Hypoglycemia risk factors: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
=== Risk factors of hypoglycemia include: === | === Risk factors of hypoglycemia include:<ref name="pmid19088155">{{cite journal| author=Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER et al.| title=Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 3 | pages= 709-28 | pmid=19088155 | doi=10.1210/jc.2008-1410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088155 }}</ref> === | ||
* Insulin or insulin secretagogue doses are excessive, ill-timed, or of the wrong type. | * 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). | * Exogenous glucose delivery is decreased (''e.g.'' after missed meals and during the overnight fast). |
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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:[1]
- 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.[2]
- 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, 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.
- ↑ Cryer PE (2008). "The barrier of hypoglycemia in diabetes". Diabetes. 57 (12): 3169–76. doi:10.2337/db08-1084. PMC 2584119. PMID 19033403.