Glucose Clamp Investigations: The ups and downs

With the results of the Diabetes Control and Complications Trial (DCCT) now known (1), health-care providers are faced with the task of implementing more strict glucose control in diabetic patients. Yet, the methodology on the safest way to complete this change in health-care delivery is far from crystallized. Epidemiological data from the DCCT strongly suggest that hypoglycemia begets hypoglycemia (2). Over half of the severe hypoglycemie episodes occurred without warning signs. The importance of understanding the pathophysiological mechanisms behind this disturbing excess of morbidity is clear.