Abstract
Hypoglycemia is one barrier in providing optimal glycemic control in diabetes patients, and ironically the risk factors for hypoglycemia tend to be higher in patients with poor glycemic control. Severe hypoglycemia is common among patients with diabetes across all levels of glycemic control. Identifying causes, symptoms, and optimal treatment, as well as changing unsafe behaviors are ways to avoid severe hypoglycemic events. There is potential for harm from hypoglycemia, so re-education to treat and prevent hypoglycemia should be instituted, in accordance with current practice guidelines. Personalized attention is warranted, especially for patients receiving insulin or oral hypoglycemic agents who may not have been properly educated or may need re-education regarding hypoglycemia.
References
1. Signorovitch JE, Macaulay D, Diener M, Yan Y, Wu EQ, Gruenberger JB, Frier BM. Hypoglycaemia and accident risk in people with type 2 diabetes mellitus treated with non-insulin antidiabetes drugs. Diabetes Obes Metab. 2013; 15:335–41.
3. Akram K, Pedersen-Bjergaard U, Carstensen B, Borch-Johnsen K, Thorsteinsson B. Frequency and risk factors of severe hypoglycaemia in insulin-treated Type 2 diabetes: a cross-sectional survey. Diabet Med. 2006; 23:750–6.
4. Johnson ES, Koepsell TD, Reiber G, Stergachis A, Platt R. Increasing incidence of serious hypoglycemia in insulin users. J Clin Epidemiol. 2002; 55:253–9.
5. An CW, Kim HJ. Complications of hypoglycemia. Korean Diabetes Association Academic announcement proceedings. Seoul: Gold'Planning and Development;2006. p. 66–8.
6. An KJ. Clinical impacts of iatrogenic hypoglycemia. Diabetes Metab J. 2008; 9:106–9.
8. Cryer PE. Hypoglycemia in type 1 diabetes mellitus. Endocrinol Metab Clin North Am. 2010; 39:641–54.
9. Leese GP, Wang J, Broomhall J, Kelly P, Marsden A, Morrison W, Frier BM, Morris AD. DARTS/MEMO Collaboration. Frequency of severe hypoglycemia requiring emergency treatment in type 1 and type 2 diabetes: a population-based study of health service resource use. Diabetes Care. 2003; 26:1176–80.
11. Anthony M. Hypoglycemia in hospital adults. Medsurg Nurs. 2008; 17:31–40.
12. United Kingdom Prospective Diabetes Study 24: a 6-year, randomized, controlled trial comparing sulfonylurea, insulin, and metformin therapy in patients with newly diagnosed type 2 diabetes that could not be controlled with diet therapy. United Kingdom Prospective Diabetes Study Group. Ann Intern Med. 1998; 128:165–75.
13. Ginde AA, Espinola JA, Camargo CA Jr. Trends and disparities in U.S. emergency department visits for hypoglycemia, 1993–2005. Diabetes Care. 2008; 31:511–3.
14. Korean Diabetes Association. Diabetes. 4th ed.Seoul: Korea Medical Book;2011. p. p519–34.
15. Korean Diabetes Association Education Committee. The guide for diabetes education. 3rd ed.Seoul: Gold'Planning and Development;2013. p134–9, 151–9,. p. 161–79.
16. American Diabetes Association. Standards of medical care in diabetes–2014. Diabetes Care. 2014; 37(Suppl 1):S14–80.
17. Shin UJ. The risk factors of Hypoglycemia for the patients with diabetes. Nurs Sci. 2014; 26:39–49.
18. Desouza C, Salazar H, Cheong B, Murgo J, Fonseca V. Association of hypoglycemia and cardiac ischemia: a study based on continuous monitoring. Diabetes Care. 2003; 26:1485–9.
19. Tomky D. Detection, prevention, and treatment of hypoglycemia in the hospital. Diabetes Spectr. 2005; 18:39–44.
20. Deary IJ. Symptoms of hypoglycemia and effects on mental performance and emotions. Fisher BM, editor. Hypoglycemia in clinical diabetes. Chichester, West Sussex, England;. New York: John Wiley;1999. p. p29–54.