Differential Expression of Inflammatory Markers in Hypoglycemia Unawareness Associated with Type 1 Diabetes: A Case Report

• Main Authors: Yousef Al Zoubi, Bashair M. Mussa, Ankita Srivastava, Abdul Khader Mohammed, Elamin Abdelgadir, Alaaeldin Bashier, Fatheya Al Awadi, Salah Abusnana
• Format: Article
• Language: English
• Published: MDPI AG 2021-12-01
• Series: Brain Sciences
• Subjects: hypoglycemia unawareness; type 1 diabetes mellitus; cytokines; inflammatory markers; TNF-α; IL-1β
• Online Access: https://www.mdpi.com/2076-3425/11/1/17

The recurrence of hypoglycemic episodes leads to attenuation of the normal counter-regulatory mechanisms that are controlled by the hypothalamus, which results in hypoglycemia unawareness (HU). In this case report, we described for the first time the differential expression of TNF-α, IL-1β, IL-6, and IFN-γ in a blood sample that was taken from a 27-year-old patient with type 1 diabetes mellitus (T1DM) who was diagnosed with HU. The anti-diabetic regimen is currently based on insulin injection, but the patient is planning to start the use of an insulin pump to have better control of glucose levels. Our results showed a trend toward an increase in the expression of IL-1β, IL-6, and IFN-γ in the T1DM patients with HU. However, the mRNA level of TNF-α showed a significant decrease. These observations suggest that systemic inflammation could be an underlying cause of HU.