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Hypoglycemia, Malnutrition and Body Composition

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Diabetes: from Research to Clinical Practice

Part of the book series: Advances in Experimental Medicine and Biology ((AIM,volume 1307))

Abstract

Hypoglycemia is one of the most significant factors to affect prognosis, and is detrimental to patients regardless of diabetes mellitus (DM) status. The classical paradigms dictate that hypoglycemia is a result of overtreatment with glucose lowering agents (iatrogenic hypoglycemia), or, as among patients without DM, this condition is attributed to disease severity. New information shows that hypoglycemia occurs among patients that have a tendency for it. Incident hypoglycemia is very prevalent in the hospital setting, occurring in 1:6 patients with DM and in 1:17 patients without DM (Leibovitz E, Khanimov I, Wainstein J, Boaz M; Diabetes Metab Syndr Clin Res Rev. 13:222–226, 2019).

One of the major factors associated with incidence of hypoglycemia is the nutritional status on hospital admission and during the hospitalization. Assessment of nutritional status using questionnaires and biomarkers might be helpful in determining risk of hypoglycemia. Moreover, administration of oral nutritional supplements was shown to decrease this risk.

It is also well known that a high burden of comorbidities is associated with an increased risk of hypoglycemia. For example, kidney disease, whether acute or chronic, was shown to increase the risk for hypoglycemia, as well as some endocrine disorders.

In this review we elaborate on specific findings that are characteristic of patients at risk for developing hypoglycemia, as well as treatment aimed at preventing its occurrence.

The original version of this chapter was revised: subtitle was removed. The correction to this chapter is available at https://doi.org/10.1007/5584_2020_559

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Change history

  • 06 July 2020

    The original version of this chapter was inadvertently published with a subtitle which was a duplication of the chapter title.

Bibliography

  • Aldridge DR, Tranah EJ, Shawcross DL (2015) The management of acute hepatic failure. J Clin Exp Hepatol 5(549):S7–S20

    Article  PubMed  Google Scholar 

  • American Society of Parenteral and Enteral Nutrition (2002) Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. J Parenter Enter Nutr 26(1_suppl):1SA–138SA

    Article  Google Scholar 

  • Aronoff SL, Berkowitz K, Shreiner B, Want L (2004) Glucose metabolism and regulation: beyond insulin and glucagon. Diabetes Spectr 17(3):183–190

    Article  Google Scholar 

  • Beck FK, Rosenthal TC (2002) Prealbumin: a marker for nutritional evaluation. Am Fam Physician 65(8):1575–1578

    PubMed  Google Scholar 

  • Biesenbach G, Raml A, Schmekal B, Eichbauer-Sturm G (2003) Decreased insulin requirement in relation to GFR in nephropathic type 1 and insulin-treated type 2 diabetic patients. Diabet Med 20(8):642–645

    Article  CAS  PubMed  Google Scholar 

  • Boléo-Tomé C, Chaves M, Monteiro-Grillo I, Camilo M, Ravasco P (2011) Teaching nutrition integration: MUST screening in cancer. Oncologist 16(2):239–245

    Article  PubMed  PubMed Central  Google Scholar 

  • Bonaventura A, Montecucco F, Dallegri F (2015) Update on strategies limiting iatrogenic hypoglycemia. Endocr Connect 4(3):R37–R45

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Boucai L, Southern WN, Zonszein J (2011) Hypoglycemia-associated mortality is not drug-associated but linked to comorbidities. Am J Med 124(11):1028–1035

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Brodovicz KG, Mehta V, Zhang Q, Zhao C, Davies MJ, Chen J et al (2013) Association between hypoglycemia and inpatient mortality and length of hospital stay in hospitalized, insulin-treated patients. Curr Med Res Opin 29(2):101–107

    Article  CAS  PubMed  Google Scholar 

  • Burda P, Hochuli M (2015) Hepatic glycogen storage disorders. Curr Opin Clin Nutr Metab Care 18(4):415–421

    Article  CAS  PubMed  Google Scholar 

  • Burke CW (1985) Adrenocortical insufficiency. Clin Endocrinol Metab 14(4):947–976

    Article  CAS  PubMed  Google Scholar 

  • Campbell IT (1999) Limitations of nutrient intake. The effect of stressors: trauma, sepsis and multiple organ failure. Eur J Clin Nutr 53(Suppl 1):S143–S147

    Article  PubMed  Google Scholar 

  • Cansado P, Ravasco P, Camilo M (2009) A longitudinal study of hospital undernutrition in the elderly: comparison of four validated methods. J Nutr Health Aging 13(2):159–164

    Article  CAS  PubMed  Google Scholar 

  • Casiglia E, Tikhonoff V (2017) Long-standing problem of β-blocker-elicited hypoglycemia in diabetes mellitus. Hypertens (Dallas, Tex 1979) 70(1):42–43

    Article  CAS  Google Scholar 

  • Charlton KE, Kolbe-Alexander TL, Nel JH (2007) The MNA, but not the DETERMINE, screening tool is a valid indicator of nutritional status in elderly Africans. Nutrition 23(7–8):533–542

    Article  PubMed  Google Scholar 

  • Chattopadhyay PS, Gupta SK, Chattopadhyay R, Kundu PK, Chakraborti R (1995) Malnutrition-related diabetes mellitus (MRDM), not diabetes-related malnutrition. A report on genuine MRDM. Diabetes Care 18(2):276–277

    Article  CAS  PubMed  Google Scholar 

  • Chaytor NS, Barbosa-Leiker C, Ryan CM, Germine LT, Hirsch IB, Weinstock RS (2019) Clinically significant cognitive impairment in older adults with type 1 diabetes. J Diabetes Complicat 33(1):91–97

    Article  Google Scholar 

  • Cherrington AD, Liljenquist JE, Shulman GI, Williams PE, Lacy WW (1979) Importance of hypoglycemia-induced glucose production during isolated glucagon deficiency. Am J Phys 236(3):E263–E271

    CAS  Google Scholar 

  • Conn JW, Fajans SS, Selyzer HS (1956) Spontaneous hypoglycemia as an early manifestation of diabetes mellitus. Diabetes 5(6):437–442

    Article  CAS  PubMed  Google Scholar 

  • Cooperberg BA, Cryer PE (2010) Insulin reciprocally regulates glucagon secretion in humans. Diabetes 59(11):2936–2940

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Correia MITD, Campos ACL (2003) ELAN Cooperative Study. Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. Nutrition 19(10):823–825

    Article  PubMed  Google Scholar 

  • Crevel E, Ardigo S, Perrenoud L, Vischer UM (2009) Acrocyanosis as a cause of pseudohypoglycemia: letters to the editor. J Am Geriatr Soc 57:1519–1520

    Article  PubMed  Google Scholar 

  • Cryer PE (2009) Preventing hypoglycaemia: what is the appropriate glucose alert value? Diabetologia 52(1):35–37

    Article  CAS  PubMed  Google Scholar 

  • Cryer PE (2012) Severe hypoglycemia predicts mortality in diabetes. Diabetes Care 35(9):1814–1816

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cryer PE (2013) Mechanisms of hypoglycemia-associated autonomic failure in diabetes. N Engl J Med. (Massachussetts Medical Society) 369:362–372

    Article  CAS  Google Scholar 

  • Das S, Tripathy BB, Samal KC, Panda NC (1984) Plasma lipids and lipoprotein cholesterol in undernourished diabetic subjects and adults with protein energy malnutrition. Diabetes Care 7(6):579–586

    Article  CAS  PubMed  Google Scholar 

  • Davis TME, Brown SGA, Jacobs IG, Bulsara M, Bruce DG, Davis WA (2010) Determinants of severe hypoglycemia complicating type 2 diabetes: the Fremantle diabetes study. J Clin Endocrinol Metab 95(5):2240–2247

    Article  CAS  PubMed  Google Scholar 

  • Davis CJ, Sowa D, Keim KS, Kinnare K, Peterson S (2012) The use of Prealbumin and C-reactive protein for monitoring nutrition support in adult patients receiving enteral nutrition in an urban medical center. J Parenter Enter Nutr 36(2):197–204

    Article  CAS  Google Scholar 

  • Detsky AS, Mclaughlin J, Baker JP, Johnston N, Whittaker S, Mendelson RA et al (1987) What is subjective global assessment of nutritional status? J Parenter Enter Nutr 11(1):8–13

    Article  CAS  Google Scholar 

  • Drenick EJ, Alvarez LC, Tamasi GC, Brickman AS (1972) Resistance to symptomatic insulin reactions after fasting. J Clin Invest 51(10):2757–2762

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Edington J, Boorman J, Durrant ER, Perkins A, Giffin CV, James R et al (2000) Prevalence of malnutrition on admission to four hospitals in England. Clin Nutr 19(3):191–195

    Article  CAS  PubMed  Google Scholar 

  • El Khoury M, Yousuf F, Martin V, Cohen RM (2008) Pseudohypoglycemia: a cause for unreliable finger-stick glucose measurements. Endocr Pract 14(3):337–339

    Article  PubMed  Google Scholar 

  • Fanali G, Di Masi A, Trezza V, Marino M, Fasano M, Ascenzi P (2012) Human serum albumin: from bench to bedside. Mol Asp Med 33(3):209–290

    Article  CAS  Google Scholar 

  • FAO, IFAD, WFP (2015) The State of Food Insecurity in the World 2015. Meeting the 2015 international hunger targets: taking stock of uneven progress. FAO, Rome

    Google Scholar 

  • Felig P, Brown WV, Levine RA, Klatskin G (1970) Glucose homeostasis in viral hepatitis. N Engl J Med 283(26):1436–1440

    Article  CAS  PubMed  Google Scholar 

  • Finegold DN, Stanley CA, Baker L (1980) Glycemic response to glucagon during fasting hypoglycemia: an aid in the diagnosis of hyperinsulinism. J Pediatr 96(2):257–259

    Article  CAS  PubMed  Google Scholar 

  • Fischer KF, Lees JA, Newman JH (1986) Hypoglycemia in hospitalized patients. N Engl J Med 315(20):1245–1250

    Article  CAS  PubMed  Google Scholar 

  • Foà PP, Dunbar JC, Klein SP, Levy SH, Malik MA, Campbell BB et al (1980) Reactive hypoglycemia and A-cell (‘pancreatic’) glucagon deficiency in the adult. JAMA 244(20):2281–2285

    Article  PubMed  Google Scholar 

  • Giryes S, Leibovitz E, Matas Z, Fridman S, Gavish D, Shalev B et al (2012) MEasuring nutrition risk in hospitalized patients: MENU, a hospital-based prevalence survey. Isr Med Assoc J 14(7):405–409

    PubMed  Google Scholar 

  • Gomez F, Galvan RR, Cravioto J, Frenk S (1955) Malnutrition in infancy and childhood, with special reference to kwashiorkor. Adv Pediatr Infect Dis 7:131–169

    CAS  Google Scholar 

  • Gomez-Perez SL, Haus JM, Sheean P, Patel B, Mar W, Chaudhry V et al (2016) Measuring abdominal circumference and skeletal muscle from a single cross-sectional computed tomography image: a step-by-step guide for clinicians using National Institutes of Health ImageJ. J Parenter Enter Nutr 40(3):308–318

    Article  Google Scholar 

  • Grollman A, McCaleb WE, White FN (1964) Glucagon deficiency as a cause of hypoglycemia. Metabolism 13(8):686–690

    Article  CAS  PubMed  Google Scholar 

  • Grover Z, Ee LC (2009) Protein Energy Malnutrition. Pediatr Clin N Am 56(5):1055–1068

    Article  Google Scholar 

  • Gunning RR, Garber AJ (1978) Bioactivity of instant glucose: failure of absorption through oral mucosa. JAMA 240(15):1611–1612

    Article  CAS  PubMed  Google Scholar 

  • Gurwitz JH, Bohn RL, Glynn RJ, Monane M, Mogun H, Avorn J (1994) Glucocorticoids and the risk for initiation of hypoglycemic therapy. Arch Intern Med 154(1):97–101

    Article  CAS  PubMed  Google Scholar 

  • Hasse J, Strong S, Gorman MA, Liepa G (1993) Subjective global assessment: alternative nutrition-assessment technique for liver-transplant candidates. Nutrition 9(4):339–343

    CAS  PubMed  Google Scholar 

  • Hepburn DA, Deary IJ, Frier BM, Patrick AW, Quinn JD, Fisher BM (1991) Symptoms of acute insulin-induced hypoglycemia in humans with and without IDDM. Factor-analysis approach. Diabetes Care 14(11):949–957

    Article  CAS  PubMed  Google Scholar 

  • Hodge M, McArthur E, Garg AX, Tangri N, Clemens KK (2017) Hypoglycemia incidence in older adults by estimated GFR. Am J Kidney Dis 70(1):59–68

    Article  CAS  PubMed  Google Scholar 

  • International Hypoglycaemia Study Group IHS (2017) Glucose concentrations of less than 3.0 mmol/L (54 mg/dL) should be reported in clinical trials: a joint position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 40(1):155–157

    Article  CAS  Google Scholar 

  • Irina G, Refaela C, Adi B, Avia D, Liron H, Chen A et al (2018) Low blood ALT Activity and High FRAIL questionnaire scores correlate with increased mortality and with each other. A prospective study in the internal medicine department. J Clin Med 7(11):386

    Article  CAS  PubMed Central  Google Scholar 

  • Jensen GL, Bistrian B, Roubenoff R, Heimburger DC (2009) Malnutrition syndromes: a conundrum vs continuum. J Parenter Enter Nutr 33(6):710–716

    Article  Google Scholar 

  • Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T et al (2009) Validation of the mini nutritional assessment short-form (MNA®-SF): a practical tool for identification of nutritional status. J Nutr Heal Aging 13(9):782–788

    Article  CAS  Google Scholar 

  • Karmen A, Wroblewski F, Ladue JS (1955) Transaminase activity in human blood. J Clin Invest 34(1):126–131

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Khanimov I, Segal G, Wainstein J, Boaz M, Shimonov M, Leibovitz E (2019) High-intensity statins are associated with increased incidence of hypoglycemia during hospitalization of individuals not critically ill. Am J Med 132:1305–1310

    Article  CAS  PubMed  Google Scholar 

  • Khanimov I, Boaz M, Shimonov M, Wainstein J, Leibovitz E (2020) Systemic treatment with glucocorticoids is associated with incident hypoglycemia and mortality: a historical prospective analysis. Am J Med (in press)

    Google Scholar 

  • Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) ESPEN guidelines for nutrition screening 2002. Clin Nutr 22(4):415–421

    Article  CAS  PubMed  Google Scholar 

  • Krinsley JS, Grover A (2007) Severe hypoglycemia in critically ill patients: risk factors and outcomes∗. Crit Care Med 35(10):2262–2267

    Article  PubMed  Google Scholar 

  • Lam CWK (2009) 2. Inflammation, cytokines and chemokines in chronic kidney disease. EJIFCC 20(1):12–20

    PubMed  PubMed Central  Google Scholar 

  • Lee KT, Abadir PM (2015) Failure of glucose monitoring in an individual with pseudohypoglycemia. J Am Geriatr Soc (Blackwell Publishing Inc) 63:1706–1708

    Article  Google Scholar 

  • Lee JL, Oh ES, Lee RW, Finucane TE (2015) Serum albumin and prealbumin in calorically restricted, nondiseased individuals: a systematic review. Am J Med 128(9):1023.e1–1023.e22

    Article  CAS  Google Scholar 

  • Leibovitz E, Adler H, Giryes S, Ditch M, Burg NF, Boaz M (2018a) Malnutrition risk is associated with hypoglycemia among general population admitted to internal medicine units. Results from the MENU study. Eur J Clin Nutr 72(6):888–893

    Article  PubMed  Google Scholar 

  • Leibovitz E, Wainstein J, Boaz M (2018b) Association of albumin and cholesterol levels with incidence of hypoglycaemia in people admitted to general internal medicine units. Diabet Med 35:1735–1741

    Article  CAS  PubMed  Google Scholar 

  • Leibovitz E, Khanimov I, Wainstein J, Boaz M (2019a) Documented hypoglycemia is associated with poor short and long term prognosis among patients admitted to general internal medicine departments. Diabetes Metab Syndr Clin Res Rev 13(1):222–226

    Article  Google Scholar 

  • Leibovitz E, Moore F, Mintser I, Levi A, Dubinsky R, Boaz M (2019b) Consumption of nutrition supplements is associated with less hypoglycemia during admission-results from the MENU project. Nutrients 11(8):1832

    Article  CAS  PubMed Central  Google Scholar 

  • Maltzman JS, Berns JS (2005) Are inflammatory cytokines the “evil humors” that increase morbidity and cardiovascular mortality in chronic kidney disease? Semin Dial 18(5):441–443

    Article  PubMed  Google Scholar 

  • Mannucci E, Monami M, Mannucci M, Chiasserini V, Nicoletti P, Gabbani L et al (2006) Incidence and prognostic significance of hypoglycemia in hospitalized non-diabetic elderly patients. Aging Clin Exp Res 18(5):446–451

    Article  PubMed  Google Scholar 

  • Martin-Grace J, Dineen R, Sherlock M, Thompson CJ (2020) Adrenal insufficiency: physiology, clinical presentation and diagnostic challenges. Clin Chim Acta 505:78–91

    Article  CAS  PubMed  Google Scholar 

  • McCluskey A, Thomas AN, Bowles BJ, Kishen R (1996) The prognostic value of serial measurements of serum albumin concentration in patients admitted to an intensive care unit. Anaesthesia 51(8):724–727

    Article  CAS  PubMed  Google Scholar 

  • McCoy RG, Lipska KJ, Yao X, Ross JS, Montori VM, Shah ND (2016) Intensive treatment and severe hypoglycemia among adults with type 2 diabetes. JAMA Intern Med 176(7):969–978

    Article  PubMed  PubMed Central  Google Scholar 

  • Mears E (1996) Outcomes of continuous process improvement of a nutritional care program incorporating serum prealbumin measurements. Nutrition 12(7–8):479–484

    Article  CAS  PubMed  Google Scholar 

  • Miller ME, Bonds DE, Gerstein HC, Seaquist ER, Bergenstal RM, Calles-Escandon J et al (2010) The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study. BMJ 340(7738):138

    Google Scholar 

  • Mori S, Ito H (1988) Hypoglycemia in the elderly. Jpn J Med 27(2):160–166

    Article  CAS  PubMed  Google Scholar 

  • Neirynck N, Glorieux G, Schepers E, Dhondt A, Verbeke F, Vanholder R (2015) Pro-inflammatory cytokines and leukocyte oxidative burst in chronic kidney disease: culprits or innocent bystanders? Nephrol Dial Transplant 30(6):943–951

    Article  CAS  PubMed  Google Scholar 

  • Nirantharakumar K, Marshall T, Hodson J, Narendran P, Deeks J, Coleman JJ et al (2012) Hypoglycemia in non-diabetic in-patients: clinical or criminal? Sesti G, editor. PLoS One 7(7):e40384

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Numeroso F, Barilli AL, Delsignore R (2008) Prevalence and significance of hypoalbuminemia in an internal medicine department. Eur J Intern Med 19(8):587–591

    Article  CAS  PubMed  Google Scholar 

  • Nydick M, Samols E, Kuzuya T, Williams RH (1964) A difficult diagnostic problem in spontaneous hypoglycemia. Reactive hypoglycemia in mild diabetes mellitus. Ann Intern Med 61:1122–1127

    Article  CAS  PubMed  Google Scholar 

  • Olefsky JM, Kimmerling G (1976) Effects of glucocorticoids on carbohydrate metabolism. Am J Med Sci 271(2):202–210

    Article  CAS  PubMed  Google Scholar 

  • Quesada I, Tudurí E, Ripoll C, Nadal A (2008) Physiology of the pancreatic α-cell and glucagon secretion: Role in glucose homeostasis and diabetes. J Endocrinol 199:5–19

    Article  CAS  PubMed  Google Scholar 

  • Rasmussen HH, Holst M, Kondrup J (2010) Measuring nutritional risk in hospitals. Clin Epidemiol 2:209

    Article  PubMed  PubMed Central  Google Scholar 

  • Riddell MC, Gallen IW, Smart CE, Taplin CE, Adolfsson P, Lumb AN et al (2017) Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol 5(5):377–390

    Article  PubMed  Google Scholar 

  • Rothschild MA, Oratz M, Schreiber SS (1973) Progress in gastroenterology albumin metabolism. Gastroenterology 64(642):324–337

    Article  CAS  PubMed  Google Scholar 

  • Rushakoff RJ, Lewis SB (2001) Case of pseudohypoglycemia. Diabetes Care 24:2157–2158

    Article  CAS  PubMed  Google Scholar 

  • Saunders J, Smith T (2010) Malnutrition: causes and consequences. Clin Med 10(6):624–627

    Article  Google Scholar 

  • Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L et al (2013a) Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. J Clin Endocrinol Metab 98(5):1845–1859

    Article  CAS  PubMed  Google Scholar 

  • Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L et al (2013b) Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care 36(5):1384–1395

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Segel SA, Paramore DS, Cryer PE (2002) Hypoglycemia-associated autonomic failure in advanced type 2 diabetes. Diabetes 51(3):724–733

    Article  CAS  PubMed  Google Scholar 

  • Service FJ (1995) Hypoglycemic disorders. N Engl J Med 332(17):1144–1152

    Article  CAS  PubMed  Google Scholar 

  • Shilo S, Berezovsky S, Friedlander Y, Sonnenblick M (1998) Hypoglycemia in hospitalized nondiabetic older patients. J Am Geriatr Soc 46(8):978–982

    Article  CAS  PubMed  Google Scholar 

  • Skipper A, Ferguson M, Thompson K, Castellanos VH, Porcari J (2012) Nutrition screening tools: an analysis of the evidence. J Parenter Enter Nutr 36(3):292–298

    Article  Google Scholar 

  • Snijder MB, Dekker JM, Visser M, Bouter LM, Stehouwer CDA, Yudkin JS et al (2004) Trunk fat and leg fat have independent and opposite associations with fasting and postload glucose levels: the hoorn study. Diabetes Care 27(2):372–377

    Article  PubMed  Google Scholar 

  • Snyder RW, Berns JS (2004) Use of insulin and oral hypoglycemic medications in patients with diabetes mellitus and advanced kidney disease. Semin Dial 17(5):365–370

    Article  PubMed  Google Scholar 

  • Sreedhara R, Avram MM, Blanco M, Batish R, Avram MM, Mittman N (1996) Prealbumin is the best nutritional predictor of survival in hemodialysis and peritoneal dialysis. Am J Kidney Dis 28(6):937–942

    Article  CAS  PubMed  Google Scholar 

  • Stacpoole PW, Interlandi JW, Nicholson WE, Rabin D (1982) Isolated ACTH deficiency: a heterogeneous disorder. Critical review and report of four new cases. Medicine (Baltimore) 61(1):13–24

    Article  CAS  Google Scholar 

  • Steiber A, Leon JB, Secker D, McCarthy M, McCann L, Serra M et al (2007) Multicenter study of the validity and reliability of subjective global assessment in the hemodialysis population. J Ren Nutr 17(5):336–342

    Article  PubMed  Google Scholar 

  • Stratton RJ, Green CJ, Elia M (eds) (2003) Disease-related malnutrition: an evidence-based approach to treatment. CABI, Wallingford

    Google Scholar 

  • Sullivan DH, Sun S, Walls RC (1999) Protein-energy undernutrition among elderly hospitalized patients: a prospective study. JAMA 281(21):2013–2019

    Article  CAS  PubMed  Google Scholar 

  • Taksande A, Taksande B, Kumar, Vilhekar KY (2008) Malnutrition related diabetes mellitus. J Mahatma Gandhi Inst Med Sci 13:19–24

    Google Scholar 

  • Toda G, Fujishiro M, Yamada T, Shojima N, Sakoda H, Suzuki R et al (2014) Lung abscess without sepsis in a patient with diabetes with refractory episodes of spontaneous hypoglycemia: a case report and review of the literature. J Med Case Rep 8(1):51

    Article  PubMed  PubMed Central  Google Scholar 

  • Todd GRG, Acerini CL, Ross-Russell R, Zahra S, Warner JT, McCance D (2002) Survey of adrenal crisis associated with inhaled corticosteroids in the United Kingdom. Arch Dis Child 87(6):457–461

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tormey WP, O’Brien PA (1993) Clinical associations of an increased transthyretin band in routine serum and urine protein electrophoresis. Ann Clin Biochem Int J Biochem Lab Med 30(6):550–554

    Article  Google Scholar 

  • Turchin A, Matheny ME, Shubina M, Scanlon JV, Greenwood B, Pendergrass ML (2009) Hypoglycemia and clinical outcomes in patients with diabetes hospitalized in the general ward. Diabetes Care 32(7):1153–1157

    Article  PubMed  PubMed Central  Google Scholar 

  • Turnbull FM, Abraira C, Anderson RJ, Byington RP, Chalmers JP, Duckworth WC et al (2009) Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia 52(11):2288–2298

    Article  CAS  PubMed  Google Scholar 

  • Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S et al (1999) The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 15(2):116–122

    Article  CAS  PubMed  Google Scholar 

  • Vespasiani-Gentilucci U, De Vincentis A, Ferrucci L, Bandinelli S, Antonelli Incalzi R, Picardi A (2017) Low alanine aminotransferase levels in the elderly. J Gerontol Ser A 00(00):1–6

    Google Scholar 

  • Vidnes J, Oyasaeter S (1977) Glucagon deficiency causing severe neonatal hypoglycemia in a patient with normal insulin secretion. Pediatr Res 11(9 I):943–949

    Article  CAS  PubMed  Google Scholar 

  • Vincent J-L, Dubois M-J, Navickis RJ, Wilkes MM (2003) Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Ann Surg 237(3):319–334

    PubMed  PubMed Central  Google Scholar 

  • Wasserman DH (2009) Four grams of glucose. Am J Physiol Endocrinol Metab 296(1):E11–E21

    Article  CAS  PubMed  Google Scholar 

  • Waterlow JC (1972) Classification and definition of protein-calorie malnutrition. Br Med J 3(5826):566–569

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • White JV, Guenter P, Jensen G, Malone A, Schofield M (2012) Consensus statement: academy of nutrition and dietetics and American society for parenteral and enteral nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Parenter Enter Nutr 36(3):275–283

    Article  Google Scholar 

  • Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP, Selby JV (2009) Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA 301(15):1565–1572

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Workgroup on Hypoglycemia, American Diabetes Association (2005) Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care 28(5):1245–1249

    Article  Google Scholar 

  • Yaffe K, Falvey CM, Hamilton N, Harris TB, Simonsick EM, Strotmeyer ES et al (2013) Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus. JAMA Intern Med 173(14):1300–1306

    Article  PubMed  PubMed Central  Google Scholar 

  • Ye XJ, Ji YB, Ma BW, Huang DD, Chen WZ, Pan ZY, Shen X, Zhuang CL, Yu Z (2018) Comparison of three common nutritional screening tools with the new European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition among patients with geriatric gastrointestinal cancer: a prospective study in China. BMJ Open 8(4):e019750

    Article  PubMed  PubMed Central  Google Scholar 

  • Young AM, Kidston S, Banks MD, Mudge AM, Isenring EA (2013) Malnutrition screening tools: comparison against two validated nutrition assessment methods in older medical inpatients. Nutrition 29(1):101–106

    Article  PubMed  Google Scholar 

  • Yun JS, Ko SH (2015) Avoiding or coping with severe hypoglycemia in patients with type 2 diabetes. Korean J Intern Med 30(1):6–16

    Article  PubMed  Google Scholar 

  • Yun J-S, Park Y-M, Han K, Cha S-A, Ahn Y-B, Ko S-H (2019) Severe hypoglycemia and the risk of cardiovascular disease and mortality in type 2 diabetes: a nationwide population-based cohort study. Cardiovasc Diabetol 18(1):103

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Zapatero A, Gómez-Huelgas R, González N, Canora J, Asenjo Á, Hinojosa J et al (2014) Frequency of hypoglycemia and its impact on length of stay, mortality, and short-term readmission in patients with diabetes hospitalized in internal medicine wards. Endocr Pract 20(9):870–875

    Article  PubMed  Google Scholar 

  • Zhang Z, Pereira S, Luo M, Matheson E (2017) Evaluation of blood biomarkers associated with risk of malnutrition in older adults: a systematic review and meta-analysis. Nutrients 9(8):829

    Article  PubMed Central  CAS  Google Scholar 

  • Zoungas S, Patel A, Chalmers J, De Galan BE, Li Q, Billot L et al (2010) Severe hypoglycemia and risks of vascular events and death. N Engl J Med 363(15):1410–1418

    Article  CAS  PubMed  Google Scholar 

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Conflict of Interest

All authors declare no conflict of interest.

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Authors and Affiliations

  1. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    I. Khanimov, M. Shimonov & J. Wainstein

  2. Diabetes Unit, Edith Wolfson Medical Center, Holon, Israel

    M. Shimonov

  3. Department of Surgery “A”, Edith Wolfson Medical Center, Holon, Israel

    J. Wainstein

  4. Department of Internal Medicine “A”, Yoseftal Hospital, Eilat, Israel

    Eyal Leibovitz

Authors
  1. I. Khanimov
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  2. M. Shimonov
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  3. J. Wainstein
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  4. Eyal Leibovitz
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Corresponding author

Correspondence to Eyal Leibovitz .

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Editors and Affiliations

  1. Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden, Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden

    Md. Shahidul Islam

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Khanimov, I., Shimonov, M., Wainstein, J., Leibovitz, E. (2020). Hypoglycemia, Malnutrition and Body Composition. In: Islam, M.S. (eds) Diabetes: from Research to Clinical Practice. Advances in Experimental Medicine and Biology(), vol 1307. Springer, Cham. https://doi.org/10.1007/5584_2020_526

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  • DOI: https://doi.org/10.1007/5584_2020_526

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