Hypoglycemia risk factors
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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 fasting and alcohol intake are less common risk factors in diabetic patients.
Risk Factors
Risk factors of hypoglycemia include:[1][2]
- Excessive amounts of Insulin or insulin secretagogues drugs, inappropriate timing or type of administration
- Decreased glucose intake (missed meals and overnight)
- Increased glucose need during exercise
- Decreased 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 may cause decreased Insulin clearance
Risk factors for hypoglycemia-associated autonomic failure
There are three defense mechanisms against hypoglycemia:[3][4]
- Decrease in insulin levels
- Increase in glucagon production
- Increase in epinephrine levels
Failure of any of these defense mechanisms increase the chance 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.