Diabetes, Heart and Cardiovascular Diseases News Chronicle.  Diabetes, Cardiovascular and Heart Diseases
 Article 327
    Published on April 24, 2018

Type 2 diabetics patients need to be more aware of hypoglycemia signs and risks

Even though hypoglycemia condition is associated with type 1 diabetes (T1D) patient, experts says type 2 diabetes (T2D) patients are also at greater risk for extreme low blood sugar or glucose levels (hypoglycemia condition). The National Institute of Diabetes and Digestive and Kidney Diseases defines hypoglycemia as a condition where blood sugar or glucose levels drop below 70 mg/dL. Following type ii diabetes patients are at greater risk for hypoglycemia events.

  1. Patients taking insulin drug.
  2. Patients aged more than 65 years.
  3. Patients using sulfonylureas drugs.
  4. In those people who
    • Consume alcohol.
    • Spent more than usual time in exercise or workout.
    • Eaten less than usual during one or more meals.

Type 1 diabetes patients use a continuous glucose monitoring (CGM) device to prevent hypo (either hypoglycemia or hyperglycemia) events. These hypo events can significantly affect an individual's quality of life, capability to drive safely, daily working and social life. A severe hypo (either hypoglycemia or hyperglycemia) is classified as a medical emergency. The American Diabetes Association (ADA) says hypoglycemia condition causes serious health complications to diabetes patient such as life-threatening unconsciousness (diabetic coma), changes in the electrical activity in the brain (seizures) and even death.

A study findings shows failure to detect hypoglycemia events are too often in people with type 2 diabetes. Researchers have an environmental scan on number of articles, clinical guidance documents (20), quality measures (34) and clinician and patient tools (more than 50) to know the frequency of hypoglycemic events and subsequent health outcomes in type 2 diabetes patients. Researchers have observed following in their analytical study.

  • There were about 300,000 emergency room visits due to hypoglycemia events among type 1 and type 2 diabetes patients during 2009.
  • About 18.1 percent of the hypoglycemia patients who were hospitalized due to hypoglycemia events during 2010 were readmitted within 30 days with the same reason. About 5 percent of those patients died within a month (30-day mortality rate is 5 percent).

In a meta-analysis of type 2 diabetes patients using insulin drug, researchers have noted 23 modest and one severe hypoglycemia events per year, indicating even type 2 diabetes patients were affected with hypoglycemia events. Researchers have categorized hypoglycemia events into following categories for the awareness of a patient and healthcare professional to prevent health complications.

Category Category description
Level 1 Patient may not know that his/her blood sugar level is less than 70 mg/dL, a condition known as hypoglycemia unawareness, a hypoglycemia event without any warning.
Level 2 Blood sugar level is less than 54 mg/dL, a hypoglycemia condition causing serious health complications.
Level 3 Independent of blood sugar or glucose levels. Any critical mental or physical health condition requiring assistance.

Researchers say importance to hypoglycemia events in type 2 diabetes patients were often underappreciated and not taken care by healthcare professionals. They pay more attention in reducing high blood sugar or glucose levels (or HbA1c) levels in type 2 diabetes patients and subsequently increasing risk to hypoglycemic events.

Researchers have observed that there are no quality resources to assist healthcare professionals in identifying, assessing and managing diabetes patients who are at risk to hypoglycemia events. They say following risk assessment tools can help healthcare professionals in addressing hypoglycemia events.

  • The VA Hypoglycemia Risk Reduction - Patients at Risk for Hypoglycemia. DOI : doi.org/10.2337/ds16-0006
  • Hypoglycemia Risk Stratification Tool, developed by Kaiser Permanente, United States in partnership with the FDA. This tool can identify 156 possible risk factors to hypoglycemia events.

Authors says their study is a first step in establishing more accurate guidelines for the diagnosis and treatment of hypoglycemia events in type 2 diabetes patients. They also suggest that a type 2 diabetes patient as well as the healthcare professional treating type 2 diabetes patient should know the risks associated with hypoglycemia events and its signs and symptoms.

Researchers have suggested Hypoglycemia Risk Stratification Tool from Kaiser Permanente to identify hypoglycemia events.

Lead author of the study was Dr. Robert W. Lash, MD, an endocrinologist, chief professional and clinical affairs officer, Endocrine Society, Washington, DC, United States. The study findings were published 5 March 2018 in the Journal of Clinical Endocrinology & Metabolism. Title of the article was "Preventing Hypoglycemia in Type 2 Diabetes." DOI : doi.org/10.1210/jc.2017-02804

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Sulfonylureas : Sulfonylureas drugs improve insulin secretion from the beta cells in the pancreas.



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