Hypoglycemia primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Primary Prevention
[1,2,4,34].
patient education : [42].
- Ability to recognize early symptoms.
- Frequent self-monitoring of blood glucose [3]: continuous glucose monitoring may facilitate glycemic control. It shlould be more restrict for patients using alcohol and B-blockers. Alcohol, fatigue, and beta blockers;beta blockers can mask the early warning symptoms of hypoglycemia.[40]
- Glycemic control can minimize complications and prevent cardiovascular events.[35-38].
- In patients with type 1 or type 2 diabetes, Long acting insulin mixed with short acting ones as the pre-meal bolus insulin reduce the risk of hypoglycemia especially before meals and sleep.
- Bedtime snacks are the best way to prevent nocturnal hypoglycemia 50
- Sensor-augmented insulin pumps . 51
Exercise can cause hypoglycemia in patients with insulin-deficient diabetes [1,2,4,12,34]
- frequent SMBG
- reduced insulin doses,
- carbohydrate ingestion
The most effective means of preventing further episodes of hypoglycemia depends on the cause.
- The risk of further episodes of diabetic hypoglycemia can often be reduced by lowering the dose of insulin or other medications, or by more meticulous attention to blood sugar balance during unusual hours, higher levels of exercise, or alcohol intake.
- Many of the inborn errors of metabolism require avoidance or shortening of fasting intervals, or extra carbohydrates.
- For the more severe disorders, such as type 1 glycogen storage disease, this may be supplied in the form of cornstarch every few hours or by continuous gastric infusion.
- Hypoglycemia due to dumping syndrome
- Mixed diets including fat and protein with carbohydrates may slow digestion and reduce early insulin secretion
- Glucosidase inhibitor which slows starch digestion.
Reactive hypoglycemia: Many people find improvement by changing eating patterns (smaller meals, avoiding excessive sugar, mixed meals.