Washington Manual of Medical Therapeutics
Hypoglycemia
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General Principles
Classification
Iatrogenic factors usually account for hypoglycemia in the setting of diabetes, complicating therapy with insulin or SFUs and limiting achievement of glycemic control during intensive therapy in patients with diabetes.1 Hypoglycemia is uncommon in patients not treated for diabetes and can be classified as fasting or postprandial hypoglycemia.
Risk Factors
Hypoglycemia resulting from too intensive diabetes management with insulin or SFU may increase the risk of mortality in older patients with CV risk factors and should be avoided.
- Risk factors for hypoglycemia during insulin or SFU treatment include skipped or insufficient meals, unaccustomed physical exertion, misguided therapy, alcohol ingestion, and drug overdose.
- Recurrent episodes of hypoglycemia impair recognition of hypoglycemic symptoms, thereby increasing the risk for severe hypoglycemia (hypoglycemia unawareness).
- Hypoglycemia unawareness results from defective glucose counterregulation with blunting of autonomic symptoms and counterregulatory hormone secretion during hypoglycemia. Seizures or coma may develop in such patients without the usual warning symptoms of hypoglycemia.
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General Principles
Classification
Iatrogenic factors usually account for hypoglycemia in the setting of diabetes, complicating therapy with insulin or SFUs and limiting achievement of glycemic control during intensive therapy in patients with diabetes.1 Hypoglycemia is uncommon in patients not treated for diabetes and can be classified as fasting or postprandial hypoglycemia.
Risk Factors
Hypoglycemia resulting from too intensive diabetes management with insulin or SFU may increase the risk of mortality in older patients with CV risk factors and should be avoided.
- Risk factors for hypoglycemia during insulin or SFU treatment include skipped or insufficient meals, unaccustomed physical exertion, misguided therapy, alcohol ingestion, and drug overdose.
- Recurrent episodes of hypoglycemia impair recognition of hypoglycemic symptoms, thereby increasing the risk for severe hypoglycemia (hypoglycemia unawareness).
- Hypoglycemia unawareness results from defective glucose counterregulation with blunting of autonomic symptoms and counterregulatory hormone secretion during hypoglycemia. Seizures or coma may develop in such patients without the usual warning symptoms of hypoglycemia.
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