Risk Factors and Adverse Outcomes of Severe Hypoglycemia in Type 2 Diabetes Mellitus

Overview

Journal Diabetes Metab J

Specialty Endocrinology

Date 2016 Oct 22

PMID 27766794

Citations 29

Authors

Jae Seung Yun

Seung Hyun Ko

Affiliations

Soon will be listed here.

Abstract

Hypoglycemia has been considered as a major barrier to achieving the proper glycemic target in type 2 diabetes mellitus patients. In particular, severe hypoglycemia (SH), which is defined as a hypoglycemic episode requiring the assistance of another person to raise the patient's glucose level, is a serious complication of diabetes because of its possible fatal outcomes. Recently, the recommendations for diabetes care have emphasized a patient-centered approach, considering the individualized patient factors including hypoglycemia. Many studies have been performed which analyzed the risk factors and clinical outcomes for SH. From the studies, researchers recommend that targeting a less stringent glycosylated hemoglobin level and selecting a safer class of drugs for hypoglycemia are appropriate for patients with a high risk of SH. Also, careful clinical attention to prevent hypoglycemia, including intensive education, is necessary to minimize the risk of SH and SH-related fatal outcomes.

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References

Cryer P . Mechanisms of hypoglycemia-associated autonomic failure in diabetes. N Engl J Med. 2013; 369(4):362-72. DOI: 10.1056/NEJMra1215228. View

Signorovitch J, Macaulay D, Diener M, Yan Y, Wu E, Gruenberger J . Hypoglycaemia and accident risk in people with type 2 diabetes mellitus treated with non-insulin antidiabetes drugs. Diabetes Obes Metab. 2012; 15(4):335-41. PMC: 3593162. DOI: 10.1111/dom.12031. View

Goto A, Arah O, Goto M, Terauchi Y, Noda M . Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis. BMJ. 2013; 347:f4533. DOI: 10.1136/bmj.f4533. View

Cox D, Kovatchev B, Koev D, Koeva L, Dachev S, Tcharaktchiev D . Hypoglycemia anticipation, awareness and treatment training (HAATT) reduces occurrence of severe hypoglycemia among adults with type 1 diabetes mellitus. Int J Behav Med. 2005; 11(4):212-8. DOI: 10.1207/s15327558ijbm1104_4. View

. Risk of hypoglycaemia in types 1 and 2 diabetes: effects of treatment modalities and their duration. Diabetologia. 2007; 50(6):1140-7. DOI: 10.1007/s00125-007-0599-y. View

Davis M, Mellman M, Friedman S, Chang C, Shamoon H . Recovery of epinephrine response but not hypoglycemic symptom threshold after intensive therapy in type 1 diabetes. Am J Med. 1994; 97(6):535-42. DOI: 10.1016/0002-9343(94)90349-2. View

Gerich J . Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications. Diabet Med. 2010; 27(2):136-42. PMC: 4232006. DOI: 10.1111/j.1464-5491.2009.02894.x. View

Kong A, Yang X, Luk A, Ma R, So W, Ozaki R . Severe hypoglycemia identifies vulnerable patients with type 2 diabetes at risk for premature death and all-site cancer: the Hong Kong diabetes registry. Diabetes Care. 2014; 37(4):1024-31. DOI: 10.2337/dc13-2507. View

Miller C, Phillips L, Ziemer D, Gallina D, COOK C . Hypoglycemia in patients with type 2 diabetes mellitus. Arch Intern Med. 2001; 161(13):1653-9. DOI: 10.1001/archinte.161.13.1653. View

10.

Punthakee Z, Miller M, Launer L, Williamson J, Lazar R, Cukierman-Yaffee T . Poor cognitive function and risk of severe hypoglycemia in type 2 diabetes: post hoc epidemiologic analysis of the ACCORD trial. Diabetes Care. 2012; 35(4):787-93. PMC: 3308284. DOI: 10.2337/dc11-1855. View

11.

Inzucchi S, Bergenstal R, Buse J, Diamant M, Ferrannini E, Nauck M . Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012; 35(6):1364-79. PMC: 3357214. DOI: 10.2337/dc12-0413. View

12.

Yoon K, Lee J, Kim J, Cho J, Choi Y, Ko S . Epidemic obesity and type 2 diabetes in Asia. Lancet. 2006; 368(9548):1681-8. DOI: 10.1016/S0140-6736(06)69703-1. View

13.

McCoy R, Lipska K, Yao X, Ross J, Montori V, Shah N . Intensive Treatment and Severe Hypoglycemia Among Adults With Type 2 Diabetes. JAMA Intern Med. 2016; 176(7):969-78. PMC: 5380118. DOI: 10.1001/jamainternmed.2016.2275. View

14.

Gerich J . Lilly lecture 1988. Glucose counterregulation and its impact on diabetes mellitus. Diabetes. 1988; 37(12):1608-17. DOI: 10.2337/diab.37.12.1608. View

15.

Puente E, Silverstein J, Bree A, Musikantow D, Wozniak D, Maloney S . Recurrent moderate hypoglycemia ameliorates brain damage and cognitive dysfunction induced by severe hypoglycemia. Diabetes. 2010; 59(4):1055-62. PMC: 2844814. DOI: 10.2337/db09-1495. View

16.

Strachan M, Deary I, EWING F, Frier B . Recovery of cognitive function and mood after severe hypoglycemia in adults with insulin-treated diabetes. Diabetes Care. 2000; 23(3):305-12. DOI: 10.2337/diacare.23.3.305. View

17.

Seaquist E, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L . Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care. 2013; 36(5):1384-95. PMC: 3631867. DOI: 10.2337/dc12-2480. View

18.

. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352(9131):837-53. View

19.

. Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care. 2005; 28(5):1245-9. DOI: 10.2337/diacare.28.5.1245. View

20.

Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven P . Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2008; 360(2):129-39. DOI: 10.1056/NEJMoa0808431. View