Neurological Sequelae of Hypoglycaemia

Perros, P; Bjorgaas, MR

doi:10.1002/9781118695432.ch15

Neurological Sequelae of Hypoglycaemia

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Abstract

© 2014 by John Wiley & Sons, Ltd. All rights reserved. The brain, like the retina, kidney and peripheral nervous system, can be regarded as a vulnerable organ in diabetes. Severe hypoglycaemia is associated with structural changes in the brain, mainly a reduction in grey matter in areas that support memory and verbal abilities. Young children are particularly vulnerable. The pathogenesis of diabetic encephalopathy is as yet unknown, but hypoglycaemia probably plays a significant role. Every effort should be made to avoid exposure to severe hypoglycaemia in young children with type 1 diabetes. The targets for glycaemic control should be set flexibly and individually for those with a history of recurrent severe hypoglycaemia. Hypoglycaemia should be considered as a possible diagnosis in all diabetic individuals presenting with any neurological syndrome including those presenting with a convulsion. Cerebral oedema should be sought if a patient does not quickly recover consciousness after treatment.