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Hypoglycemia: Diagnosis, Management, and Prevention

  • Raquel N. Faradji
  • Ana C. Uribe-Wiechers
  • María Elena Sainz de la Maza Viadero
Chapter

Abstract

Hypoglycemia is one of the most common complications of diabetes and a major limiting factor in the glycemic management of diabetes. Individuals with type 1 diabetes (T1D) and long-standing type 2 diabetes (T2D) have altered counterregulatory responses to hypoglycemia, which puts them at risk for recurrent hypoglycemia and may develop hypoglycemia unawareness. Acute hypoglycemia is associated with increased morbidity, impacts quality of life, and can even be fatal. Severe hypoglycemia should be treated promptly and should be followed by drastic changes in patient’s therapy and lifestyle. Optimal glycemic control while minimizing the risk of hypoglycemia is possible by applying the principles of aggressive therapy and practicing hypoglycemic risk reduction.

Keywords

Hypoglycemia Severe hypoglycemia (SH) Hypoglycemia unawareness Hypoglycemia-associated autonomic failure (HAAF) Nocturnal hypoglycemia Self-monitoring blood glucose (SMBG) Continuous glucose monitoring (CGM) 

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Suggested Reading

    Books

    1. Davis SN, Lamos EM, Younk LM. Chapter 47: Hypoglycemia and hypoglycemic syndromes. In: Jameson JL, De Groot LJ, editors. Endocrinology: adult and pediatric. 7th ed. Philadelphia: Elsevier Saunders; 2016. p. 816–838e8.CrossRefGoogle Scholar

    T1D and Hypoglycemia

    1. Little SA, Leelarathna L, Barandse SM, Walkinshaw E, Tan HK, Solomon L, et al. Severe hypoglycaemia in type 1 diabetes mellitus: underlying drivers and potential strategies for successful prevention. Diabetes Metab Res Rev. 2014;30:175–90.PubMedCrossRefGoogle Scholar

    Physiology and Pathophysiology of Hypoglycemia:

    1. Cryer PE. Banting lecture: hypoglycemia: the limiting factor in the management of IDDM. Diabetes. 1994;43:1378–89.PubMedCrossRefGoogle Scholar
    2. Cryer PE. Mechanisms of hypoglycemia-associated autonomic failure in diabetes. N Engl J Med. 2013;369(4):362–72.PubMedCrossRefGoogle Scholar
    3. Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care. 2003;26:1902–12.PubMedCrossRefGoogle Scholar
    4. McCrimmon RJ, Sherwin RS. Hypoglycemia in type 1 diabetes. Diabetes. 2010;59:2333–9.PubMedPubMedCentralCrossRefGoogle Scholar

    Insulins and Hypoglycemia

    1. Little S, Shaw J, Home P. Hypoglycemia rates with basal insulin analogs. Diabetes Technol Ther. 2011;13(supplement 1):S53–64.PubMedCrossRefGoogle Scholar

    Pancreas Transplantation

    1. Rickels MR. Recovery of endocrine function after islet and pancreas transplantation. Curr Diab Rep. 2012;12:587–96.PubMedPubMedCentralCrossRefGoogle Scholar

    HRS – Hypoglycemia Risk Score

    Hypoglycemia in ACCORD, ADVANCE, and VADT

    1. Skyler JS, Bergenstal R, Bonow RO, Buse J, Deedwania P, Gale E, Howard B, et al. Intensive glucose control and the prevention of cardiovascular events: implications if the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. Circulation. 2009;119:351–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Raquel N. Faradji
    • 1
    • 2
    • 3
    • 4
  • Ana C. Uribe-Wiechers
    • 1
    • 4
    • 5
  • María Elena Sainz de la Maza Viadero
    • 1
    • 2
    • 6
  1. 1.Clinica EnDiMexico CityMexico
  2. 2.RENACED Diabetes Tipo 1Mexico CityMexico
  3. 3.Pathophysiology of the Endocrine System, Escuela de Medicina TEC-ABC, Tecnologico de Monterrey, Centro Medico ABCMexico CityMexico
  4. 4.Sociedad Mexicana de Nutrición y EndocrinologíaMexico CityMexico
  5. 5.Escuela de Medicina TEC-ABC, Tecnologico de Monterrey, Centro Medico ABCMonterreyMexico
  6. 6.Didactic Resources for Nutrition, Escuela de Dietetica y Nutricion ISSSTEMexico CityMexico

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