Hypoglycemia risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Hypoglycemia is relatively common in people with diabetes.
Risk Factors
Risk factors of hypoglycemia include:
- Insulin or insulin secretagogue doses are excessive, ill-timed, or of the wrong type.
- Exogenous glucose delivery is decreased (e.g. after missed meals and during the overnight fast).
- Glucose utilization is increased (e.g. during exercise).
- Endogenous glucose production is decreased (e.g. after alcohol ingestion).
- Sensitivity to insulin is increased (e.g. after weight loss, an increase in regular exercise or improved glycemic control, and in
- the middle of the night).
- Insulin clearance is decreased (e.g. with renal failure).
Risk factors for hypoglycemia-associated autonomic failure
There are three defences against hypoglycemia; decrease of insulin. increase of glucagon and increase of epinephrine. Failure of any of these defenses increase chances of hypoglycemia. This occurs rapidly in type 1 diabetes and more gradually in type 2 diabetes.[1]
- Absolute endogenous insulin deficiency.
- A history of severe hypoglycemia, hypoglycemia unawareness, or both.
- Aggressive glycemic therapy (lower HbA1C levels, lower glycemic goals).
References
- ↑ Cryer PE (2008). "The barrier of hypoglycemia in diabetes". Diabetes. 57 (12): 3169–76. doi:10.2337/db08-1084. PMC 2584119. PMID 19033403.