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Christine Rode Andreasen Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Andreas Andersen Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Filip Krag Knop Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Tina Vilsbøll Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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significantly reduced body weight without increasing hypoglycaemia or ketoacidosis ( 60 ). Thus, no convincing data support the general use of GLP-1RAs as adjuvant therapy in patients with T1D. Still, with the right combination and timing with insulin, treatment

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Marko Stojanovic Neuroendocrinology Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia
University of Belgrade, Medical Faculty, Belgrade, Serbia

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Zida Wu Department of Medicine for Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Berlin, Germany

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Craig E Stiles Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

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Dragana Miljic Neuroendocrinology Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia
University of Belgrade, Medical Faculty, Belgrade, Serbia

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Ivan Soldatovic University of Belgrade, Medical Faculty, Belgrade, Serbia
Insitute of Medical Statistics and Informatics, Belgrade, Serbia

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Sandra Pekic Neuroendocrinology Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia
University of Belgrade, Medical Faculty, Belgrade, Serbia

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Mirjana Doknic Neuroendocrinology Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia
University of Belgrade, Medical Faculty, Belgrade, Serbia

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Milan Petakov Neuroendocrinology Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Belgrade, Serbia
University of Belgrade, Medical Faculty, Belgrade, Serbia

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Vera Popovic University of Belgrade, Medical Faculty, Belgrade, Serbia

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Christian Strasburger Department of Medicine for Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin, Campus Mitte, Berlin, Germany

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Márta Korbonits Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

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0.1 ng/mL range. Baseline serum AIP was independent of age, gender or BMI. Serum AIP levels in all investigated groups were stable over time in samples taken at 30-min intervals over 2-h course and were unchanged by severe hypoglycaemia (induced by

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Aldo Bonaventura Department of Internal Medicine, Division of Cardiology, Division of Laboratory Medicine, First Clinic of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

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Fabrizio Montecucco Department of Internal Medicine, Division of Cardiology, Division of Laboratory Medicine, First Clinic of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
Department of Internal Medicine, Division of Cardiology, Division of Laboratory Medicine, First Clinic of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
Department of Internal Medicine, Division of Cardiology, Division of Laboratory Medicine, First Clinic of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

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Franco Dallegri Department of Internal Medicine, Division of Cardiology, Division of Laboratory Medicine, First Clinic of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino – IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

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measures recommended to limit iatrogenic hypoglycaemia are summarized in Fig. 1 . Figure 1 Measures to limit iatrogenic hypoglycemia. The first step is to limit the hypoglycemic episodes, since this approach can completely restore hypoglycemia awareness in

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Sommayya Aftab Department of Paediatric Endocrinology, Great Ormond Street Hospital, London, UK

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Diliara Gubaeva Department of Paediatric Endocrinology, Endocrinology Research Centre, Moscow, Russia

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Jayne A L Houghton The Genomics Laboratory, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK

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Antonia Dastamani Department of Paediatric Endocrinology, Great Ormond Street Hospital, London, UK

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Ellada Sotiridou Department of Paediatric Endocrinology, Great Ormond Street Hospital, London, UK

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Clare Gilbert Department of Paediatric Endocrinology, Great Ormond Street Hospital, London, UK

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Sarah E Flanagan Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK

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Anatoly Tiulpakov Department of Paediatric Endocrinology, Endocrinology Research Centre, Moscow, Russia

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Maria Melikyan Department of Paediatric Endocrinology, Endocrinology Research Centre, Moscow, Russia

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Pratik Shah Department of Paediatric Endocrinology, Great Ormond Street Hospital, London, UK

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’-triphosphate (GTP) ( 5 , 6 ). Activated mutations in the GLUD1 gene lead to loss of this allosteric inhibition by GTP, which in turn increases leucine-induced glutamate oxidation to alpha-ketoglutarate, resulting in hyperinsulinemic hypoglycaemia ( 7 ). This

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Espen Nordheim Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Faculty of Medicine, University of Oslo, Oslo, Norway

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Jørn Petter Lindahl Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway

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Rasmus Kirkeskov Carlsen Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway

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Anders Åsberg Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Department of Pharmacy, University of Oslo, Oslo, Norway

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Kåre Inge Birkeland Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Faculty of Medicine, University of Oslo, Oslo, Norway

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Rune Horneland Department of Transplantation Medicine, Section of Transplantation Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway

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Birgitte Boye Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Department of Behavioural Medicine, University of Oslo, Oslo, Norway

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Hanne Scholz Department of Transplantation Medicine, Section of Transplantation Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Centre of Excellence-HTH, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

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Trond Geir Jenssen Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Faculty of Medicine, University of Oslo, Oslo, Norway
Metabolic and Renal Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway

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1 diabetes. Patients with different phenotypes of diabetes have been accepted, the major categories being patients with persistent hyperglycaemia (HbA1c > 10% (>86 mmol/mol)), patients with recurring episodes of hypoglycaemia or with fluctuating or

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Ivar Følling Department of Endocrinology, Akershus University Hospital, Lørenskog, Norway
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, Lørenskog, Norway

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Anna B Wennerstrøm Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, Lørenskog, Norway

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Tor J Eide Division of Laboratory Medicine, Department of Pathology, Oslo University Hospital, Oslo, Norway

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Hilde Loge Nilsen Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, Lørenskog, Norway

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/or cure of hypoglycaemia after tumour extirpation ( 10 , 12 , 13 ). There are also reports of patients with hyperinsulinemic hypoglycaemia without convincing evidence that their extrapancreatic tumour produced the insulin. Dysregulated ectopic

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Rama Lakshman Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

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Charlotte Boughton Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, UK

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Roman Hovorka Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

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microvascular complications ( 2 ). Optimal glycaemic control is often limited by the risk of hypoglycaemia, and is made more challenging because insulin needs vary considerably day to day ( 3 ). A minority of people with T1D currently achieve the recommended

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Eva Olga Melin Diabetes Research Laboratory, Lund University, Lund, Sweden
Department of Research and Development, Region Kronoberg, Växjö, Sweden

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Magnus Hillman Diabetes Research Laboratory, Lund University, Lund, Sweden

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Mona Landin-Olsson Diabetes Research Laboratory, Lund University, Lund, Sweden
Department of Endocrinology, Skane University Hospital, Lund, Sweden

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control, hypoinsulinaemia, hypoglycaemia episodes, impaired kidney function, depression, physical inactivity, smoking and other types of substance abuse, all affect the levels of cortisol secretion ( 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ). In our

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Louise Færch Department of Cardiology, Department of Growth and Reproduction, Faculty of Health Sciences, Nephrology and Endocrinology H, Hillerød University Hospital, Dyrehavevej 29, DK-3400 Hillerød, Denmark

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Anders Juul Department of Cardiology, Department of Growth and Reproduction, Faculty of Health Sciences, Nephrology and Endocrinology H, Hillerød University Hospital, Dyrehavevej 29, DK-3400 Hillerød, Denmark
Department of Cardiology, Department of Growth and Reproduction, Faculty of Health Sciences, Nephrology and Endocrinology H, Hillerød University Hospital, Dyrehavevej 29, DK-3400 Hillerød, Denmark

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Ulrik Pedersen-Bjergaard Department of Cardiology, Department of Growth and Reproduction, Faculty of Health Sciences, Nephrology and Endocrinology H, Hillerød University Hospital, Dyrehavevej 29, DK-3400 Hillerød, Denmark

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Birger Thorsteinsson Department of Cardiology, Department of Growth and Reproduction, Faculty of Health Sciences, Nephrology and Endocrinology H, Hillerød University Hospital, Dyrehavevej 29, DK-3400 Hillerød, Denmark
Department of Cardiology, Department of Growth and Reproduction, Faculty of Health Sciences, Nephrology and Endocrinology H, Hillerød University Hospital, Dyrehavevej 29, DK-3400 Hillerød, Denmark

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P Mathiesen ER . Lower levels of circulating IGF-I in type 1 diabetic women with frequent severe hypoglycaemia during pregnancy . Diabetic Medicine 2008 25 826 – 833 . ( doi:10.1111/j.1464-5491.2008.02495.x ). 6 Tan K Baxter RC . Serum

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Wiebke Arlt Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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the Society for Endocrinology Clinical Committee The Society for Endocrinology, 22 Apex Court, Woodlands, Bradley Stoke, Bristol, UK

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Hypoglycaemia (primarily in affected children; can cause long-term neurological deficits, if not promptly treated) Investigations for suspected adrenal crisis in patients not already known to have adrenal failure Adrenal insufficiency should be ruled

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