Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in...Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in approximately 40% of people with type 1 diabetesmellitus(T1DM) and with less frequency in T2 DM.Though the aetiology of HU is multifactorial,possible mechanisms include chronic exposure to low blood glucose,antecedent hypoglycaemia,recurrent severe hypoglycaemia and the failure of counter-regulatory hormones.Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms,but the mechanisms and mediators remain largely unknown.Prevention and management of HU is complex,and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team.Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes.Several medications are thought to worsen or promote HU,whereas others may have an attenuating effect on the problem.This article reviews recent advances in how the brain senses and responds to hypoglycaemia,novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses.The consequences that HU has on the person with diabetes and their family are also described.Finally,it examines the evidence for prevention and treatment of HU,and summarizes the effects of medications that may influence it.展开更多
In this paper, to better understand the impact of awareness and the network structure on epidemic transmission, we divide the population into four subpopulations corresponding to different physical states and consciou...In this paper, to better understand the impact of awareness and the network structure on epidemic transmission, we divide the population into four subpopulations corresponding to different physical states and conscious states, and we first propose a modified disease- awareness model, then verify the global stability of the disease-free and endemic equilib- ria, and finally present numerical simulations to demonstrate the theoretical analysis. By examining the spreading influences of model parameters, we find that the outbreak scale can be effectively controlled through increasing the spread rate of awareness or reducing the rate of awareness loss. That is to say, all sorts of media publicity are meaningful. Meanwhile, we find that infection will be affected by consciousness through the control variable.展开更多
文摘Hypoglycemia unawareness(HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms.It is a major limitation to achieving tight diabetes and reduced quality of life.HU occurs in approximately 40% of people with type 1 diabetesmellitus(T1DM) and with less frequency in T2 DM.Though the aetiology of HU is multifactorial,possible mechanisms include chronic exposure to low blood glucose,antecedent hypoglycaemia,recurrent severe hypoglycaemia and the failure of counter-regulatory hormones.Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms,but the mechanisms and mediators remain largely unknown.Prevention and management of HU is complex,and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team.Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes.Several medications are thought to worsen or promote HU,whereas others may have an attenuating effect on the problem.This article reviews recent advances in how the brain senses and responds to hypoglycaemia,novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses.The consequences that HU has on the person with diabetes and their family are also described.Finally,it examines the evidence for prevention and treatment of HU,and summarizes the effects of medications that may influence it.
文摘In this paper, to better understand the impact of awareness and the network structure on epidemic transmission, we divide the population into four subpopulations corresponding to different physical states and conscious states, and we first propose a modified disease- awareness model, then verify the global stability of the disease-free and endemic equilib- ria, and finally present numerical simulations to demonstrate the theoretical analysis. By examining the spreading influences of model parameters, we find that the outbreak scale can be effectively controlled through increasing the spread rate of awareness or reducing the rate of awareness loss. That is to say, all sorts of media publicity are meaningful. Meanwhile, we find that infection will be affected by consciousness through the control variable.
