Hypoglycemia risk factors: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
=== Risk factors of hypoglycemia include: === | |||
1. Insulin or insulin secretagogue doses are excessive, ill-timed, or of the wrong type. | |||
2. Exogenous glucose delivery is decreased (''e.g.'' after missed meals and during the overnight fast). | |||
3. Glucose utilization is increased (''e.g.'' during exercise). | |||
4. Endogenous glucose production is decreased (''e.g.'' after alcohol ingestion). | |||
5. 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). | |||
6. 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. 1,2,4,31 | |||
1. Absolute endogenous insulin deficiency. | |||
2. A history of severe hypoglycemia, hypoglycemia unawareness, or both. | |||
3. Aggressive glycemic therapy (lower HbA1C levels, lower glycemic goals). | |||
==References== | ==References== | ||
Revision as of 14:16, 14 July 2017
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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.
2. Exogenous glucose delivery is decreased (e.g. after missed meals and during the overnight fast).
3. Glucose utilization is increased (e.g. during exercise).
4. Endogenous glucose production is decreased (e.g. after alcohol ingestion).
5. 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).
6. 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. 1,2,4,31
1. Absolute endogenous insulin deficiency.
2. A history of severe hypoglycemia, hypoglycemia unawareness, or both.
3. Aggressive glycemic therapy (lower HbA1C levels, lower glycemic goals).