Hypoglycemia risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Overview

Risk factors of hypoglycemia include diabetic patients with excessive insulin doses especially after missed meals or after exercise. Nocturnal fasting and alcohol intake are less common risk factors in diabetic patients.

Risk Factors

Risk factors of hypoglycemia include:[1][2]

Risk factors for hypoglycemia-associated autonomic failure

There are three defense mechanisms against hypoglycemia:[3][4]

Failure of any of these defense mechanisms increase the chance of hypoglycemia. This occurs rapidly in type 1 diabetes and more gradually in type 2 diabetes mainly due to:[5]

  • Absolute endogenous insulin deficiency in type1 DM
  • A history of severe hypoglycemia, hypoglycemia unawareness, or both
  • Aggressive glycemic therapy (lower HbA1C levels, lower glycemic goals)

References

  1. Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER; et al. (2009). "Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline". J Clin Endocrinol Metab. 94 (3): 709–28. doi:10.1210/jc.2008-1410. PMID 19088155.
  2. Cryer PE, Davis SN, Shamoon H (2003). "Hypoglycemia in diabetes". Diabetes Care. 26 (6): 1902–12. PMID 12766131.
  3. Cryer PE (2002). "Hypoglycaemia: the limiting factor in the glycaemic management of Type I and Type II diabetes". Diabetologia. 45 (7): 937–48. doi:10.1007/s00125-002-0822-9. PMID 12136392.
  4. Cryer PE (2004). "Diverse causes of hypoglycemia-associated autonomic failure in diabetes". N Engl J Med. 350 (22): 2272–9. doi:10.1056/NEJMra031354. PMID 15163777.
  5. Cryer PE (2008). "The barrier of hypoglycemia in diabetes". Diabetes. 57 (12): 3169–76. doi:10.2337/db08-1084. PMC 2584119. PMID 19033403.