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Review

Increasing awareness of hypoglycaemia in patients with Type 2 diabetes treated with oral agents

, , , &
Pages 1503-1513 | Accepted 08 Aug 2013, Published online: 06 Sep 2013
 

Abstract

Hypoglycaemia is the most common acute complication of type 2 diabetes and can limit therapeutic efforts to improve glycaemic control in order to protect against long-term complications. It is a potential side effect of the drugs used to treat diabetes, specifically exogenous insulin or insulin secretagogues. As many people are prescribed these agents, hypoglycaemia is frequent in clinical practice, although patients commonly do not inform their healthcare professional of the problems spontaneously. The impact of hypoglycaemia on the patient and to the healthcare system is significant through reduced treatment satisfaction and adherence, reduced quality of life and serious health consequences. This has financial implications and costs for the patient, the public and the economy at large.

The single most important risk factor for hypoglycaemia is previous hypoglycaemia. Prevention depends on appropriate education regarding diabetes management and selfcare, self-monitoring of blood glucose, awareness of factors that may precipitate hypoglycaemia, and an individualized approach to therapy and glycaemic control targets.

The purpose of this review is to increase understanding of the impact and consequences of hypoglycaemia, in particular that associated with sulphonylurea therapy, and to highlight areas requiring more attention in order to improve the overall management of people with type 2 diabetes.

Transparency

Declaration of funding

This study was funded by Merck Sharpe & Dohme Ltd.

Declaration of financial/other relationships

A.H.B. has disclosed that he has received research grants and consulting fees from Sanofi Avenits, Eli Lilly and Novo Nordisk; he is also on the Speakers’ Bureaus of Merck Sharpe & Dohme, Novartis, Boehringer Ingleheim, Novo Nordisk, Bristol Meyer Squibb, Takeda and Astra Zeneca. R.B. has disclosed that he has been sponsored by, is a consultant to and is on the Speakers’ Bureaus of Merck Sharpe & Dohme, Boehringer Ingleheim, Novartis, Novo Nordisk, Bristol Meyer Squibb, GlaxoSmithKline, Eli Lilly, Janssen, Sanofi Aventis, Roche, Takeda and Astra Zeneca. W.H. has disclosed that he has received grants from Boehringer Ingleheim, Novartis, and Novo Nordisk; he has also been a consultant to and is on the Speakers’ Bureaus of Merck Sharpe & Dohme, Novartis, and Novo Nordisk, and is on the Speakers’ Bureau of Boehringer Ingleheim. J.J. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article. H.L. is an employee of Merck Sharp & Dohme Ltd.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgements

The concept of this review paper has been developed in collaboration with the authors and MSD. The authors, including an author from MSD, had complete editorial control over the manuscript and the article represents the views of the authors. The authors were supported by a medical writer, who was fully funded by MSD.

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