Materiały źródłowe

• #1 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. […] To prevent hypoglycemia, much effort must be invested in patient education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage, together with setting personalized goals for glycemic control. […] Great effort must be invested in patient education on hypoglycemia prevention and management. […] The approach to hypoglycemia prevention includes patient education, appropriate dietary and exercise regimens, glucose monitoring, medication adjustment, and close clinical supervision. […] The patients and those around them should be educated to identify symptoms of hypoglycemia and given appropriate treatment as soon as possible.

• #2 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://www.wjgnet.com/1948-9358/full/v12/i12/2036.htm

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. […] To prevent hypoglycemia, much effort must be invested in patient education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage, together with setting personalized goals for glycemic control. […] Great effort must be invested in patient education on hypoglycemia prevention and management. […] The approach to hypoglycemia prevention includes patient education, appropriate dietary and exercise regimens, glucose monitoring, medication adjustment, and close clinical supervision. […] The patients and those around them should be educated to identify symptoms of hypoglycemia and given appropriate treatment as soon as possible.

• #3 Low Blood Glucose (Hypoglycemia) | ADA

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose

  Low blood glucose is when your levels fall below 70 mg/dL. […] It’s important to treat low blood glucose levels as soon as possible, as they can quickly become dangerous. […] Severe low blood glucose is an emergency and will require help from others to treat it. […] It’s important to talk to your health care professional about your own blood glucose levels and if you’re at risk for going low. Together, you can determine what level is too low for you and when you should treat for a low. […] Fast-acting carbs are the best choice to treat hypoglycemia and preventing a severe hypoglycemia incident. […] Understanding what causes your blood glucose to go down is important so you can steps to prevent lows from happening.

• #4 Hypoglycemia Prevention Initiative | Endocrine Society

  https://www.endocrine.org/hypoglycemia-prevention-initiative

  The study, Reducing Hypoglycemia From Overtreatment of Type 2 Diabetes in Older Adults: The HypoPrevent Study, was published September 21, 2023, in the Journal of the American Geriatrics Society. […] Objectives: 1: Increasing outpatient hypoglycemia surveillance risk assessment by integrating a risk assessment into primary care clinical workflow […] 2: Improving the management of older type 2 diabetes patients on insulin and sulfonylureas […] 3: Developing outpatient hypoglycemia quality measures and integrating them into primary care practices to incentivize high-quality care. […] Top Three Preventable Adverse Drug Reaction Identified as one of the top three preventable adverse drug reactions by the US Department of Health and Human Services. […] Average incidence of hypoglycemia among people with T2D on insulin is 23 mild or moderate events and 1 severe episode per year.

• #5 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia in diabetes is associated with increased morbidity and constitutes a barrier to glycemic control. Much effort must be invested in hypoglycemia prevention, including patient education, appropriate dietary and exercise regimens, adjustment of the treatment regimen, and implementation of glucose monitoring systems as appropriate.

• #6 Diabetes Canada | Clinical Practice Guidelines

  https://guidelines.diabetes.ca/cpg/chapter14

  It is important to prevent, recognize and treat hypoglycemic episodes secondary to the use of insulin or insulin secretagogues. […] It is safer and more effective to prevent hypoglycemia than to treat it after it occurs, so people with diabetes who are at high risk for hypoglycemia should be identified and counselled about ways to prevent low blood glucose. […] It is important to counsel individuals who are at risk of hypoglycemia and their support persons about the recognition and treatment of hypoglycemia. […] The goals of treatment for hypoglycemia are to detect and treat a low blood glucose level promptly by using an intervention that provides the fastest rise in blood glucose to a safe level, to eliminate the risk of injury and to relieve symptoms quickly. Once the hypoglycemia has been reversed, the person should have the usual meal or snack that is due at that time of the day to prevent repeated hypoglycemia. If a meal is 1 hour away, a snack (including 15g carbohydrate and a protein source) should be consumed.

• #7 Hypoglycemia: An unwelcome companion to effective diabetes management

  https://www.myamericannurse.com/hypoglycemia-diabetes-management/

  Hypoglycemia places people with diabetes at risk for injury and prevents them from achieving their diabetes management goals. […] Informed RNs can improve patient outcomes by tailoring hypoglycemia assessment, prevention, and treatment to individual needs and potential risks. […] Hypoglycemia prevention builds patients confidence in their diabetes management. […] Hypoglycemia prevention is preferred to hypoglycemia treatment for achieving diabetes management goals. […] Design prevention strategies based on each persons unique experience with hypoglycemia. […] Hypoglycemia prevention builds patients confidence in their diabetes management.

• #8 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. […] To prevent hypoglycemia, much effort must be invested in patient education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage, together with setting personalized goals for glycemic control. […] Great effort must be invested in patient education on hypoglycemia prevention and management. […] The approach to hypoglycemia prevention includes patient education, appropriate dietary and exercise regimens, glucose monitoring, medication adjustment, and close clinical supervision. […] The patients and those around them should be educated to identify symptoms of hypoglycemia and given appropriate treatment as soon as possible.

• #9 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://www.wjgnet.com/1948-9358/full/v12/i12/2036.htm

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. […] To prevent hypoglycemia, much effort must be invested in patient education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage, together with setting personalized goals for glycemic control. […] Great effort must be invested in patient education on hypoglycemia prevention and management. […] The approach to hypoglycemia prevention includes patient education, appropriate dietary and exercise regimens, glucose monitoring, medication adjustment, and close clinical supervision. […] The patients and those around them should be educated to identify symptoms of hypoglycemia and given appropriate treatment as soon as possible.

• #10 Take a look at the Recent articles

  https://www.oatext.com/Knowledge-and-practice-on-prevention-of-hypoglycemia-among-diabetic-patients-in-South-Gondar-Northwest-Ethiopia-Institution-based-cross-sectional-study.php

  Hypoglycemia is an emergency life threatening condition for diabetic patients who take their medication. Proper hypoglycemia prevention relies on knowledge and self care practice. The objective of this study was to assess knowledge and practice of hypoglycemia prevention and associated factors among diabetic patients in South Gondar, Northwest Ethiopia, 2012. […] From the total study participants 105(25.5%) were found to have good knowledge about hypoglycemia prevention. Eighty nine (21.4%) had good practice in hypoglycemia prevention. […] Knowledge and practice on hypoglycemia prevention are poor. Members of Ethiopian Diabetic Association are very low in this study. Thus the association should design and provide information tailored to patient education level. […] Knowledge about these symptoms is an important step to self care practice, because informed people are more likely to have better self care practice. It is important for patients with diabetes especially, those receiving insulin to learn about hypoglycemia, and to carry some form of simple sugar with them at all times.

• #11 Diabetes Canada | Clinical Practice Guidelines

  https://guidelines.diabetes.ca/cpg/chapter-14-2023-update

  Structured educational and psychobehavioural programs (e.g. BG awareness training) may help improve detection of hypoglycemia and reduce the frequency of level 3 hypoglycemia. The following are the prevention strategies for hypoglycemia. […] Insulin and/or insulin secretagogue therapy increases the risk of hypoglycemia. […] In adults with type 2 diabetes who require treatment advancement or adjustment, the use of antihyperglycemic agents that do not increase the risk or minimize the risk of hypoglycemia (i.e. glucagon-like peptide-1 receptor agonists [GLP-1RA], dipeptidylpeptidase 4 [DPP4] inhibitors, sodium-glucose cotransporter-2 [SGLT2] inhibitors, acarbose, and/or pioglitazone) should be considered. […] There is evidence that continuous subcutaneous insulin infusion (CSII) vs multiple daily injections (MDIs) reduces recurrent severe hypoglycemia in adults with type 1 diabetes.

• #12

  https://journals.lww.com/jodb/fulltext/2024/15010/expert_consensus_recommendations_on_the_evaluation.6.aspx

  The recommendations for T1DM are as follows: Primary care doctors should routinely inquire about hypoglycemia symptoms and educate PWD about recognizing and reporting them. Improving treatment outcomes for hypoglycemia in T1DM involves self-management of insulin dosage, increased use of CGM, and enhanced healthcare support. […] The recommendations for T2DM are as follows: Primary health care doctors should routinely inquire about hypoglycemia symptoms and educate PWD to recognize and report them. Hospitalized patients with T2DM should be monitored for hypoglycemia. Education about hypoglycemia and its awareness should be an integral part of the discharge protocol. […] The recommendations for prevention of hypoglycemia are as follows: Structured patient education, counseling, and continuous BG monitoring are critical for preventing hypoglycemia in diabetes patients. Timely meals and SMBG play important roles in prevention.

• #13 Causes and How to Prevent Hypoglycemia (Low Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention

  Your best bet is to keep your blood glucose in your target range. Keep track of your personal symptoms you feel when go low. If you start to recognize those feelings, you can act faster to treat your low glucose before it drops lower. […] Monitoring blood glucose, with either a blood glucose meter or a continuous glucose monitor (CGM) allows you to be aware of your blood glucose levels and take steps to prevent low blood glucose. Studies consistently show that the more a person checks blood glucose, the lower their risk of low blood glucose. […] Check more frequently if things around you change such as a new insulin routine, a different work schedule, an increase in physical activity, or travel across time zones.

• #14 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Dietary intervention includes instruction regarding the amount of carbohydrates at meals and its effect on blood glucose concentration and building a personalized regular meal plan. […] Physical exercise increases glucose consumption and the risk of hypoglycemia. […] Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring constitute essential tools to diagnose hypoglycemia in the early stages. […] Some hypoglycemia episodes in diabetes are associated with the treatment itself; therefore, it is important to use drugs with a low risk of hypoglycemia. […] The use of continuous subcutaneous insulin infusion (CSII) prevented hypoglycemic episodes and improved the threshold of hypoglycemia awareness in patients with type 1 diabetes who suffered from recurrent episodes of non-severe or severe hypoglycemia.

• #15 Causes and How to Prevent Hypoglycemia (Low Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention

  Your best bet is to keep your blood glucose in your target range. Keep track of your personal symptoms you feel when go low. If you start to recognize those feelings, you can act faster to treat your low glucose before it drops lower. […] Monitoring blood glucose, with either a blood glucose meter or a continuous glucose monitor (CGM) allows you to be aware of your blood glucose levels and take steps to prevent low blood glucose. Studies consistently show that the more a person checks blood glucose, the lower their risk of low blood glucose. […] Check more frequently if things around you change such as a new insulin routine, a different work schedule, an increase in physical activity, or travel across time zones.

• #16 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://www.wjgnet.com/1948-9358/full/v12/i12/2036.htm

  Dietary intervention includes instruction regarding the amount of carbohydrates at meals and its effect on blood glucose concentration and building a personalized regular meal plan. […] Physical exercise increases glucose consumption and the risk of hypoglycemia. […] Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring constitute essential tools to diagnose hypoglycemia in the early stages. […] Continuous glucose monitoring (CGM) has been investigated in many studies, with the efficacy of CGM in diabetes control tested in some studies and the integration of CGM intending to reduce hypoglycemic episodes in other studies. […] Some hypoglycemia episodes in diabetes are associated with the treatment itself; therefore, it is important to use drugs with a low risk of hypoglycemia.

• #17 Patient education: Hypoglycemia (low blood glucose) in people with diabetes (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hypoglycemia-low-blood-glucose-in-people-with-diabetes-beyond-the-basics

  Hypoglycemia prevention is important to monitor your blood glucose levels frequently and be prepared to treat it promptly at any time. Continuous glucose monitoring can help prevent hypoglycemia if you have type 1 diabetes or if you have type 2 diabetes and take insulin or other medication(s) that increases risk for hypoglycemia. Continuous glucose monitoring can alert you to a low or falling blood glucose level so that you can take action to avoid severe hypoglycemia. […] You and a close friend or relative should learn the symptoms of hypoglycemia and always carry glucose tablets, hard candy, or other sources of fast-acting carbohydrate so you can treat low blood glucose if it does happen. […] If you experience low blood glucose levels, let your health care provider know. They can help adjust your diabetes treatment plan to reduce the chances of hypoglycemia happening again.

• #18 Hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/Hypoglycemia

  Another cornerstone of prevention is strong self-monitoring of blood glucose, with consistent and frequent measurements. […] Research has shown that patients with type 1 diabetes who use continuous glucose monitoring systems with insulin pumps significantly improve blood glucose control. […] Insulin pumps help to prevent high glucose spikes, and help prevent inappropriate insulin dosing. […] Continuous glucose monitors can sound alarms when blood glucose is too low or too high, especially helping those with nocturnal hypoglycemia or hypoglycemic unawareness. […] In terms of medication adjustments, medication doses and timing can be adjusted to prevent hypoglycemia, or a medication can be stopped altogether. […] In those with hypoglycemia who do not have diabetes, there are a number of preventative measures dependent on the cause.

• #19 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Dietary intervention includes instruction regarding the amount of carbohydrates at meals and its effect on blood glucose concentration and building a personalized regular meal plan. […] Physical exercise increases glucose consumption and the risk of hypoglycemia. […] Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring constitute essential tools to diagnose hypoglycemia in the early stages. […] Some hypoglycemia episodes in diabetes are associated with the treatment itself; therefore, it is important to use drugs with a low risk of hypoglycemia. […] The use of continuous subcutaneous insulin infusion (CSII) prevented hypoglycemic episodes and improved the threshold of hypoglycemia awareness in patients with type 1 diabetes who suffered from recurrent episodes of non-severe or severe hypoglycemia.

• #20 Diabetic hypoglycemia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

  Pay attention to the early warning signs of hypoglycemia and treat low blood sugar promptly. You can raise your blood sugar quickly by eating or drinking a simple sugar source, such as glucose tablets, hard candy or fruit juice. Tell family and friends what symptoms to look for and what to do if you’re not able to treat the condition yourself. […] To help prevent diabetic hypoglycemia: […] Monitor your blood sugar. Depending on your treatment plan, you may check and record your blood sugar level several times a week or multiple times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. […] Don’t skip or delay meals or snacks. If you take insulin or oral diabetes medication, be consistent about the amount you eat and the timing of your meals and snacks.

• #21 Non-diabetic Hypoglycemia – Low Blood Sugar without Diabetes

  https://www.drugs.com/cg/non-diabetic-hypoglycemia.html

  You may need to change what and when you eat to prevent low blood sugar levels. Follow the meal plan that you and the dietitian have planned. The following guidelines may help you keep your blood sugar levels under control. […] Eat 5 to 6 small meals each day instead of 3 large meals. Eat the same amount of carbohydrate at meals and snacks each day. Most people need about 3 to 4 servings of carbohydrate at meals and 1 to 2 servings for snacks. Do not skip meals. Carbohydrate counting can be used plan your meals. Ask your healthcare provider or dietitian for information about carbohydrate counting. […] Limit refined carbohydrates. Examples are white bread, pastries (pies and cakes), regular sodas, syrups, and candy. […] Do not have drinks or foods that contain caffeine. Examples are coffee, tea, and certain types of sodas. Caffeine may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.

• #22 Non-diabetic Hypoglycemia – Low Blood Sugar without Diabetes

  https://www.drugs.com/cg/non-diabetic-hypoglycemia.html

  You may need to change what and when you eat to prevent low blood sugar levels. Follow the meal plan that you and the dietitian have planned. The following guidelines may help you keep your blood sugar levels under control. […] Eat 5 to 6 small meals each day instead of 3 large meals. Eat the same amount of carbohydrate at meals and snacks each day. Most people need about 3 to 4 servings of carbohydrate at meals and 1 to 2 servings for snacks. Do not skip meals. Carbohydrate counting can be used plan your meals. Ask your healthcare provider or dietitian for information about carbohydrate counting. […] Limit refined carbohydrates. Examples are white bread, pastries (pies and cakes), regular sodas, syrups, and candy. […] Do not have drinks or foods that contain caffeine. Examples are coffee, tea, and certain types of sodas. Caffeine may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.

• #23 Non-diabetic Hypoglycemia – Low Blood Sugar without Diabetes

  https://www.drugs.com/cg/non-diabetic-hypoglycemia.html

  You may need to change what and when you eat to prevent low blood sugar levels. Follow the meal plan that you and the dietitian have planned. The following guidelines may help you keep your blood sugar levels under control. […] Eat 5 to 6 small meals each day instead of 3 large meals. Eat the same amount of carbohydrate at meals and snacks each day. Most people need about 3 to 4 servings of carbohydrate at meals and 1 to 2 servings for snacks. Do not skip meals. Carbohydrate counting can be used plan your meals. Ask your healthcare provider or dietitian for information about carbohydrate counting. […] Limit refined carbohydrates. Examples are white bread, pastries (pies and cakes), regular sodas, syrups, and candy. […] Do not have drinks or foods that contain caffeine. Examples are coffee, tea, and certain types of sodas. Caffeine may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.

• #24 Hypoglycemia (Low Blood Sugar Levels): Symptoms, Causes, Treatment

  https://www.webmd.com/diabetes/diabetes-hypoglycemia

  If you have diabetes, ways you can prevent hypoglycemia include: […] Follow your meal plan. […] Eat at least three evenly spaced meals each day with between-meal snacks as prescribed. […] Plan your meals no more than 4 to 5 hours apart. […] Exercise 30 minutes to 1 hour after meals. Check your sugars before and after exercise, and discuss with your doctor what types of changes can be made. […] Double-check your insulin and dose of diabetes medicine before taking it. […] If you drink alcohol, be moderate and monitor your blood sugar levels. […] Know when your medicine is at its peak level. […] Test your blood sugar as often as directed by your doctor. […] Carry an identification bracelet that says you have diabetes.

• #25 Hypoglycemia (Low Blood Sugar Levels): Symptoms, Causes, Treatment

  https://www.webmd.com/diabetes/diabetes-hypoglycemia

  If you have diabetes, ways you can prevent hypoglycemia include: […] Follow your meal plan. […] Eat at least three evenly spaced meals each day with between-meal snacks as prescribed. […] Plan your meals no more than 4 to 5 hours apart. […] Exercise 30 minutes to 1 hour after meals. Check your sugars before and after exercise, and discuss with your doctor what types of changes can be made. […] Double-check your insulin and dose of diabetes medicine before taking it. […] If you drink alcohol, be moderate and monitor your blood sugar levels. […] Know when your medicine is at its peak level. […] Test your blood sugar as often as directed by your doctor. […] Carry an identification bracelet that says you have diabetes.

• #26 Non-diabetic Hypoglycemia – Low Blood Sugar without Diabetes

  https://www.drugs.com/cg/non-diabetic-hypoglycemia.html

  You may need to change what and when you eat to prevent low blood sugar levels. Follow the meal plan that you and the dietitian have planned. The following guidelines may help you keep your blood sugar levels under control. […] Eat 5 to 6 small meals each day instead of 3 large meals. Eat the same amount of carbohydrate at meals and snacks each day. Most people need about 3 to 4 servings of carbohydrate at meals and 1 to 2 servings for snacks. Do not skip meals. Carbohydrate counting can be used plan your meals. Ask your healthcare provider or dietitian for information about carbohydrate counting. […] Limit refined carbohydrates. Examples are white bread, pastries (pies and cakes), regular sodas, syrups, and candy. […] Do not have drinks or foods that contain caffeine. Examples are coffee, tea, and certain types of sodas. Caffeine may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.

• #27 Hypoglycemia Diet Plans to Help Regulate Your Blood Sugar

  https://www.healthline.com/health/hypoglycemia-diet

  Choose complex carbohydrates over simple carbohydrates. […] Reduce or eliminate alcohol, and never mix alcohol with sugar-filled mixers, such as fruit juice. […] Eat lean protein. […] Eat foods high in soluble fiber. […] Your food choices are a big part of managing hypoglycemia. Try to eat small, frequent meals with lean proteins and complex carbs. Foods high in soluble fiber, such as Greek yogurt, oatmeal, salads, and seafood, may stabilize your blood sugar over time.

• #28 Non-diabetic Hypoglycemia – Low Blood Sugar without Diabetes

  https://www.drugs.com/cg/non-diabetic-hypoglycemia.html

  Limit or do not drink alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor. Do not drink alcohol on an empty stomach. Drink alcohol with meals to avoid hypoglycemia. […] Include protein foods and vegetables in your meals. Some foods that are high in protein include beef, pork, fish, poultry (chicken and turkey), beans, and nuts. Eat a variety of vegetables with your meals.

• #29 Hypoglycemia Diet Plans to Help Regulate Your Blood Sugar

  https://www.healthline.com/health/hypoglycemia-diet

  Choose complex carbohydrates over simple carbohydrates. […] Reduce or eliminate alcohol, and never mix alcohol with sugar-filled mixers, such as fruit juice. […] Eat lean protein. […] Eat foods high in soluble fiber. […] Your food choices are a big part of managing hypoglycemia. Try to eat small, frequent meals with lean proteins and complex carbs. Foods high in soluble fiber, such as Greek yogurt, oatmeal, salads, and seafood, may stabilize your blood sugar over time.

• #30 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://www.wjgnet.com/1948-9358/full/v12/i12/2036.htm

  Dietary intervention includes instruction regarding the amount of carbohydrates at meals and its effect on blood glucose concentration and building a personalized regular meal plan. […] Physical exercise increases glucose consumption and the risk of hypoglycemia. […] Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring constitute essential tools to diagnose hypoglycemia in the early stages. […] Continuous glucose monitoring (CGM) has been investigated in many studies, with the efficacy of CGM in diabetes control tested in some studies and the integration of CGM intending to reduce hypoglycemic episodes in other studies. […] Some hypoglycemia episodes in diabetes are associated with the treatment itself; therefore, it is important to use drugs with a low risk of hypoglycemia.

• #31 Hypoglycemia Prevention and Treatment in the Ambulatory Care Setting

  https://www.uspharmacist.com/article/hypoglycemia-prevention-and-treatment-in-the-ambulatory-care-setting

  Although physical activity has many health benefits and should be encouraged in patients with diabetes, it can contribute to hypoglycemia in at-risk individuals; therefore, caution is warranted and individualized strategies for hypoglycemia prevention should be developed. […] Monitoring via finger-stick glucose readings and a glucose meter or a continuous glucose monitor (CGM) is essential for the detection and avoidance of hypoglycemia. […] Hypoglycemia unawareness impairs patient safety, and its presence should trigger reevaluation of the medication regimen and current glycemic goals. […] While implementation of strategies to prevent hypoglycemia is critical, diabetes patients at risk for hypoglycemia (e.g., those treated with insulin and/or insulin secretagogues) should be counseled about the appropriate treatment of hypoglycemia should it occur. […] The preferred treatment for hypoglycemia in conscious patients is glucose, but any readily available form of carbohydrate that contains glucose may be used. […] The ADA recommends that patients at increased risk for level 2 hypoglycemia be given a prescription for glucagon.

• #32 Hypoglycemia (Low Blood Sugar Levels): Symptoms, Causes, Treatment

  https://www.webmd.com/diabetes/diabetes-hypoglycemia

  If you have diabetes, ways you can prevent hypoglycemia include: […] Follow your meal plan. […] Eat at least three evenly spaced meals each day with between-meal snacks as prescribed. […] Plan your meals no more than 4 to 5 hours apart. […] Exercise 30 minutes to 1 hour after meals. Check your sugars before and after exercise, and discuss with your doctor what types of changes can be made. […] Double-check your insulin and dose of diabetes medicine before taking it. […] If you drink alcohol, be moderate and monitor your blood sugar levels. […] Know when your medicine is at its peak level. […] Test your blood sugar as often as directed by your doctor. […] Carry an identification bracelet that says you have diabetes.

• #33 Hypoglycemia Symptoms, Treatment, Causes & Prevention

  https://agamatrix.com/blog/hypoglycemia-symptoms-treatment/

  3. Stay Safe When Exercising […] Test your blood sugar before, during, and after any physical activity. You may also need to work with your healthcare team to determine if you need to adjust your medication or carbohydrate intake. […] 4. Talk to Your Healthcare Team […] As weve mentioned, hypoglycemia can affect everyone differently. Thats why its important to talk to your healthcare provider if you have experienced hypoglycemia. You may require a medication adjustment or alterations to your diabetes management plan. You can also inquire about a glucagon emergency kit.

• #34 Hypoglycemia (Low Blood Sugar Levels): Symptoms, Causes, Treatment

  https://www.webmd.com/diabetes/diabetes-hypoglycemia

  If you have diabetes, ways you can prevent hypoglycemia include: […] Follow your meal plan. […] Eat at least three evenly spaced meals each day with between-meal snacks as prescribed. […] Plan your meals no more than 4 to 5 hours apart. […] Exercise 30 minutes to 1 hour after meals. Check your sugars before and after exercise, and discuss with your doctor what types of changes can be made. […] Double-check your insulin and dose of diabetes medicine before taking it. […] If you drink alcohol, be moderate and monitor your blood sugar levels. […] Know when your medicine is at its peak level. […] Test your blood sugar as often as directed by your doctor. […] Carry an identification bracelet that says you have diabetes.

• #35 Diabetes Canada | Clinical Practice Guidelines

  https://guidelines.diabetes.ca/cpg/chapter-14-2023-update

  Preparing for exercise by reducing insulin doses or increasing carbohydrate intake is essential to prevent exercise-induced hypoglycemia. Individuals with diabetes, support persons, and caregivers should be counselled on the importance of reducing pre-exercise boluses or short-term basal reduction programs on their pump, particularly in those who are reluctant to increase carbohydrate intake. […] A multifaceted approach is likely required, such as the use of advanced therapeutic technologies (CGM, insulin pumps) and use of psychoeducational training.

• #36 Tips to Prevent Blood Sugar from Dropping at Night

  https://www.hackensackmeridianhealth.org/HealthU/2019/10/10/5-tips-to-prevent-blood-sugar-from-dropping-at-night/

  Check your level before bed. According to Sulay Shah, M.D., a board certified endocrinologist, the only way to know if you are at risk is to monitor your blood glucose levels as there aren’t always telltale signs. If you check and you notice that your levels are close to 70 mg/dL at bedtime, then you know you might be at risk, Dr. Shah says. In this case, he recommends eating some complex carbohydrates, like a peanut butter sandwich, an apple with peanut butter or one slice of multigrain toast with some avocado. […] Don’t skip dinner. If you aren’t eating dinner, Dr. Shah advises skipping your rapid-acting insulin or medicine, like glipizide or glimepiride, that can decrease your blood sugar levels. The goal here is to match your meal and medication, he says. […] Potentially adjust your exercise routine. Though you can exercise at any time of the day, Dr. Shah warns that aerobic exercises, like swimming or running on a treadmill, can cause your blood sugar to dip, whereas anaerobic exercises, such as weight lifting, can cause your blood sugar to increase. Therefore, Dr. Shah encourages individuals to start with anaerobic exercises and then transition to aerobic exercises. Before you work out, check your blood glucose. If your blood sugar is below 80 mg/dL, eat at least 10 to 15 grams of carbohydrates such as of an apple before the workout and another 10 to 15 grams after, says Dr. Shah. He continues, As always, you must modify your insulin accordingly. As explained by Dr. Shah, roughly 5 to 6 hours after you exercise the body becomes more insulin sensitive and muscles will utilize blood sugar to counteract the stress of the exercise.

• #37 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Dietary intervention includes instruction regarding the amount of carbohydrates at meals and its effect on blood glucose concentration and building a personalized regular meal plan. […] Physical exercise increases glucose consumption and the risk of hypoglycemia. […] Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring constitute essential tools to diagnose hypoglycemia in the early stages. […] Some hypoglycemia episodes in diabetes are associated with the treatment itself; therefore, it is important to use drugs with a low risk of hypoglycemia. […] The use of continuous subcutaneous insulin infusion (CSII) prevented hypoglycemic episodes and improved the threshold of hypoglycemia awareness in patients with type 1 diabetes who suffered from recurrent episodes of non-severe or severe hypoglycemia.

• #38

  https://link.springer.com/article/10.1007/s13300-017-0325-9

  In patients with hypoglycemic unawareness, strict avoidance of hypoglycemia by adjusting glucose goals to higher targets on a short-term basis (24 weeks) can allow the symptoms of hypoglycemia to return. […] The recommendation is a goal of 8.0% for patients at high risk for hypoglycemia, compared to the typical goal of 7.0%. […] Many of the new agents to treat diabetes are less likely to cause hypoglycemia than the older classes of medications. […] Education aimed at recognizing the signs and symptoms of hypoglycemia is imperative for both patients and families. Appropriate teaching includes individual risk factors, prevention, and treatment of hypoglycemia. […] In addition, healthcare providers must work diligently with patients and families to identify and eradicate hypoglycemia by using appropriate glucose targets and medications and modifying lifestyle.

• #39 Diabetic hypoglycemia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

  Measure medication carefully and take it on time. Take your medication as recommended by your health care provider. […] Adjust your medication or eat additional snacks if you increase your physical activity. The adjustment depends on the blood sugar test results, the type and length of the activity, and what medications you take. Follow your diabetes treatment plan when making adjustments. […] Eat a meal or snack with alcohol, if you choose to drink. Drinking alcohol on an empty stomach can cause hypoglycemia. Alcohol may also cause delayed hypoglycemia hours later, making blood sugar monitoring even more important. […] Record your low glucose reactions. This can help you and your health care team identify patterns contributing to hypoglycemia and find ways to prevent them. […] Carry some form of diabetes identification so that in an emergency others will know that you have diabetes. Use a medical identification necklace or bracelet and wallet card.

• #40 Hypoglycemia in diabetes – Causes, symptoms, treatment, and prevention | NOVI Health

  https://novi-health.com/library/hypoglycemia-in-diabetes-causes-symptoms-treatment-and-prevention

  Hypoglycemia is a potential side effect of treatment for diabetes. Although it can be dangerous, there are ways for people with diabetes to minimize the risk of hypoglycemia. […] Adjusting your doses of insulin and other medications for diabetes can help to prevent hypoglycemia. Using a continuous glucose monitor can help to detect hypoglycemia early, and makes it easier to adjust your treatment plan to avoid it. […] To prevent hypoglycemia, its important to match your dose of insulin to your bodys need for blood sugar. For example, if you exercise or skip a meal, then youll need to reduce your dose of insulin to account for this. If you find that youre experiencing frequent episodes of hypoglycemia, this could mean that your basal (background) insulin dose is too high, or that your dose of oral diabetes medications needs to be reduced.

• #41 Diabetes Canada | Clinical Practice Guidelines

  https://guidelines.diabetes.ca/cpg/chapter14

  It is important to avoid overtreatment of hypoglycemia, since this can result in rebound hyperglycemia and weight gain. […] In people with diabetes at increased risk of hypoglycemia, the following strategies may be used to reduce the risk of hypoglycemia: Avoidance of pharmacotherapies associated with increased risk of recurrent or severe hypoglycemia. […] A standardized education program targeting rigorous avoidance of hypoglycemia while maintaining overall glycemic control. […] Increased frequency of SMBG, including periodic assessment during sleeping hours. […] Less stringent glycemic targets with avoidance of hypoglycemia for up to 3 months. […] A psycho-behavioural intervention program (blood glucose awareness training). […] Structured diabetes education and frequent follow up. […] For people with diabetes at risk of severe hypoglycemia, support persons should be taught how to administer glucagon.

• #42 Diabetes Canada | Clinical Practice Guidelines

  https://guidelines.diabetes.ca/cpg/chapter-14-2023-update

  Structured educational and psychobehavioural programs (e.g. BG awareness training) may help improve detection of hypoglycemia and reduce the frequency of level 3 hypoglycemia. The following are the prevention strategies for hypoglycemia. […] Insulin and/or insulin secretagogue therapy increases the risk of hypoglycemia. […] In adults with type 2 diabetes who require treatment advancement or adjustment, the use of antihyperglycemic agents that do not increase the risk or minimize the risk of hypoglycemia (i.e. glucagon-like peptide-1 receptor agonists [GLP-1RA], dipeptidylpeptidase 4 [DPP4] inhibitors, sodium-glucose cotransporter-2 [SGLT2] inhibitors, acarbose, and/or pioglitazone) should be considered. […] There is evidence that continuous subcutaneous insulin infusion (CSII) vs multiple daily injections (MDIs) reduces recurrent severe hypoglycemia in adults with type 1 diabetes.

• #43 Hypoglycemia During Therapy of Diabetes – Endotext – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279100/

  The principles of intensive glycemic therapy relevant to minimizing the risk of iatrogenic hypoglycemia in diabetes include drug selection, selective application of diabetes treatment technologies, individualized glycemic goals, structured patient education, and short-term scrupulous avoidance of hypoglycemia. Based on the premise that the risk of hypoglycemia is modifiable, the International Hypoglycemia Study Group recommended that people with diabetes treated with a sulfonylurea, a glinide, or insulin should be educated about hypoglycemia, should treat self-monitored plasma glucose (SMPG) 70 mg/dL (3.9 mmol/L) to avoid progression to clinical iatrogenic hypoglycemia, and should regularly be queried about hypoglycemia, including the glucose level at which symptoms develop. […] Drug selection relevant to minimizing the risk of hypoglycemia includes avoidance, if possible, of sulfonylureas or glinides, the use of more physiological insulin regimens, and the use of long-acting or even ultra-long-acting daily basal insulin analogues and rapid-acting prandial insulin analogues in lieu of human insulins. Insulin analogues reduce the frequency of at least nocturnal hypoglycemia including severe nocturnal hypoglycemia compared to human insulins.

• #44 Hypoglycemia During Therapy of Diabetes – Endotext – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279100/

  Relevant diabetes treatment technologies include continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), and combinations of CSII and CGM. Although earlier meta-analyses disclosed little or no advantage of CSII, recent evidence suggest that CSII treatment is superior in achieving glucose control compared to multiple daily injections. CGM devices alone have been shown to improve glycemic control and decrease duration of hypoglycemia in patients with diabetes mellitus. […] The core approach, applicable to virtually all patients with diabetes treated with a sulfonylurea, a glinide, or insulin in whom hypoglycemia becomes a problem, is thorough, structured patient education that teaches the patient how and when their drugs can cause hypoglycemia, how to adjust their medications, meal plans, and exercise to optimize glycemic control and minimize hypoglycemia, and how to recognize and treat hypoglycemia.

• #45 Hypoglycemia During Therapy of Diabetes – Endotext – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279100/

  Relevant diabetes treatment technologies include continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), and combinations of CSII and CGM. Although earlier meta-analyses disclosed little or no advantage of CSII, recent evidence suggest that CSII treatment is superior in achieving glucose control compared to multiple daily injections. CGM devices alone have been shown to improve glycemic control and decrease duration of hypoglycemia in patients with diabetes mellitus. […] The core approach, applicable to virtually all patients with diabetes treated with a sulfonylurea, a glinide, or insulin in whom hypoglycemia becomes a problem, is thorough, structured patient education that teaches the patient how and when their drugs can cause hypoglycemia, how to adjust their medications, meal plans, and exercise to optimize glycemic control and minimize hypoglycemia, and how to recognize and treat hypoglycemia.

• #46

  https://link.springer.com/article/10.1007/s11892-018-1065-6

  In addition to assisting in achieving improved glucose control, continuous glucose monitoring (CGM) sensor technology may also aid in detection and prevention of hypoglycemia. […] Recent studies have found that the integration of CGM with continuous subcutaneous insulin infusion (CSII) therapy, a system known as sensor-augmented pump (SAP) therapy, very significantly reduces the occurrence of these conditions by providing real-time glucose readings/trends and automatically suspending insulin infusion when glucose is low (LGS) or, even, before glucose is low but is predicted to soon be low (PLGS). […] Sensor technology promises to continue to improve patients lives not only by attaining glycemic control but also by reducing hypoglycemia, a goal best achieved in conjunction with structured individualized patient education.

• #47 Hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/Hypoglycemia

  Another cornerstone of prevention is strong self-monitoring of blood glucose, with consistent and frequent measurements. […] Research has shown that patients with type 1 diabetes who use continuous glucose monitoring systems with insulin pumps significantly improve blood glucose control. […] Insulin pumps help to prevent high glucose spikes, and help prevent inappropriate insulin dosing. […] Continuous glucose monitors can sound alarms when blood glucose is too low or too high, especially helping those with nocturnal hypoglycemia or hypoglycemic unawareness. […] In terms of medication adjustments, medication doses and timing can be adjusted to prevent hypoglycemia, or a medication can be stopped altogether. […] In those with hypoglycemia who do not have diabetes, there are a number of preventative measures dependent on the cause.

• #48 Hypoglycemia in diabetes – Causes, symptoms, treatment, and prevention | NOVI Health

  https://novi-health.com/library/hypoglycemia-in-diabetes-causes-symptoms-treatment-and-prevention

  The use of continuous glucose monitoring (CGM) can help to reduce the risk of hypoglycemia. By monitoring a persons blood sugar continuously, hypoglycemia can be detected and treated quickly, and diabetes treatment can more easily be adjusted to help keep blood sugar in the normal range. […] For those who use insulin to manage their diabetes, an insulin pump may also help to reduce the risk of hypoglycemia. This method of giving insulin allows for more precise doses, and allows the dose of insulin to be adjusted frequently in order to reduce the risk of hypoglycemia. Some insulin pumps can integrate with a continuous glucose monitor, allowing the pump to continually adjust the dose of insulin based on blood sugar levels. This reduces the risk of getting too much insulin and developing hypoglycemia.

• #49

  https://link.springer.com/article/10.1007/s13300-017-0325-9

  Hypoglycemia in individuals with diabetes can increase the risk of morbidity and all-cause mortality in this patient group, particularly in the context of cardiovascular impairment, and can significantly decrease the quality of life. […] Strategies used to reduce the risk of hypoglycemia include individualizing glucose targets, selecting the appropriate medication, modifying diet and lifestyle and applying diabetes technology. […] Using a patient-centered care approach, the provider should work in partnership with the patient and family to prevent hypoglycemia through evidence-based management of the disease and appropriate education. […] The treatment of hypoglycemia is aimed at identifying treatable and/or modifiable causes, followed by strategies for prevention and risk reduction. Important factors to consider in prevention include patient awareness of hypoglycemia, individualized glucose targets, self-monitoring of blood glucose (SMBG), diet, exercise and medication regimen.

• #50 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. […] To prevent hypoglycemia, much effort must be invested in patient education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage, together with setting personalized goals for glycemic control. […] Great effort must be invested in patient education on hypoglycemia prevention and management. […] The approach to hypoglycemia prevention includes patient education, appropriate dietary and exercise regimens, glucose monitoring, medication adjustment, and close clinical supervision. […] The patients and those around them should be educated to identify symptoms of hypoglycemia and given appropriate treatment as soon as possible.

• #51

  https://link.springer.com/article/10.1007/s13300-017-0325-9

  In patients with hypoglycemic unawareness, strict avoidance of hypoglycemia by adjusting glucose goals to higher targets on a short-term basis (24 weeks) can allow the symptoms of hypoglycemia to return. […] The recommendation is a goal of 8.0% for patients at high risk for hypoglycemia, compared to the typical goal of 7.0%. […] Many of the new agents to treat diabetes are less likely to cause hypoglycemia than the older classes of medications. […] Education aimed at recognizing the signs and symptoms of hypoglycemia is imperative for both patients and families. Appropriate teaching includes individual risk factors, prevention, and treatment of hypoglycemia. […] In addition, healthcare providers must work diligently with patients and families to identify and eradicate hypoglycemia by using appropriate glucose targets and medications and modifying lifestyle.

• #52

  https://link.springer.com/article/10.1007/s13300-017-0325-9

  In patients with hypoglycemic unawareness, strict avoidance of hypoglycemia by adjusting glucose goals to higher targets on a short-term basis (24 weeks) can allow the symptoms of hypoglycemia to return. […] The recommendation is a goal of 8.0% for patients at high risk for hypoglycemia, compared to the typical goal of 7.0%. […] Many of the new agents to treat diabetes are less likely to cause hypoglycemia than the older classes of medications. […] Education aimed at recognizing the signs and symptoms of hypoglycemia is imperative for both patients and families. Appropriate teaching includes individual risk factors, prevention, and treatment of hypoglycemia. […] In addition, healthcare providers must work diligently with patients and families to identify and eradicate hypoglycemia by using appropriate glucose targets and medications and modifying lifestyle.

• #53 Hypoglycemia – EMCrit Project

  https://emcrit.org/ibcc/hypoglycemia/

  Upon admission to the ICU discontinue any oral hypoglycemic medications. Hyperglycemia should be controlled with insulin therapy only. […] Be conservative with insulin dosing: Don’t try to achieve tight glycemic control. A glucose target of 220 mg/dL (11.1 mM) is fine for most patients. Patients with diabetes and elevated hemoglobin A1C 7 may do better if their glucose is allowed to drift higher (up to ~250 mg/dL)(13.9 mM). […] When in doubt, dose insulin conservatively. Hyperglycemia is less dangerous than hypoglycemia. […] Consider reducing the insulin dose if the patient becomes NPO, or if steroid doses are decreased. […] Insulin dosing can be tricky. Among all medications, insulin is one of the most prone to serious dosing errors. […] Patients with cirrhosis or acute hepatic failure tend to develop hypoglycemia, so monitor their glucose levels and avoid giving them insulin. Some patients with severe hepatic failure will require a continuous dextrose infusion to avoid hypoglycemia.

• #54 Avoiding Nighttime Hypoglycemia | Joslin Diabetes Center

  https://joslin.org/news-stories/all-news-stories/education/2020/03/avoiding-nighttime-hypoglycemia

  Nighttime hypoglycemia can be the result of a number of factors in people with diabetes. It is important to learn what causes hypoglycemia (low glucose) in order to prevent it from happening. […] Check your glucose before going to bed. This could be either with your glucose meter or your continuous glucose monitoring device. Aim for a target of 90-150mg/dl. Know the signs and symptoms of nighttime hypoglycemia. Before you go to bed, consider all of the causes of nighttime hypoglycemia, and if you think you’re at risk, have a snack before heading to bed. Try to be consistent with your meals and/or snacks; skipping dinner or snacks you usually have can put you at risk. Eat a meal or snack when consuming alcohol. […] If you find yourself experiencing frequent nighttime hypoglycemia you may need to adjust your insulin doses. Speak to your diabetes care team about adjusting your insulin regimen or things that you can do to avoid hypoglycemia whether it be overnight or anytime during the day.

• #55 Avoiding Nighttime Hypoglycemia | Joslin Diabetes Center

  https://joslin.org/news-stories/all-news-stories/education/2020/03/avoiding-nighttime-hypoglycemia

  Nighttime hypoglycemia can be the result of a number of factors in people with diabetes. It is important to learn what causes hypoglycemia (low glucose) in order to prevent it from happening. […] Check your glucose before going to bed. This could be either with your glucose meter or your continuous glucose monitoring device. Aim for a target of 90-150mg/dl. Know the signs and symptoms of nighttime hypoglycemia. Before you go to bed, consider all of the causes of nighttime hypoglycemia, and if you think you’re at risk, have a snack before heading to bed. Try to be consistent with your meals and/or snacks; skipping dinner or snacks you usually have can put you at risk. Eat a meal or snack when consuming alcohol. […] If you find yourself experiencing frequent nighttime hypoglycemia you may need to adjust your insulin doses. Speak to your diabetes care team about adjusting your insulin regimen or things that you can do to avoid hypoglycemia whether it be overnight or anytime during the day.

• #56 Avoiding Nighttime Hypoglycemia | Joslin Diabetes Center

  https://joslin.org/news-stories/all-news-stories/education/2020/03/avoiding-nighttime-hypoglycemia

  Nighttime hypoglycemia can be the result of a number of factors in people with diabetes. It is important to learn what causes hypoglycemia (low glucose) in order to prevent it from happening. […] Check your glucose before going to bed. This could be either with your glucose meter or your continuous glucose monitoring device. Aim for a target of 90-150mg/dl. Know the signs and symptoms of nighttime hypoglycemia. Before you go to bed, consider all of the causes of nighttime hypoglycemia, and if you think you’re at risk, have a snack before heading to bed. Try to be consistent with your meals and/or snacks; skipping dinner or snacks you usually have can put you at risk. Eat a meal or snack when consuming alcohol. […] If you find yourself experiencing frequent nighttime hypoglycemia you may need to adjust your insulin doses. Speak to your diabetes care team about adjusting your insulin regimen or things that you can do to avoid hypoglycemia whether it be overnight or anytime during the day.

• #57 Hypoglycemia Diet Plans to Help Regulate Your Blood Sugar

  https://www.healthline.com/health/hypoglycemia-diet

  Your food choices are a big part of managing hypoglycemia. You can eat small, frequent meals with lean proteins and complex carbs. Foods high in soluble fiber, as will seafood and Greek yogurt, may stabilize blood sugar over time. […] No matter the reason, you can take steps to help manage and prevent hypoglycemia through your meal planning. This involves snacking, scheduled meals, and following a generally healthy eating pattern that your healthcare team can guide you on. […] Eating a light snack close to bedtime will help keep your blood sugar stable throughout the night. […] Eat small meals every 3 to 4 hours throughout the day rather than 3 large meals per day. Avoid foods high in saturated fats or trans fats. […] Choose foods with a low glycemic index score. […] Reduce or eliminate processed and refined sugars from your diet.

• #58 Sweet dreams: avoiding nocturnal hypoglycemia – BETTER

  https://type1better.com/en/sweet-dreams-avoiding-nocturnal-hypoglycemia/

  Low blood sugar (hypoglycemia) can happen at any time of day, but it is specifically risky during sleep. […] Whether severe or not, a nocturnal hypoglycemic episode disrupts sleep quality, productivity during the day, and can be associated with persistent fatigue. […] Participants in the BETTER registry reported various strategies to prevent nocturnal hypoglycemia. Here are some you can try: […] Consider consuming a bedtime snack with carbohydrates (foods containing or that convert to sugars in our body) and protein, especially if bedtime glucose levels are low, you had a significantly active day, consumed alcohol, or were unusually physically active in the evening. […] You could adjust insulin doses depending on your evening activities (e.g., exercise) or consider a different type of insulin that was shown to reduce the risk of nocturnal hypoglycemia (e.g., long-acting insulin analogs).

• #59 Sweet dreams: avoiding nocturnal hypoglycemia – BETTER

  https://type1better.com/en/sweet-dreams-avoiding-nocturnal-hypoglycemia/

  Low blood sugar (hypoglycemia) can happen at any time of day, but it is specifically risky during sleep. […] Whether severe or not, a nocturnal hypoglycemic episode disrupts sleep quality, productivity during the day, and can be associated with persistent fatigue. […] Participants in the BETTER registry reported various strategies to prevent nocturnal hypoglycemia. Here are some you can try: […] Consider consuming a bedtime snack with carbohydrates (foods containing or that convert to sugars in our body) and protein, especially if bedtime glucose levels are low, you had a significantly active day, consumed alcohol, or were unusually physically active in the evening. […] You could adjust insulin doses depending on your evening activities (e.g., exercise) or consider a different type of insulin that was shown to reduce the risk of nocturnal hypoglycemia (e.g., long-acting insulin analogs).

• #60 Diabetic hypoglycemia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

  Measure medication carefully and take it on time. Take your medication as recommended by your health care provider. […] Adjust your medication or eat additional snacks if you increase your physical activity. The adjustment depends on the blood sugar test results, the type and length of the activity, and what medications you take. Follow your diabetes treatment plan when making adjustments. […] Eat a meal or snack with alcohol, if you choose to drink. Drinking alcohol on an empty stomach can cause hypoglycemia. Alcohol may also cause delayed hypoglycemia hours later, making blood sugar monitoring even more important. […] Record your low glucose reactions. This can help you and your health care team identify patterns contributing to hypoglycemia and find ways to prevent them. […] Carry some form of diabetes identification so that in an emergency others will know that you have diabetes. Use a medical identification necklace or bracelet and wallet card.

• #61 Non-diabetic Hypoglycemia – Low Blood Sugar without Diabetes

  https://www.drugs.com/cg/non-diabetic-hypoglycemia.html

  Limit or do not drink alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor. Do not drink alcohol on an empty stomach. Drink alcohol with meals to avoid hypoglycemia. […] Include protein foods and vegetables in your meals. Some foods that are high in protein include beef, pork, fish, poultry (chicken and turkey), beans, and nuts. Eat a variety of vegetables with your meals.

• #62 Non-diabetic Hypoglycemia – Low Blood Sugar without Diabetes

  https://www.drugs.com/cg/non-diabetic-hypoglycemia.html

  Limit or do not drink alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor. Do not drink alcohol on an empty stomach. Drink alcohol with meals to avoid hypoglycemia. […] Include protein foods and vegetables in your meals. Some foods that are high in protein include beef, pork, fish, poultry (chicken and turkey), beans, and nuts. Eat a variety of vegetables with your meals.

• #63 Tips to Prevent Blood Sugar from Dropping at Night

  https://www.hackensackmeridianhealth.org/HealthU/2019/10/10/5-tips-to-prevent-blood-sugar-from-dropping-at-night/

  Monitor your alcohol intake. If you notice that your blood sugar is dropping after having a few beers or vodka sodas, then Dr. Shah warns that you may need to try to eat complex carbohydrates with the alcohol. Dr. Shah notes that blood sugar tends to drop 3 to 4 hours after drinking alcohol. When you regularly drink alcohol, you are decreasing the amount of stored glucose in the liver which helps to maintain a blood sugar in normal range, he explains. […] Understand your risk factors. Certain patient populations, such as older adults and those with diseases of the kidney or liver, need to make sure that their blood sugars are not too tightly controlled. Talk with your physician so they can modify your glycemic target to keep you in safe range, Dr. Shah says. […] To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans. […] We are lucky that in this day and age, we can predict hypoglycemia and prevent it through technology like continuous glucose monitors, explains Dr. Shah. Additionally, he notes that there are newer insulins available to help decrease episodes of hypoglycemia.

• #64 Tips to Prevent Blood Sugar from Dropping at Night

  https://www.hackensackmeridianhealth.org/HealthU/2019/10/10/5-tips-to-prevent-blood-sugar-from-dropping-at-night/

  Monitor your alcohol intake. If you notice that your blood sugar is dropping after having a few beers or vodka sodas, then Dr. Shah warns that you may need to try to eat complex carbohydrates with the alcohol. Dr. Shah notes that blood sugar tends to drop 3 to 4 hours after drinking alcohol. When you regularly drink alcohol, you are decreasing the amount of stored glucose in the liver which helps to maintain a blood sugar in normal range, he explains. […] Understand your risk factors. Certain patient populations, such as older adults and those with diseases of the kidney or liver, need to make sure that their blood sugars are not too tightly controlled. Talk with your physician so they can modify your glycemic target to keep you in safe range, Dr. Shah says. […] To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans. […] We are lucky that in this day and age, we can predict hypoglycemia and prevent it through technology like continuous glucose monitors, explains Dr. Shah. Additionally, he notes that there are newer insulins available to help decrease episodes of hypoglycemia.

• #65 Hypoglycemia Diet Plans to Help Regulate Your Blood Sugar

  https://www.healthline.com/health/hypoglycemia-diet

  Choose complex carbohydrates over simple carbohydrates. […] Reduce or eliminate alcohol, and never mix alcohol with sugar-filled mixers, such as fruit juice. […] Eat lean protein. […] Eat foods high in soluble fiber. […] Your food choices are a big part of managing hypoglycemia. Try to eat small, frequent meals with lean proteins and complex carbs. Foods high in soluble fiber, such as Greek yogurt, oatmeal, salads, and seafood, may stabilize your blood sugar over time.

• #66 Tips to Prevent Blood Sugar from Dropping at Night

  https://www.hackensackmeridianhealth.org/HealthU/2019/10/10/5-tips-to-prevent-blood-sugar-from-dropping-at-night/

  Monitor your alcohol intake. If you notice that your blood sugar is dropping after having a few beers or vodka sodas, then Dr. Shah warns that you may need to try to eat complex carbohydrates with the alcohol. Dr. Shah notes that blood sugar tends to drop 3 to 4 hours after drinking alcohol. When you regularly drink alcohol, you are decreasing the amount of stored glucose in the liver which helps to maintain a blood sugar in normal range, he explains. […] Understand your risk factors. Certain patient populations, such as older adults and those with diseases of the kidney or liver, need to make sure that their blood sugars are not too tightly controlled. Talk with your physician so they can modify your glycemic target to keep you in safe range, Dr. Shah says. […] To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans. […] We are lucky that in this day and age, we can predict hypoglycemia and prevent it through technology like continuous glucose monitors, explains Dr. Shah. Additionally, he notes that there are newer insulins available to help decrease episodes of hypoglycemia.

• #67 Hypoglycemia Prevention Initiative | Endocrine Society

  https://www.endocrine.org/hypoglycemia-prevention-initiative

  The Hypoglycemia Prevention Initiative is a multi-year joint effort of the Endocrine Society and Avalere Health to determine best practices in primary care to reduce the impact of hypoglycemia on older (65+) people with type 2 diabetes (T2D) who use insulin and/or sulfonylurea, have a recent A1c 7%, and are at increased risk of hypoglycemia. […] The initial effort of this initiative is the Hypoglycemia Prevention Study (HypoPrevent), an implementation research and quality improvement (QI) study designed to test an intervention in primary care settings to identify older people with T2D at risk of hypoglycemia and a clinical decision support tool designed to facilitate risk reduction. […] This study assesses various methods to decrease the risk of hypoglycemia on an individual basis through shared decision making (SDM), individualized A1c goals and/or changes to their glucose-lowering medications regimen.

• #68 Diabetic hypoglycemia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

  Measure medication carefully and take it on time. Take your medication as recommended by your health care provider. […] Adjust your medication or eat additional snacks if you increase your physical activity. The adjustment depends on the blood sugar test results, the type and length of the activity, and what medications you take. Follow your diabetes treatment plan when making adjustments. […] Eat a meal or snack with alcohol, if you choose to drink. Drinking alcohol on an empty stomach can cause hypoglycemia. Alcohol may also cause delayed hypoglycemia hours later, making blood sugar monitoring even more important. […] Record your low glucose reactions. This can help you and your health care team identify patterns contributing to hypoglycemia and find ways to prevent them. […] Carry some form of diabetes identification so that in an emergency others will know that you have diabetes. Use a medical identification necklace or bracelet and wallet card.

• #69 Hypoglycemia | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia

  The best way to avoid hypoglycemia is to test blood glucose regularly, eat meals and snacks on a regular schedule, follow the exercise plan suggested by diabetes health care team, and always take diabetes medications as recommended. […] You can avoid hypoglycemia by being prepared. Be prepared to check blood glucose level regularly and especially when you have any symptoms of hypoglycemia. Be prepared to treat those symptoms by keeping glucose tablets or hard candies handy. […] You should check blood glucose level before driving any vehicle or operating machinery to make sure it is in the normal range. This is especially important if you have repeated episodes of hypoglycemia or if you have trouble sensing when blood glucose is low.

• #70 Diabetic hypoglycemia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

  Measure medication carefully and take it on time. Take your medication as recommended by your health care provider. […] Adjust your medication or eat additional snacks if you increase your physical activity. The adjustment depends on the blood sugar test results, the type and length of the activity, and what medications you take. Follow your diabetes treatment plan when making adjustments. […] Eat a meal or snack with alcohol, if you choose to drink. Drinking alcohol on an empty stomach can cause hypoglycemia. Alcohol may also cause delayed hypoglycemia hours later, making blood sugar monitoring even more important. […] Record your low glucose reactions. This can help you and your health care team identify patterns contributing to hypoglycemia and find ways to prevent them. […] Carry some form of diabetes identification so that in an emergency others will know that you have diabetes. Use a medical identification necklace or bracelet and wallet card.

• #71 Hypoglycemia | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia

  The best way to avoid hypoglycemia is to test blood glucose regularly, eat meals and snacks on a regular schedule, follow the exercise plan suggested by diabetes health care team, and always take diabetes medications as recommended. […] You can avoid hypoglycemia by being prepared. Be prepared to check blood glucose level regularly and especially when you have any symptoms of hypoglycemia. Be prepared to treat those symptoms by keeping glucose tablets or hard candies handy. […] You should check blood glucose level before driving any vehicle or operating machinery to make sure it is in the normal range. This is especially important if you have repeated episodes of hypoglycemia or if you have trouble sensing when blood glucose is low.

• #72 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Hypoglycemia requires immediate treatment by eating or drinking sugar/carbohydrates. Severe hypoglycemia can be life-threatening and requires treatment with emergency glucagon and/or medical intervention. […] Unfortunately, it can be difficult to totally prevent low blood sugar when you have diabetes. But you can adjust your diabetes management plan to try to lower the number of hypoglycemia episodes you experience. […] The following steps can help prevent low blood sugar: Take all your medications exactly as prescribed. Follow your healthcare providers instructions about food and exercise. Use a continuous glucose monitor (CGM) or check your blood sugar regularly, including before and after meals, before and after exercise and before bed. After youve treated a low blood sugar episode, write down the details of the episode. Include details such as the time, what you ate recently, whether you exercised, the symptoms and your glucose level. This can help you and your provider adjust your management plan to try and prevent future lows.

• #73 Hypoglycemia | Endocrinology and Diabetes

  https://health.ucdavis.edu/conditions/endocrinology-diabetes/diabetes/hypoglycemia

  You can take steps to prevent hypoglycemia and optimize your blood sugar. Try to recognize symptoms when they first start and: […] Regularly checking your blood glucose levels can help you take action when needed. You can use a blood glucose meter or a CGM system. Ask your provider about the options available and how often you should check. […] Physical activity, especially intense or new forms of exercise, can cause your blood sugar to decrease. Eating or drinking something with carbs or sugar before you start can help prevent a drop. Also, make sure you drink enough water during exercise, as dehydration can cause blood glucose levels to drop. […] Make sure those around you know what to do if your blood sugar gets dangerously low. You can tell them common symptoms to watch for and how to test your blood sugar. They should also know how to use a glucagon injection kit if needed. […] You can keep a diary of your blood sugar levels, food intake, medications and exercise. These details may help you and your provider realize patterns and figure out how best to manage your blood sugar.

• #74 A new injectable to prevent and treat hypoglycemia – UCLA

  https://www.chemistry.ucla.edu/news/a-new-injectable-to-prevent-and-treat-hypoglycemia/

  Prof. Heather Maynard is co-leader of a group of UCLA researchers who have developed glucose-responsive micelles that encapsulate and protect glucagon, releasing it only when blood sugar levels drop dangerously low, offering a potential new method to prevent hypoglycemia in people with diabetes. […] To prevent and treat this condition, researchers in ACS Central Science report encapsulating the hormone glucagon. […] To improve commercial glucagon stability and prevent hypoglycemia, Andrea Hevener and Heather Maynard looked to micelles: nanoscale, soap-like bubbles that can be customized to assemble or disassemble in different environments and are used for drug delivery. […] While more studies are needed, the researchers say their proof-of-concept is a first step toward a new on-demand and effective method for preventing or mitigating extremely low blood sugar levels.

• #75 A new injectable to prevent and treat hypoglycemia – American Chemical Society

  https://www.acs.org/pressroom/presspacs/2024/october/a-new-injectable-to-prevent-and-treat-hypoglycemia.html

  A Glucose-Responsive Glucagon-Micelle for the Prevention of Hypoglycemia […] To prevent and treat this condition, researchers in ACS Central Science report encapsulating the hormone glucagon. […] To improve commercial glucagon stability and prevent hypoglycemia, Andrea Hevener and Heather Maynard looked to micelles: nanoscale, soap-like bubbles that can be customized to assemble or disassemble in different environments and are used for drug delivery. […] To prevent hypoglycemia, the micelles could be injected ahead of time and circulate in the bloodstream until they are needed. […] While more studies are needed, the researchers say their proof-of-concept is a first step toward a new on-demand and effective method for preventing or mitigating extremely low blood sugar levels.

• #76 New Drug to Prevent Hypoglycemia Enters Clinical Trials

  https://breakthrought1d.ca/new-drug-to-prevent-hypoglycemia-enters-clinical-trials/

  If approved, this would be the first once daily therapeutic for people with T1D to help reduce the effects of hypoglycemia, one of the most common complications of the disease. […] Hypoglycemia is an unintended consequence of insulin therapy, and happens when one takes too much insulin. […] If these early trials are successful, ZT-01 will be much closer to approval, and to providing much-needed relief to the millions of people with T1D and their families who suffer from the fear and dangers of hypoglycemia.

• #77 Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8696639/

  Hypoglycemia is a common complication in patients with diabetes, mainly in those treated with insulin, sulfonylurea, or glinide. […] To prevent hypoglycemia, much effort must be invested in patient education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage, together with setting personalized goals for glycemic control. […] Great effort must be invested in patient education on hypoglycemia prevention and management. […] The approach to hypoglycemia prevention includes patient education, appropriate dietary and exercise regimens, glucose monitoring, medication adjustment, and close clinical supervision. […] The patients and those around them should be educated to identify symptoms of hypoglycemia and given appropriate treatment as soon as possible.

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