RECOVERY OF HYPOGLYCEMIA-ASSOCIATED COMPROMISED CEREBRAL FUNCTION AFTER A SHORT INTERVAL OF EUGLYCEMIA IN INSULIN-DEPENDENT DIABETIC-PATIENTS

To test the hypothesis that compromised cerebral function, induced by recurrent hypoglycaemic episodes, may recover after a short interval o f euglycaemia, we examined electrophysiological activity and symptom a wareness during two sequential euglycaemic-hypoglycaemic clamp studies in 11 insulin-dependent diabetic patients without any signs of periph eral or autonomic neuropathy. Neurophysiological testing and evaluatio n of hypoglycaemic symptoms were performed at stable glycaemic plateau s of 5.6, 3.3, 2.2, and 1.7 mmol/l. The first clamp study was preceded by 3 short-term hypoglycaemic episodes, whereas the second clamp stud y followed a 2 day interval of strict euglycaemia. The latter caused a recovery of electrophysiological activity, which was demonstrated by recovery of delays of the middle latency auditory evoked potentials (l atency shift of the P-a component, MANOVA, P < 0.01). Reversal of hypo glycaemic symptom unawareness involved the overall symptom perception (MANOVA, P < 0.04), as well as the autonomic symptoms of heart poundin g (P < 0.05) and sweating (P < 0.05). We conclude that the previously reported impaired cerebral function, occurring as a consequence of rep etitive hypoglycaemic episodes, may recover after a single euglycaemic interval.