Intensive glucose-lowering therapy, particularly among vulnerable clinically complex adults, is strongly discouraged because it may lead to hypoglycemia. However, intensive treatment was equally prevalent among US adults, irrespective of clinical complexity (Mayo)
Diabetes News
Tag: hypoglycemia
Efficacy of two telemonitoring systems to improve glycaemic control during basal insulin initiation in patients with type 2 diabetes: The TeleDiab‐2 randomized controlled trial
Both telemonitoring systems improved glycaemic control to a similar extent, without increasing hypoglycaemic episodes (Diabetes, Obesity and Metabolism)
Use of sensor‐integrated pump therapy to reduce hypoglycaemia in people with Type 1 diabetes: a real‐world study in the UK
Real‐world UK data show that increasing automation of insulin suspension reduces hypoglycaemia exposure in people with Type 1 diabetes (Diabetic Medicine)
First aid glucose administration routes for symptomatic hypoglycaemia
These results have important implications for individuals with symptoms of mild to moderate hypoglycaemia, their family members and first‐aid providers (Cochrane)
Impaired awareness of hypoglycemia: a new risk factor for adverse pregnancy outcomes in type 1 diabetes
Impaired awareness of hypoglycemia: a new risk factor for adverse pregnancy outcomes in type 1 diabetes (Diabetes Research and Clinical Practice)
Low versus high carbohydrate diet in type 1 diabetes: A 12‐week randomized open‐label crossover study
Compared with an intake of 250 g of carbohydrate per day, restriction of carbohydrate intake to 100 g per day in adults with type 1 diabetes reduced time spent in hypoglycaemia, glycaemic variability and weight with no effect on cardiovascular risk factors (Diabetes, Obesity and Metabolism)
Double‐blind, randomized clinical trial comparing the efficacy and safety of continuing or discontinuing the dipeptidyl peptidase‐4 inhibitor sitagliptin when initiating insulin glargine therapy in patients with type 2 diabetes
When initiating insulin glargine therapy, continuation of sitagliptin, compared with discontinuation, resulted in a clinically meaningful greater reduction in HbA1c without an increase in hypoglycaemia (Diabetes, Obesity and Metabolism)
Glycemic goal attainment and hypoglycemia outcomes in type 2 diabetes patients initiating insulin glargine 300 units/mL or 100 units/mL: Real‐world results from the DELIVER Naïve cohort study
Among insulin‐naïve adults with T2D, Gla‐300 was associated with significantly better HbA1c reductions (latest value during 90–180‐day follow‐up) and similar or improved hypoglycemia outcomes (3‐ and 6‐month follow‐up) than Gla‐100 (Diabetes, Obesity and Metabolism)
Sliding scale insulin for non‐critically ill hospitalised adults with diabetes mellitus
Based on low‐ to very low‐certainty evidence, our results for non‐critically ill hospitalised adults with diabetes mellitus in the medical and surgical in‐hospital setting showed that a basal‐bolus insulin strategy that applied higher total daily doses of insulin than the sliding scale insulin regimen might result in better short‐term glycaemic control but might also cause an increase in severe hypoglycaemic episodes (Cochrane Systematic Review)
Asymptomatic hypoglycaemia in Type 1 diabetes: incidence and risk factors
Asymptomatic hypoglycaemia constitutes the majority of hypoglycaemic events in Type 1 diabetes. Reduced hypoglycaemia awareness and high insulin dose are risk factors for asymptomatic hypoglycaemia, but other conventional risk factors for severe hypoglycaemia do not correlate with risk of asymptomatic episodes (Diabetic Medicine)
Development and validation of a risk prediction model for severe hypoglycemia in adult patients with type 2 diabetes
This 14-variable prediction model for SH events may be a useful tool to identify high-risk patients and guide prevention of SH in adult patients with T2DM (Clinical Epidemiology)
Inpatient hypoglycaemia; should we should we focus on the guidelines, the targets or our tools?
These guidelines suggest using lower limits of glucose targets varying from 4.0 to 6.0 mmol/l [2–4]. Levy et al. propose a lower glucose limit of 5 mmol/l with the catchphrase ‘stop at 5 and keep the inpatient alive’ (Diabetic Medicine)
Development of a model to predict 5-year risk of severe hypoglycemia in patients with type 2 diabetes
Using the ACCORD data, we identified attributes to predict 5-year risk of SH in patients with T2DM, which warrant evaluation in broader populations to determine applicability (BMJ Open, Diabetes Research & Care)
A randomized comparison of three prandial insulin dosing algorithms for children and adolescents with Type 1 diabetes
The Pankowska Equation resulted in reduced postprandial hyperglycaemia at the expense of an increase in hypoglycaemia. There were no significant differences when carbohydrate counting was compared to the Food Insulin Index. Further research is required to optimize prandial insulin dosing (Diabetic Medicine)
A retrospective observational study of people with Type 1 diabetes with self‐reported severe hypoglycaemia reveals high level of ambulance attendance but low levels of therapy change and specialist intervention
We observed a high level of ambulance service intervention but surprisingly low levels of hypoglycaemia follow‐up, therapy change and specialist intervention in people self‐reporting severe hypoglycaemia. These results suggest there may be important gaps in care pathways for people with Type 1 diabetes self‐reporting severe hypoglycaemia (Diabetic Medicine)
Impact of drugs on hypoglycaemia in hospitalised patients
The relationship between hypoglycaemia and polypharmacy reinforces the advice to limit polymedication as much as possible, especially in elderly patients. This result underlines the potential involvement of clinical pharmacists with the aim to reduce the risk of hypoglycaemia during hospitalisation (BMJ)
Weight-based carbohydrate treatment of hypoglycaemia in people with Type 1 diabetes using insulin pump therapy: a randomized crossover clinical trial
Weight-based treatment using 0.3 g/kg glucose was more effective for symptomatic hypoglycaemia in children and adults with Type 1 diabetes who were using continuous subcutaneous insulin infusion than treatment based on current international recommendations (Diabetic Medicine)
Association of Insulin Pump Therapy vs Insulin Injection Therapy With Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults With Type 1 Diabetes
Among young patients with type 1 diabetes, insulin pump therapy, compared with insulin injection therapy, was associated with lower risks of severe hypoglycemia and diabetic ketoacidosis and with better glycemic control during the most recent year of therapy. (JAMA)
Hypoglycaemia in the over 75s: Understanding the predisposing factors in type 2 diabetes (T2DM)
Prevalence of hypoglycaemia was greater in those individuals with higher HbA1C and in those on sulphonylurea/insulin treatment (Primary Care Diabetes)
Are we missing hypoglycaemia? Elderly patients with insulin-treated diabetes present to primary care frequently with non-specific symptoms associated with hypoglycaemia
Non-specific symptoms are common in those >65 years. In insulin-treated patients at high hypoglycaemia risk, nausea, falls and unsteadiness should prompt consideration of hypoglycaemia (Primary Care Diabetes)
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