

confidence: 78%

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

et al. 2014

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Hypoglycemia is associated with increased activity in the low-frequency bands in the electroencephalogram (EEG). We investigated whether hypoglycemia awareness and unawareness are associated with different hypoglycemia-associated EEG changes in patients with type 1 diabetes. Twenty-four patients participated in the study: 10 with normal hypoglycemia awareness and 14 with hypoglycemia unawareness. The patients were studied at normoglycemia (5–6 mmol/L) and hypoglycemia (2.0–2.5 mmol/L), and during recovery (5–6 mmol/L) by hyperinsulinemic glucose clamp. During each 1-h period, EEG, cognitive function, and hypoglycemia symptom scores were recorded, and the counterregulatory hormonal response was measured. Quantitative EEG analysis showed that the absolute amplitude of the θ band and α-θ band up to doubled during hypoglycemia with no difference between the two groups. In the recovery period, the θ amplitude remained increased. Cognitive function declined equally during hypoglycemia in both groups and during recovery reaction time was still prolonged in a subset of tests. The aware group reported higher hypoglycemia symptom scores and had higher epinephrine and cortisol responses compared with the unaware group. In patients with type 1 diabetes, EEG changes and cognitive performance during hypoglycemia are not affected by awareness status during a single insulin-induced episode with hypoglycemia.

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Section: Discussionsupporting

confidence: 78%

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

et al. 2014

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“…Previous studies have attempted to find out EEG changes caused by hypoglycemia [8][9][10]. Nevertheless, most of them stopped at pointing out some spontaneous changes during hypoglycemic episodes as well as permanent changes after hypoglycemia without proposing a method of detecting hypoglycemia in real-time.…”

Section: Introduction Corrding To the Diabetes Control And Complicmentioning

confidence: 99%

Identification of hypoglycemic states for patients with T1DM using various parameters derived from EEG signals

Nguyen

Ling

Jones

et al. 2011

2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Abstract-For patients with Type 1 Diabetes Mellitus, hypoglycemia is a very common but dangerous complication which can lead to unconsciousness, coma and even death. The variety of hypoglycemia symptoms is originated from the inadequate supply of glucose to the brain. In this study, we explored the connection between hypoglycemia episodes and the electrical activity of neurons within the brain or EEG signals. By analyzing EEG signals from a clinical study of five children with T1DM, associated with hypoglycemia at night, we found that under hypoglycemia conditions, some EEG parameters changed significantly. Based on these results, we proposed a method of detecting hypoglycemic episodes using EEG signals, including a feed-forward multi-layer neural network algorithm for classifying. The classification results are 72% sensitivity and 55% specificity when using the signals from 2 electrodes C3 and O2. We also used signals from different channels to see the contribution of each to performance of classifying. The results of the study show the potentiality of our method and will be improved and developed in the near future.

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“…Previous EEG studies showed that the reduced alpha activity is associated with the lack of vigilance or awareness [10,11]. This is a common symptom to T1DM patients which normally happens under hypoglycemia conditions [4,12]. In our previous work, it is demonstrated that there is no significant and consistent response in the beta frequency band.…”

Section: B Signal Processing and Feature Extractionmentioning

confidence: 95%

“…Since the electroencephalogram (EEG) is directly related to the metabolism of brain cells, a failure of cerebral glucose supply can cause early changes in EEG signals. A number of studies have reported important traces in EEG signals induced by hypoglycemia episodes in T1DM patients [4,5]. Recent studies also lead to acceptable results which show the potential ability of detecting hypoglycemia from EEG signals [6][7][8].…”

Section: Introductionmentioning

confidence: 94%

Analyzing EEG signals under insulin-induced hypoglycemia in type 1 diabetes patients

Nguyen

Nguyễn

Ling

et al. 2013

2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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Abstract-Hypoglycemia is dangerous and considered as a limiting factor of the glycemic control therapy for patients with type 1 diabetes mellitus (T1DM). Nocturnal hypoglycemia is especially feared because early warning symptoms are unclear during sleep so an episode of hypoglycemia may lead to a fatal effect on patients. The main objective of this paper is to explore the correlation between hypoglycemia and electroencephalography (EEG) signals. To do this, the EEG of five T1DM adolescents from an overnight insulin-induced study is analyzed by spectral analysis to extract four different parameters. We aim to explore the response of these parameters during the clamp study which includes three main phases of normal, hypoglycemia and recovery. We also look at data at the blood glucose level (BGL) of 3.3-3.9 mmol/l to find a threshold to distinguish between non-hypoglycemia and hypoglycemia states. The results show that extracted EEG parameters are highly correlated with patients' conditions during the study. It is also shown that at the BGL of 3.3 mmol/l, responses to hypoglycemia in EEG signals start to significantly occur.

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Severe hypoglycaemia unawareness is associated with an early decrease in vigilance during hypoglycaemia

Cited by 34 publications

References 40 publications

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

Hypoglycemia-Associated Changes in the Electroencephalogram in Patients With Type 1 Diabetes and Normal Hypoglycemia Awareness or Unawareness

Identification of hypoglycemic states for patients with T1DM using various parameters derived from EEG signals

Analyzing EEG signals under insulin-induced hypoglycemia in type 1 diabetes patients

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