Recognizing and minimizing hypoglycemia: The need for individualized care

Abstract

Hypoglycemia is a condition known to disrupt many everyday activities and is associated with increased risks of hospitalization, falls, motor vehicle accidents and mortality. Many patients with diabetes have an increased risk of hypoglycemia due to interventions targeting glycemic control. In these patients, hypoglycemia and fear of hypoglycemia may further reduce adherence to glucose-lowering regimens, contributing to the further aggravation of diabetes-related complications. Avoiding hypoglycemia should be one of the principal goals of any treatment strategies employing agents that can induce hypoglycemia in order to prevent the occurrence of associated symptoms and consequences. The education of patients and their families is an important feature of individualized management strategies in order to prevent, mitigate and treat hypoglycemic episodes. Patients with diabetes need to be made aware of how to recognize the signs of hypoglycemia and of the simple, highly effective steps that they can take to self-manage hypoglycemic episodes. Clinicians should be familiar with the risk factors for hypoglycemia, especially the profiles of the different classes of glucose-lowering medications such as the sulfonylureas and insulin. This article aims to review the risk factors for hypoglycemia and its implications for patients and healthcare systems, and provide practical advice for minimizing the risk of hypoglycemia and its consequences.

Keywords:

• Complications of diabetes
• education
• hypoglycemia
• individualized care

Acknowledgments

The contents of the paper and the opinions expressed within are those of the authors, and it was the decision of the authors to submit the manuscript for publication. The authors contributed to the writing of this manuscript, including critical review and editing of each draft, and approval of the submitted version. The authors received writing/editorial support in the preparation of this manuscript provided by Nicola Truss, PhD of Excerpta Medica, funded by Sanofi US, Inc.

Declaration of interest

F Lavernia discloses the following relationships: advisory board for Sanofi, Janssen Pharmaceuticals, Lilly Global; speakers bureau for Janssen Pharmaceuticals. P Kushner discloses the following relationships: speakers bureau and consultant for AstraZeneca/BMS and Boehringer Ingelheim; consultant for Lilly and P fizer; consultant and speaker for Janssen. D Trence discloses the following relationships: stockholder of Sanofi. D Rice discloses the following relationship: employee of Sanofi U.S. Inc. G Dailey discloses the following relationship: speakers bureau and consultant for Sanofi and AstraZeneca. L Kuritzky discloses the following relationships: consultant and/or advisor to Novo Nordisk, Sanofi U.S. Inc., Lilly USA, Boehringer Ingelheim, Janssen; speakers bureau for Janssen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.