Featured Research

from universities, journals, and other organizations

Severe low blood sugar occurs often in patients with Type 2 diabetes

Date:
July 30, 2013
Source:
Kaiser Permanente
Summary:
Patients with diabetes who take certain types of medications to lower their blood sugar sometimes experience severe low blood sugar levels, whether or not their diabetes is poorly or well controlled, according to a new study. The finding challenges the conventional wisdom that hypoglycemia is primarily a problem among diabetic patients with well-controlled diabetes (who have low average blood sugar levels).

Patients with diabetes who take certain types of medications to lower their blood sugar sometimes experience severe low blood-sugar levels, whether or not their diabetes is poorly or well controlled, according to a new study by Kaiser Permanente and Yale University School of Medicine. The finding, published in the current online issue of Diabetes Care, challenges the conventional wisdom that hypoglycemia is primarily a problem among diabetic patients with well-controlled diabetes (who have low average blood-sugar levels).

Related Articles


Low blood sugar, or hypoglycemia, can cause unpleasant symptoms but is typically treatable with food or a sweet drink. Severe hypoglycemia occurs when blood sugar gets so low a patient needs assistance, and may result in dizziness or mental confusion, injury, car accident, coma or, rarely, even death. Several recent studies have found that patients who experienced severe hypoglycemia were also at higher risk for dementia, falls, fractures and heart attacks, compared with patients who did not experience hypoglycemia.

"Many clinicians may assume that hypoglycemia is not much of a problem in poorly controlled type 2 diabetes given their high average blood-sugar levels," said senior author and study principal investigator, Andrew Karter, PhD, of the Kaiser Permanente Division of Research. "This study suggests that we should pay much closer attention to hypoglycemia, even in poorly controlled patients. Providers should explain the symptoms of hypoglycemia, how to treat it, and how to avoid it -- for example, by not skipping meals. Most of all, providers should ask all their diabetic patients whether they've experienced hypoglycemia, even those patients with very high average levels of blood sugar."

The researchers surveyed patients with type 2 diabetes being treated with medications to lower their blood sugar and asked about their experiences with severe hypoglycemia. Nearly 11 percent of the more than 9,000 respondents experienced severe hypoglycemia in the prior year, and it occurred at all levels of blood-sugar control.

Researchers categorized patients into five categories of HbA1c, a measure of average blood sugar, ranging from lowest to highest. The prevalence of severe hypoglycemia was calculated for each category. Patients with the lowest and highest HbA1c values tended to be at higher risk for hypoglycemia, compared to those with HbA1c values in the middle range. However, the differences were small and hypoglycemia was common in all HbA1c categories.

"Hypoglycemia is the most common acute complication of diabetes therapy and is associated with poor health outcomes," said lead author Kasia Lipska, MD, MHS, an endocrinologist from the Yale University School of Medicine. "In clinical trials, patients treated intensively, aiming for excellent blood-sugar control, experienced much more hypoglycemia than patients treated less aggressively. But we didn't know as much about the relationship between blood-sugar control and hypoglycemia in everyday clinical practice. We wanted to understand whether patients who achieve the lowest average blood sugars are really at the greatest risk for hypoglycemia."

"It is important to note that it's not the HbA1c that directly causes hypoglycemia, it's the therapies we use to lower it," said Dr. Lipska. "Future research needs to better identify those patients at the highest risk for hypoglycemia so we can reduce the risk. For now, we know that poor control is certainly not protective."

The researchers suggest that evaluations of quality of diabetes care should include adverse effects associated with treatment, such as hypoglycemia. "While aggressive treatment of high blood sugar was once considered a hallmark of better care, recent clinical trials have raised concerns about the risks of tight control, particularly in the frail and elderly," said Karter.

Additional authors on the study include Margaret Warton, MPH, and Howard H. Moffet, MPH, of the Kaiser Permanente Division of Research; Elbert S. Huang, MD, MPH, of the University of Chicago School of Medicine; and Silvio E. Inzucchi, MD, and Harlan M. Krumholz, MD, SM, of the Yale University School of Medicine.


Story Source:

The above story is based on materials provided by Kaiser Permanente. Note: Materials may be edited for content and length.


Cite This Page:

Kaiser Permanente. "Severe low blood sugar occurs often in patients with Type 2 diabetes." ScienceDaily. ScienceDaily, 30 July 2013. <www.sciencedaily.com/releases/2013/07/130730101715.htm>.
Kaiser Permanente. (2013, July 30). Severe low blood sugar occurs often in patients with Type 2 diabetes. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2013/07/130730101715.htm
Kaiser Permanente. "Severe low blood sugar occurs often in patients with Type 2 diabetes." ScienceDaily. www.sciencedaily.com/releases/2013/07/130730101715.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Experimental Ebola Vaccine Shows Promise In Human Trial

Experimental Ebola Vaccine Shows Promise In Human Trial

Newsy (Nov. 27, 2014) — A recent test of a prototype Ebola vaccine generated an immune response to the disease in subjects. Video provided by Newsy
Powered by NewsLook.com
Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) — Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) — Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins