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Open AccessReview

A Systematic Review of Neuroprotective Strategies in the Management of Hypoglycemia

Department of Neurology, Jena University Hospital - Friedrich Schiller University, Jena 07747, Germany
Institute for Biochemistry II, Jena University Hospital - Friedrich Schiller University, Jena 07743, Germany
Orthopedic Department, Jena University Hospital - Friedrich Schiller University, Campus Eisenberg, Klosterlausnitzer Straße 81, Eisenberg 07607, Germany
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(3), 550;
Received: 30 December 2018 / Revised: 18 January 2019 / Accepted: 24 January 2019 / Published: 28 January 2019
(This article belongs to the Special Issue Neuroprotective Strategies 2018)
Severe hypogylcemia has been found to induce cerebral damage. While a number of illnesses can lead to hypoglycemic episodes, antidiabetic medications prescribed for glycemic control are a common cause. Considering the rising prevalence of diabetes mellitus in the population, we investigated neuroprotective strategies during hypoglycemia in the form of a systematic review in adherence to the PRISMA statement. A review protocol was registered in the PROSPERO database. A systematic literature search of PubMed, Web of Science, and CENTRAL was performed in September 2018. Based on a predefined inclusion protocol, results were screened and evaluated by two researchers. Both animal experiments and human studies were included, and their risk of bias was assessed with SYRCLE’s and the Cochrane risk of bias tools, respectively. Of a total of 16,230 results, 145 were assessed in full-text form: 27 articles adhered to the inclusion criteria and were qualitatively analyzed. The retrieved neuroprotective strategies could be categorized into three subsets: (1) Energy substitution, (2) hypoglycemia unawareness, and (3) other neuroprotective strategies. While on a study level, the individual results appeared promising, more research is required to investigate not only specific neuroprotective strategies against hypoglycemic cerebral damage, but also its underlying pathophysiological mechanisms. View Full-Text
Keywords: hypoglycemia; neuroprotection; diabetes hypoglycemia; neuroprotection; diabetes
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Nistor, M.; Schmidt, M.; Graul, I.; Rakers, F.; Schiffner, R. A Systematic Review of Neuroprotective Strategies in the Management of Hypoglycemia. Int. J. Mol. Sci. 2019, 20, 550.

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