Frequency and Predictors of Self-Reported Hypoglycemia in Insulin-Treated Diabetes.

Samir Malkani,Anupam Kotwal

doi:10.1155/2017/7425925

Abstract

Aims Hypoglycemia is a limiting factor for achieving stringent glycemic control in diabetes. This study analyzes the frequency and predictors of hypoglycemia in insulin-treated diabetes in an ambulatory setting. Methods A retrospective chart review was performed to study self-monitored blood glucose (SMBG) data for 3 months prior to a patient's HbA1c test. Results Hypoglycemia occurred more frequently in type 1 than in type 2 diabetes; however, 19% of type 2 diabetes patients did experience at least one episode of severe hypoglycemia. For type 1 diabetes, hypoglycemia had a positive association with glycemic variability and duration of diabetes and a negative association with HbA1c and lowest blood glucose (BG). For type 2 diabetes, a positive association was noted with glycemic variability and a negative association with age and lowest BG. Conclusions Delineating factors predisposing to hypoglycemia in type 2 diabetes is difficult. Lower HbA1c is a potential predictor of hypoglycemia in type 1 but not in type 2 diabetes. Longer duration of diabetes for type 1 and younger age for type 2 are associated with more hypoglycemia. Glycemic variability portends increased risk for hypoglycemia and should be a focus of further research.

Highlights

Hypoglycemia is a major limiting factor for achieving stringent glycemic control in diabetes
Insulin treatment of diabetes increases the likelihood of experiencing hypoglycemia
We studied a cohort of patients with relatively well-controlled diabetes in terms of their hemoglobin A1c (HbA1c) values, who had diabetes for a long duration increasing their risk of hypoglycemiaassociated autonomic failure (HAAF)

Summary

Introduction

Hypoglycemia is a major limiting factor for achieving stringent glycemic control in diabetes. It influences selfmanagement of diabetes with some patients accepting suboptimal glycemic control to reduce the risk of hypoglycemia [1]. Severe hypoglycemia can cause seizures and arrhythmias. It is associated with dementia [2], and it has been linked with poor cardiovascular outcomes [3] and death [4]. Hypoglycemia has been shown to trigger adrenergic discharge and the expression of proinflammatory cytokines [5]

Methods

Results

Discussion

Conclusion