Hypoglycemia in Diabetes: The Dark Side of Diabetes Treatment. A Patient-Centered Review

J Diabetes. 2019 Sep;11(9):711-718. doi: 10.1111/1753-0407.12933. Epub 2019 May 27.

Abstract

Hypoglycemia is a frequent occurrence in patients with diabetes who are treated with insulin and insulin secretagogues. Hypoglycemia is the limiting factor that prevents patients from achieving the glycemic control known to reduce the microvascular complications of diabetes. Recurrent episodes of hypoglycemia can lead to impaired awareness of hypoglycemia where the first symptom of a low blood sugar is unconsciousness. The fear of hypoglycemia has a significant effect on the quality of life of patients and their families. In the acute setting, hypoglycemia can kill, and clinical trials have demonstrated that a single episode of severe hypoglycemia increases the risk of subsequent mortality and cardiovascular events. Clinicians must make efforts to recognize and prevent hypoglycemia in order to prevent the adverse events associated with this event. Patient education is central to these efforts. Recent developments in glucose monitoring and drug development have provided more approaches that can be used to reduce the risk of hypoglycemia in patients with diabetes.

接受胰岛素与胰岛素促泌剂治疗的糖尿病患者常常会发生低血糖。目前已经很明确, 控制血糖可以减少糖尿病患者发生微血管并发症的风险, 但是低血糖却是阻碍患者达到血糖控制目标的限制性因素。反复发作的低血糖可导致患者对低血糖的感知受损, 此时低血糖的第一个症状就是意识丧失。对低血糖的恐惧对患者及其家属的生活质量都有显著的影响。在紧急环境低血糖还有可能致命, 临床试验表明, 一次严重的低血糖发作会增加随后的死亡率以及心血管事件的风险。为了防止低血糖相关不良事件的发生, 临床医生必须努力识别与预防低血糖。对患者教育是这些努力的核心。最近研制出了更多的血糖监测方法与治疗药物以减少糖尿病患者发生低血糖的风险。.

Keywords: cardiovascular disease; diabetes; hypoglycemia; insulin; mortality; 低血糖; 心血管疾病; 死亡率; 糖尿病; 胰岛素.

Publication types

  • Review

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus / drug therapy*
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemia / prevention & control*
  • Hypoglycemic Agents / adverse effects*
  • Medication Adherence*
  • Patient Education as Topic*
  • Patient-Centered Care*
  • Quality of Life

Substances

  • Blood Glucose
  • Hypoglycemic Agents