Hypoglycemia presents as a constellation of symptoms that may range from mild and nonspecific to severe and life-threatening. Patients with unrecognised hypoglycemia must be promptly re-evaluated to identify the hypoglycemia triggers that should be addressed.
Signs of hypoglycemia include headache, altered level of consciousness, dizziness and blurred vision. Dysautonomia, autonomic disfunction and alterations in cerebral oxygen delivery may also be evident in these patients. While most of such signs can be treated with the appropriate antihypoglycemic medication, severe cases of hypoglycemia may call for rapid treatment with glucose to restore blood glucose to its normal level. Hypoglycemia is also the cause of severe encephalopathy in diabetic patients. Therefore, hypoglycemia usually must be considered whenever severe neurological complications occur in diabetics.
About 70 percent of adults and 55 percent of children with type 1 diabetes don't meet current treatment targets according to AACE/ADA guidelines. Most patients do not consult their care provider or do not comply with current hypoglycemic guidelines.
Hypoglycemia is common after gastric bypass, even in those with normal blood glucose levels. Most hypoglycemia occur in the early post-operative period. Although insulin is the most common treatment for hypoglycemia after gastric bypass, it is rarely sufficient to correct the fasting glucose level to normal.
Hypoglycemia cannot be cured. In patients with glucose counterregulatory deficiency, a normal glucose level may be an advantage. In patients with insulin-dependent diabetes and a good glucose control, hypoglycemia cannot be treated and may be even beneficial. In patients with non-insulin-dependent diabetes, with insulin resistance and a poor glucose control, hypoglycemia can be useful. For patients with a normal glucose level, insulin treatment should be tried instead of insulin-dependent glucocorticoid treatment. The treatment of hypoglycemic crises should be practiced with caution because relapse is common and unpredictable.
The current medical literature suggests that a variety of factors, such as hyperthyroidism, insulin deficiency, insulin resistance, congenital adrenal hyperplasia, certain types of tumors, excessive exercise and lack of sleep can contribute to hypoglycemia. Most of the hypoglycemia-causing factors that have been identified are associated with altered glucose metabolism.
Hypoglycemia remains a rare and often devastating problem. A common underlying cause is that the patient has a condition in which glycogen is not produced in the liver, which can occur in insulin-dependent diabetes as well as non-insulin-dependent diabetes.
Results from a recent paper showed that patients who have no prior history of hypoglycemia should have access to clinical trials in hypoglycemia. The study also supported the assumption that patients with hypoglycemia were already being treated for hypoglycemic effects of anti-diabetic drugs before entering the clinical trial. The study also supports the use of a clinical trial as the method of choice to manage hypoglycemia.
This article, and its recommendations, can be used to inform clinicians about the best treatment options for hypoglycemia. Treatments included in this article may decrease the need for hospitalization. These treatments are not cure, just ways to control problems with hypoglycemia.
Data from a recent study of the present study suggest that an effective treatment has been chosen, although the reason for choosing it and in what proportion of patients, is unclear and requires further investigation.
The recent advancements involve the administration of insulin and/or dextrose in combination with epinephrine, which can be an effective alternative in treatment of hypoglycemia. Future advances include the new therapeutic approaches for the treatment of hypoglycemia. Further studies with larger samples and long-term follow-ups need to be developed to explore the effects of these therapeutic approaches upon the development and progression of diabetes over the course of a lifetime.
The risk of diabetes treatment is not a key factor in treating physicians' decisions on diabetes treatment. Many physicians are skeptical about the medical benefits of oral glucose lowering agents and insulin and do not give this type of treatment as first-line therapy to the majority of their patients with diabetes. In light of our findings, it is important for people with Type 1 diabetes to be informed about the risks and benefits of diabetes treatment, so they can make their own well-informed decisions about treatment.