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Medically minimising the impact of hypoglycaemia in type 2 diabetes: a review

Radzi M Noh1, Alex J Graveling, Brian M Frier

  • 1Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK.

Expert Opinion on Pharmacotherapy
|June 15, 2011
PubMed
Abstract

Insights

Hypoglycaemia is a significant concern in type 2 diabetes management, leading to morbidity and financial burden. Careful drug selection and individualized glycaemic targets are crucial to minimize risks, especially for patients with cardiovascular disease.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Hypoglycaemia is an underestimated side effect of type 2 diabetes therapies, causing significant morbidity and financial burden.
  • Strict glycaemic control trials in type 2 diabetes have highlighted the harm of hypoglycaemia, particularly in patients with coronary heart disease.

Purpose of the Study:

  • To discuss the morbidity associated with hypoglycaemia in type 2 diabetes.
  • To identify individuals at high risk for severe hypoglycaemia.
  • To provide a rational approach for selecting anti-diabetes drugs to minimize hypoglycaemia risk.

Main Methods:

  • Review of evidence for non-pharmacological strategies.
  • Examination of hypoglycaemia risks with various treatment modalities.
  • Discussion of responses to and morbidity of hypoglycaemia.

Main Results:

  • Insulin and insulin secretagogues require judicious use and individualized glycaemic targets to avoid hypoglycaemia.
  • Incretin mimetics offer lower hypoglycaemia risk with comparable efficacy to traditional agents for hyperglycaemia management.

Conclusions:

  • Individualized glycaemic targets and judicious use of insulin/secretagogues are essential in type 2 diabetes management.
  • Incretin mimetics present a favorable risk profile regarding hypoglycaemia.
  • Research into the link between hypoglycaemia and cardiovascular events is vital for determining appropriate glycaemic targets.

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