5393 Stephanie Amiel: Reversal of unawareness of hypoglycemia.
New England J. Med. 329 (1993), 876-877.
Brain function depends on an adequate supply of glucose from the blood, and 
the principal danger of an inadequate supply is the loss of cognitive 
function. Hypoglycemia sufficient to cause cognitive dysfunction does not 
normally occur, because small decreases in blood glucose concentrations 
elicit efficient protective neurohumoral responses, which include activation 
of the sympathetic nervous system, diminuition of endogenous insulin 
secretion, and release of hyperglycemic hormones such as glucagon, 
catecholamines, and cortisol. These responses not only act to raise the 
blood glucose concentration but are also associated with symptoms such as 
sweating, hunger, and shakiness. Severe unheralded neuroglycopenia is a 
well-recognized feature in patients with insulin-secreting tumours. 
The patient with an insulinoma is not a perfect model for the patient with 
diabetes who is treated with insulin, and removal of the tumour may restore 
awareness of hypoglycemia by a mechanism other than abolition of hypoglycemia.
A comment to the article by Mitrakou a.o. in the same issue of the NEJM.

Stella Bowing: Everyday cooking for diabetics.
Fisher 1997. 1-55561118-4. $16.

Martha Chitwood: Southern-style diabetic cooking.
American Diabetes Association 1997. 0-94544869-4. $12.

Simon Court/Bill Lamb: Childhood and adolescent diabetes.
Wiley 1997. 0-471-97003-4. $60.

Laurie Guffey: How to cook for people with diabetes.
American Diabetes Association 1997. 0-94544868-6. $12.

6095 C. Hales: Fetal nutrition and adult diabetes.
Science & Medicine 1994/3, 54-63.

C. Hales/David Barker: Type 2 (non-insulin-dependent) diabetes mellitus. 
The trifty phenotype hypothesis. Diabetologia 35 (1992), 595-601.

Colleen Howard: The diabetic dessert cookbook.
Avon 1997. 0-38078823-3. $11.

12270 Ulrich Kattmann: Glucose im Flies''gleichgewicht.
Unterricht Biologie Oktober 1990, 32-35.

7123 Paul Lacy: Inselzellverpflanzung bei Diabetes.
Spektrum 1995/9, 72-78. Die guenstigste und eleganteste Therapie beim
juvenilen (insulinabhaengigen) Diabetes mellitus waere, das funktions-
untuechtige Gewebe der Bauchspeicheldruese zu ersetzen, das normalerweise
das Hormon Insulin bildet. Neuerdings zeichnen sich dafuer Techniken ab,
die eine staendige Kontrolle des Immunsystems eruebrigen.

Paul Lacy: Status of islet cell transplantation.
Diabetes Care 16/3 (1993), 76-92.

9293 Robert Lanza/William Chick: Encapsulated cell therapy.
Transplantation of pancreatic islet cells within immunoisolating membranes
has been evaluated as part of the effort to devise a biocompatible
artificial pancreas that will adequately regulate blood glucose over an
appreciable period of time. Science & Medicine July/August 1995, 16-25.

5386 A. Mitrakou a.o.: Reversibility of unawareness of hypoglycemia in 
patients with insulinomas. New England J. Med. 329 (1993), 834-839.
A lack of appropriate autonomic warning symptoms before the development of 
neuroglycopenia (unawareness of hypoglycemia) occurs frequently in patients 
with insulin-dependent diabetes mellitus. Although the condition was first 
reported shortly after the introduction of insulin therapy, its pathogenesis 
remains unclear. It is associated with intensive insulin therapy, a prolonged 
duration of diabetes, impaired glucose counterregulation, and frequent 
episodes of hypoglycemia. Because a decreased awareness of impending 
hypoglycemia can prevent patients from taking timely protective steps, this 
phenomenon can lead to more frequent and more severe episodes of hypoglycemia.
It has been proposed that hypoglycemia itself may induce this unawareness of 
hypoglycemia. And indeed, the authors conclude in their study that 
hypoglycemia itself can induce unawareness of the autonomic and 
neuroglycopenic symptoms of hypoglycemia and decrease the counterregulatory 
hormonal responses to hypoglycemia.

R. Olk/Carol Lee: La retinopatia diabetica. Medserve, Milano circa 1994, 180p.

Camillo Ricordi (ed.): Pancreatic islet transplantation.
Landes 1992.

11753 Ralf To''njes: Diabetes und Superantigene.
Spektrum 1998/2, 28-30.