Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies
Richard Silbert1, Alejandro Salcido-Montenegro2,3, Rene Rodriguez-Gutierrez2,3,4
1Department of Medicine Residency Program, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Current Diabetes Reports
|June 23, 2018
Summary
Hypoglycemia, a common complication of type 2 diabetes therapy, poses significant risks. Patient-centered, multidisciplinary care strategies are emerging to identify and manage hypoglycemia risk factors effectively.
Area of Science:
- Endocrinology and Metabolism
- Diabetes Mellitus Research
- Public Health and Epidemiology
Background:
- Hypoglycemia is a frequent and serious adverse effect of diabetes treatment, often limiting therapeutic options.
- Despite being preventable, hypoglycemia in type 2 diabetes (T2DM) leads to considerable personal and societal costs.
Purpose of the Study:
- To review the epidemiology of hypoglycemia in patients with type 2 diabetes.
- To discuss the primary risk factors associated with hypoglycemia.
- To introduce potential strategies for the prevention of hypoglycemia.
Main Methods:
- Review of existing literature on hypoglycemia rates, definitions, and measurement in type 2 diabetes.
- Analysis of data from randomized controlled trials and observational studies.
- Examination of patient-reported outcomes and risk factor prevalence.
Main Results:
- Hypoglycemia rates in T2DM vary widely due to heterogeneous reporting; severe hypoglycemia rates range from 0.7 to 12 per 100 person-years in RCTs.
- Patient-reported symptomatic hypoglycemia is more common, affecting up to 58% of non-insulin users and 64% of insulin users over specified periods.
- Key risk factors include older age, comorbidities, long diabetes duration, prior hypoglycemia, insulin/sulfonylurea use, food insecurity, and fasting.
Conclusions:
- Hypoglycemia is a prevalent issue in type 2 diabetes management.
- Multidisciplinary, patient-centered care, including treatment de-intensification and diabetes technology, shows promise in reducing hypoglycemia.
- Further prospective trials are needed to validate hypoglycemia risk reduction strategies.
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