Hypoglycemia risk factors: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 18: | Line 18: | ||
=== Risk factors for hypoglycemia-associated autonomic failure === | === Risk factors for hypoglycemia-associated autonomic failure === | ||
There are three defenses against hypoglycemia:<ref name="pmid12136392">{{cite journal| author=Cryer PE| title=Hypoglycaemia: the limiting factor in the glycaemic management of Type I and Type II diabetes. | journal=Diabetologia | year= 2002 | volume= 45 | issue= 7 | pages= 937-48 | pmid=12136392 | doi=10.1007/s00125-002-0822-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12136392 }}</ref> | There are three defenses against hypoglycemia:<ref name="pmid12136392">{{cite journal| author=Cryer PE| title=Hypoglycaemia: the limiting factor in the glycaemic management of Type I and Type II diabetes. | journal=Diabetologia | year= 2002 | volume= 45 | issue= 7 | pages= 937-48 | pmid=12136392 | doi=10.1007/s00125-002-0822-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12136392 }}</ref><ref name="pmid15163777">{{cite journal| author=Cryer PE| title=Diverse causes of hypoglycemia-associated autonomic failure in diabetes. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 22 | pages= 2272-9 | pmid=15163777 | doi=10.1056/NEJMra031354 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15163777 }}</ref> | ||
* Decrease [[insulin]] levels in [[blood]] | * Decrease [[insulin]] levels in [[blood]] | ||
* Increase [[glucagon]] production | * Increase [[glucagon]] production | ||
Revision as of 14:40, 2 October 2017
|
Hypoglycemia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hypoglycemia risk factors On the Web |
|
American Roentgen Ray Society Images of Hypoglycemia risk factors |
|
Risk calculators and risk factors for Hypoglycemia risk factors |
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 or with alcohol. Absolute endogenous insulin deficiency is another risk factor.
Risk Factors
Risk factors of hypoglycemia include:[1][2]
- Excessive amounts of Insulin or insulin-inducing drugs, inappropriate timing or type of administration
- Decrease glucose intake (missed meals and overnight)
- Increased glucose need during exercise
- Decrease endogenous glucose production after alcohol intake
- Sensitivity to insulin is increased due to:
- Weight loss
- Improved glycemic control
- Physiologically in the middle of the night
- renal failure due to decreased Insulin clearance
Risk factors for hypoglycemia-associated autonomic failure
There are three defenses against hypoglycemia:[3][4]
- Decrease insulin levels in blood
- Increase glucagon production
- Increase epinephrine levels
Failure of any of these defenses increase chances 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
- ↑ 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, Davis SN, Shamoon H (2003). "Hypoglycemia in diabetes". Diabetes Care. 26 (6): 1902–12. PMID 12766131.
- ↑ 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.
- ↑ 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.
- ↑ Cryer PE (2008). "The barrier of hypoglycemia in diabetes". Diabetes. 57 (12): 3169–76. doi:10.2337/db08-1084. PMC 2584119. PMID 19033403.