Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology, and Management



The threat and incidence of hypoglycemia is the major limiting factor in intensive glycemic control for both type 1 and type 2 diabetes. This article reviews the physiology of the normal counterregulatory responses to hypoglycemia and the deficient counterregulatory defenses that occur in patients with diabetes. Treatment paradigms for establishing good glycemic control while limiting hypoglycemia are also discussed.


  • Vanessa J. Briscoe, PhD, is a clinical research nurse practitioner, and Stephen N. Davis, MD, is chief of the Division of Diabetes, Endocrinology and Metabolism and Rudolph Kampmeier Professor of Medicine and Molecular Physiology and Biophysics at the Vanderbilt School of Medicine in Nashville, Tenn.

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