Hypoglycemia: The neglected complication

• Published in: Indian journal of endocrinology and metabolism Vol. 17; no. 5; pp. 819 - 834
• Main Authors: Kalra, Sanjay, Mukherjee, Jagat, Venkataraman, Subramanium, Bantwal, Ganapathi, Shaikh, Shehla, Saboo, Banshi, Das, Ashok, Ramachandran, Ambady
• Format: Journal Article
• Language: English
• Published: India Medknow Publications 01.09.2013; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Care and treatment; Complications and side effects; Diabetes mellitus; Diabetes therapy; Diagnosis; glucagon; Hypoglycemia; hypoglycemia unawareness; insulin; management; physiologic impact; quality of life; Review; Risk factors; India; hypoglycemia unawareness; insulin; management; physiologic impact; Diabetes mellitus; hypoglycemia; glucagon; quality of life
• ISSN: 2230-8210; 2230-9500
• DOI: 10.4103/2230-8210.117219

Hypoglycemia is an important complication of glucose-lowering therapy in patients with diabetes mellitus. Attempts made at intensive glycemic control invariably increases the risk of hypoglycemia. A six-fold increase in deaths due to diabetes has been attributed to patients experiencing severe hypoglycemia in comparison to those not experiencing severe hypoglycemia Repeated episodes of hypoglycemia can lead to impairment of the counter-regulatory system with the potential for development of hypoglycemia unawareness. The short- and long-term complications of diabetes related hypoglycemia include precipitation of acute cerebrovascular disease, myocardial infarction, neurocognitive dysfunction, retinal cell death and loss of vision in addition to health-related quality of life issues pertaining to sleep, driving, employment, recreational activities involving exercise and travel. There is an urgent need to examine the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this neglected life-threatening complication. Early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens with minimal or no risk of hypoglycemia and appropriate educational programs for healthcare professionals and patients with diabetes are the major ways forward to maintain good glycemic control, minimize the risk of hypoglycemia and thereby prevent long-term complications.