Materiały źródłowe

• #1 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  Hypoglycemia is common with type 1 diabetes, particularly in those patients receiving intensive insulin therapy. Severe hypoglycemic events have reportedly been anywhere between 62 to 320 episodes per 100 patient-years in type 1 diabetes. […] As opposed to patients who have type 1 diabetes and require insulin therapy exclusively, patients with type 2 diabetes experience hypoglycemia relatively less frequently compared to patients with type 1 diabetes. This can be, in part, due to pharmacotherapies that do not induce hypoglycemia, like metformin. The incidence of hypoglycemia in patients with type 2 diabetes has been reportedly approximately 35 episodes for 100 patient years. […] There are no reported disparities in incidents based on gender.

• #2 Hypoglycemia – Wikipedia

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

  Hypoglycemia is common in people with type 1 diabetes, and in people with type 2 diabetes taking insulin, glinides, or sulfonylurea. It is estimated that type 1 diabetics experience two mild, symptomatic episodes of hypoglycemia per week. Additionally, people with type 1 diabetes have at least one severe hypoglycemic episode per year, requiring treatment assistance. In terms of mortality, hypoglycemia causes death in 6-10% of type 1 diabetics. […] In those with type 2 diabetes, hypoglycemia is less common compared to type 1 diabetics, because medications that treat type 2 diabetes like metformin, glitazones, alpha-glucosidase inhibitors, glucagon-like peptide 1 agonists, and dipeptidyl peptidase IV inhibitors, do not cause hypoglycemia. Hypoglycemia is common in type 2 diabetics who take insulin, glinides, or sulfonylurea. Insulin use remains a key risk factor in developing hypoglycemia, regardless of diabetes type.

• #3 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  The incidence of hypoglycemia in a population is difficult to ascertain. Patients and physicians frequently attribute symptoms (eg, anxiety, irritability, hunger) to hypoglycemia without documenting the presence of low blood sugar. The true prevalence of hypoglycemia, with blood sugar levels below 50 mg/dL, is generally 5-10% of people presenting with symptoms suggestive of hypoglycemia. […] A Brazilian study, by Lamounier et al, found that during a 4-week prospective evaluation period, at least one hypoglycemic event occurred in 91.7% of study patients with type 1 diabetes and in 61.8% of those with type 2 diabetes. This included nocturnal hypoglycemia in 54.0% and 27.4% of patients, respectively; asymptomatic hypoglycemia in 20.6% and 10.6% of patients, respectively; and severe hypoglycemic events in 20.0% and 10.3% of patients, respectively.

• #4 Hypoglycemia Facts and Stats: What You Need to Know

  https://www.verywellhealth.com/facts-about-hypoglycemia-6504416

  Hypoglycemia is low blood glucose levels. Generally, when blood glucose levels are below 70 milligrams per deciliter (mg/dL), it is called hypoglycemia. Hypoglycemia typically occurs in people with diabetes, though people without diabetes can experience hypoglycemia too. […] Hypoglycemia is common among people with diabetes. It is particularly seen in people with type 1 diabetes or type 2 diabetes who take insulin or other specific diabetes medications. […] Global research has shown that 4 in 5 people with type 1 diabetes and almost half of people with type 2 diabetes who take insulin reported experiencing hypoglycemia at least once over a period of four weeks. […] Severe hypoglycemia, or when your blood glucose levels are so low that you need someone to help you treat it, is not as common. About 2 in 100 American adults with diabetes who take insulin or other specific diabetes medications that help increase insulin in the blood, might experience severe hypoglycemia yearly.

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

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

  Hypoglycemia is common in people with diabetes, especially people who take insulin to manage the condition. […] One study found that 4 in 5 people with Type 1 diabetes and nearly half of all people with Type 2 diabetes who take insulin reported a low blood sugar episode at least once over a four-week period. […] People with Type 2 diabetes who take meglitinide or sulfonylurea oral diabetes medications are also at an increased risk for low blood sugar. […] You can experience hypoglycemia without having diabetes, but its uncommon. […] Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] Common situations that can lead to hypoglycemia for people with diabetes include: Taking too much insulin, the wrong insulin or injecting it into your muscle instead of in your fat tissue. […] If you have diabetes and are experiencing frequent low blood sugar episodes, talk to a provider who helps you manage diabetes. They can help you adjust your management plan, which may include changes to your medication regimen, meal plans or exercise routine.

• #6 Hypoglycemia – Diabetes Canada

  https://www.diabetes.ca/health-care-providers/clinical-practice-guidelines/chapter-14

  Hypoglycemia is defined by: 1) the development of autonomic or neuroglycopenic symptoms (Table 1); 2) a low plasma glucose (PG) level (4.0 mmol/L for people with diabetes treated with insulin or an insulin secretagogue); and 3) symptoms responding to the administration of carbohydrate (7). Hypoglycemia is most frequent in people with type 1 diabetes, followed by people with type 2 diabetes managed by insulin, and people with type 2 diabetes managed by sulfonylureas. […] The major risk factors for severe hypoglycemia in people with type 1 diabetes include a prior episode of severe hypoglycemia (810), current low glycated hemoglobin (A1C) (6.0%) (9,1113), hypoglycemia unawareness (14), long duration of diabetes (12,15), autonomic neuropathy (16), adolescence (17) and preschool-aged children unable to detect and/or treat mild hypoglycemia on their own. Risk factors for hypoglycemia in people with type 2 diabetes include advancing age (18), severe cognitive impairment (19), poor health literacy (20), food insecurity (21), increased A1C (18,22), hypoglycemia unawareness (23), duration of insulin therapy, renal impairment and neuropathy (22). Individuals at high risk for severe hypoglycemia should be informed of their risk and counselled, along with their significant others, on preventing and treating hypoglycemia (including use of glucagon), preventing driving and industrial accidents through self-monitoring of blood glucose (SMBG), and taking appropriate precautions prior to the activity, and documenting blood glucose (BG) readings taken during sleeping hours.

• #7 The Impact of Hypoglycemia on Patients with Diabetes Mellitus: A Cross-Sectional Analysis

  https://www.mdpi.com/2077-0383/11/3/626

  Individuals with BMI < 23.9 kg/m2 are more likely to suffer from hypoglycemia. [...] A significant correlation was also observed among individuals with unhealthy alcohol drinking behaviors and smokers. [...] Hyperlipidemia, retinopathy, and asthma were identified as common comorbidities among hypoglycemic patients. [...] Understanding the interactions between diabetes and sociodemographic, environmental, or other disease-related risk factors may provide new strategies to optimize glycemic control and reduce the occurrence of hypoglycemia.

• #8 Non-Diabetic Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK573079/

  Non-diabetic hypoglycemia is relatively uncommon as compared to hypoglycemia in patients with diabetes. A large retrospective review of 38,898 patients admitted to hospitals with non-critical illness showed the estimated frequency of 36 per 10000 admissions. It was noted that patients with age above 65 years on admission were 50% more likely to have an episode of hypoglycemia. […] The incidence of Insulinoma is estimated to be 0.4 per 100,000 person-years with 59% female preponderance and age of 47 years at the surgery. Hypoglycemia is a well-known complication of bariatric surgery, especially Roux-en-Y gastric bypass. A population-based study noted a 2 to 7 fold increase in hospital admission due to hypoglycemia in patients who underwent bariatric surgery. However, the absolute risk of hospitalization is very low (approximately 0.2%) with hypoglycemia after gastric bypass surgery. In comparison, the general population risk was 0.04%.

• #9 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Hypoglycemia is a known complication of several medications, and the incidence is difficult to determine with any certainty. In addition, this condition is a known complication of many therapies for diabetes; therefore, the incidence of hypoglycemia in a population of people with diabetes is very different from that in a population of people without diabetes. […] Insulin-producing tumors are a rare but important treatable cause of hypoglycemia, with an annual US incidence of 1-2 cases per million persons per year. […] Reactive hypoglycemia is reported most frequently by women aged 25-35 years; however, other causes of hypoglycemia are not associated with a sex predilection. The average age of a patient diagnosed with an insulinoma is the early 40s, but cases have been reported in patients ranging from birth to age 80 years.

• #10 Non-Diabetic Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK573079/

  Another study noted that less than 1% of the patient after Roux-en-Y gastric bypass might require hospitalization due to hypoglycemia. Furthermore, less than 10% of patients may develop clinically significant hypoglycemia. In a study involving 40 patients who had undergone Roux-en-Y gastric bypass, 75% of patients were noted to have asymptomatic hypoglycemia on continuous glucose monitoring.

• #11 Neonatal Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/802334-overview

  The overall incidence of symptomatic hypoglycemia in newborns varies from 1.3-3 per 1000 live births. Incidence varies with the definition, population, method and timing of feeding, and the type of glucose assay. Serum glucose levels are higher than whole blood values. The incidence of hypoglycemia is greater in high-risk neonatal groups (see History). […] Early feeding decreases the incidence of hypoglycemia. Inborn errors of metabolism that lead to neonatal hypoglycemia are rare but can be screened for in infancy. […] In a Japanese study, more than 80% of admissions from the nursery to the neonatal intensive care unit (NICU) after birth were due to apnea or hypoglycemia in neonates born at 35-36 weeks’ gestation.

• #12 Neonatal hypoglycaemia

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neonatal_hypoglycaemia/

  Hypoglycaemia is the most common metabolic disorder of the neonate, and occurs in 5-15% of all neonates. […] Most neonates with hypoglycaemia are initially asymptomatic, and therefore, early detection of hypoglycaemia is based on surveillance of neonates who have risk factors for hypoglycaemia. […] All neonatal admissions presenting with risk factors for hypoglycaemia should have a CBG or a TBG on admission or if there is any clinical signs of hypoglycaemia. […] A capillary bedside glucometer reading is unreliable at low readings; hence it is important to confirm that the TBG is less than 2.6 mmol/L which can be done by CBG. […] When a neonate is hypoglycaemic prompt treatment is the goal. The aim of the treatment is to quickly bring the neonates BGL greater than 2.6mmol/L. […] Education for family members regarding hypoglycaemia is an important aspect of the neonates holistic care.

• #13 Hypoglycemia Facts and Stats: What You Need to Know

  https://www.verywellhealth.com/facts-about-hypoglycemia-6504416

  A global study of 24 countries reported that the highest rates of hypoglycemia events were reported in Latin America for type 1 diabetes and Russia for type 2 diabetes. […] In a study looking at trends of severe hypoglycemia in U.S. veterans from 2004 to 2015, researchers reported the rates of severe hypoglycemia declined over the years. […] Most studies investigating mortality rates related to hypoglycemia have found severe hypoglycemic events are stronger predictors of mortality than mild or moderate hypoglycemia. […] For example, one study of adults with diabetes found that five years after reporting their frequency and severity of hypoglycemia, people who reported having experienced severe hypoglycemia had a 3.4-fold higher mortality than those who reported mild or no hypoglycemic events.

• #14 Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study | BMC Emergency Medicine | Full Text

  https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-021-00457-9

  The objective of this study was to describe the epidemiology of severe hypoglycaemia in Kuwait, aiming to provide a preliminary background to update the current guidelines and improve patient management. […] A total of 167 cases met the inclusion criteria. The incidence of severe hypoglycaemia in the national EMS was 11 per 100,000. […] Severe hypoglycaemia is not uncommon during EMS calls. Appropriate management by EMS personnel is fruitful, resulting in favourable scene outcomes and reducing the hospital transportation rate. […] The study describes severe hypoglycaemia epidemiology in Kuwait, which has not been described before. Our results showed that severe hypoglycaemia resulting in a request for EMS is common in Kuwait EMS emergencies. Eleven per 100,000 EMS calls were for severe hypoglycaemia.

• #15 The Impact of Hypoglycemia on Patients with Diabetes Mellitus: A Cross-Sectional Analysis

  https://www.mdpi.com/2077-0383/11/3/626

  The increasing mortality and morbidity in patients with diabetes mellitus constitute a severe public health problem. […] In this study, we performed a cross-sectional analysis among 300 Polish participants with type 1 and type 2 diabetes to determine and classify risk factors associated with increased incidences of hypoglycemia. […] Approximately 2–4% of deaths of DM patients are due to hypoglycemic episodes. […] The prevalence rates of depression are up to three times higher in patients with type 1 diabetes and twice as high in people with type 2 diabetes than the general population worldwide. […] The rate of exhibiting hypoglycemic episodes was 62.0% (186/300). […] The presence of hypoglycemia increases the risk of severe hypoglycemia (six-fold for type 1 diabetes mellitus and 17-fold for type 2 diabetes mellitus).

• #16 Hypoglycemic and pregnant: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/321734

  People with diabetes are especially vulnerable to hypoglycemia when pregnant, particularly those with type 1 diabetes. A 2021 article suggests it affects between 36% and 71% of pregnant people who take insulin. […] Diabetes is a common cause of hypoglycemia during pregnancy. However, hyperglycemia is more common than hypoglycemia during pregnancy, but both can occur at different stages of pregnancy. […] According to the American Diabetes Association, around 9.2% of pregnancies in the United States involve gestational diabetes every year. This condition usually goes away after the baby is born. […] Mild hypoglycemia may not harm a developing baby. A doctor may recommend eating more or adjusting medication. However, regular hypoglycemia during pregnancy may harm a developing baby. […] The most significant complications related to hypoglycemia in pregnancy are due to diabetes. A pregnant person with diabetes can have complications, such as preeclampsia, and their babies may need additional monitoring. […] Whatever the cause of hypoglycemia during pregnancy, careful monitoring of the parent and baby can reduce the risk of serious complications.

• #17 Severe Hypoglycemia Linked to Increased Risk of Death in People With Diabetes | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2017/severe-hypoglycemia-linked-to-increased-risk-of-death-in-people-with-diabetes

  A single instance of blood sugar falling so low as to require an emergency department visit was associated with nearly double the risk of cardiovascular disease or death, finds a new Johns Hopkins Bloomberg School of Public Health study of older adults with type 2 diabetes. […] Additionally, using data from a large longitudinal study, the researchers found that one third of the older adults with diabetes who had experienced a severe low blood sugar episode (hypoglycemia) died within three years of the incident. […] The researchers say that their findings suggest that doctors might want to pay special attention to patients who have been sent to the emergency department for hypoglycemia after losing consciousness, having a seizure or experiencing another serious health event. […] Hypoglycemia is clearly an under-recognized risk factor for death and cardiovascular disease in people with diabetes.

• #18

  https://link.springer.com/article/10.1007/s00125-020-05366-3

  Hypoglycaemia (blood glucose concentration below the normal range) has been recognised as a complication of insulin treatment from the very first days of the discovery of insulin, and remains a major concern for people with diabetes, their families and healthcare professionals today. […] The main driver of hypoglycaemia in diabetes is glucose lowering therapy: exogenous insulin or insulin secretagogues, such as sulfonylureas. […] Severe hypoglycaemia occurs at a rate of 1.3 episodes per person per year in people with type 1 diabetes; but its occurrence is extremely skewed, with only 40% of individuals experiencing an episode in any one year, and 10% of adults with type 1 diabetes contributing nearly 70% of all episodes in the year, with many of these people reporting recurrent events. […] There is a growing body of evidence linking severe hypoglycaemia to future mortality both in hospital and in the community, with estimates of increased risk ranging from 50% to 600%. […] Hypoglycaemia has been a complication of diabetes treatments since the discovery of insulin, and remains a major concern for people with diabetes, their families and friends, and healthcare professionals and providers.

• #19 Hypoglycaemia (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/hypoglycaemia

  Hypoglycaemia epidemiology is uncommon in people without diabetes. […] Studies have also suggested that hypoglycaemia is associated with an increased risk of cardiovascular events and mortality. […] Severe hypoglycaemia is estimated to be associated with an increased future mortality risk of 50-60%.

• #20 Hypoglycemia Facts and Stats: What You Need to Know

  https://www.verywellhealth.com/facts-about-hypoglycemia-6504416

  A large prospective cohort study looking at hospitalized people with and without diabetes found that hypoglycemia, regardless of insulin use, was also associated with higher short- and long-term mortality. […] Research suggests that Blacks are more likely to experience hypoglycemia than Whites. […] In addition, older age is a risk factor for hypoglycemia. Women may be more likely than men to experience it. […] People who have experienced severe hypoglycemia seem to have an increased risk of mortality compared to those who have experienced mild or no hypoglycemia.

• #21 Hypoglycemia in patients with type 2 diabetes mellitus during hospitalization: associated factors and prognostic value | Diabetology & Metabolic Syndrome | Full Text

  https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-023-01212-9

  Hypoglycemia occurred in 154 (47.5%) patients during their hospitalization and was associated with advanced age, previous insulin therapy, higher Charlson Comorbidity Index, lower body mass index and lower baseline HbA1c values. […] Hypoglycemia was associated with greater in-hospital and long-term mortality, longer hospital stays, higher readmission rates, and poorer metabolic control after discharge. […] Hypoglycemia during hospital admission is a marker of a poor prognosis in patients with type 2 diabetes. […] The present study aimed to investigate, specifically in patients with T2DM, the risk factors for development of hypoglycemia during hospitalization, as well as the potential influence on short- and long-term mortality and glycemic control of mild and severe hypoglycemia during the hospital stay.

• #22 Hypoglycemia in patients with type 2 diabetes mellitus during hospitalization: associated factors and prognostic value | Diabetology & Metabolic Syndrome | Full Text

  https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-023-01212-9

  The present study shows that hypoglycemia in patients with T2DM, which is common during hospitalization (occurring in nearly a half of cases), is associated with increased in-hospital and long-term mortality, longer hospital stays, higher rates of readmission, and poorer metabolic control after discharge. […] Our study confirms the results of previous studies showing that hypoglycemia during hospitalization, insulin-mediated or not, is a marker of short-term mortality. […] Furthermore, it is one of the few studies that has analyzed the influence of hypoglycemia on long-term mortality, showing that it remains a risk factor after a follow-up period of up to 3 years after hospital discharge. […] The present results could have practical clinical implications. The results might help predict the risk of hypoglycemia in patients with T2DM who are admitted to the hospital.

• #23 Low Blood Sugar Emergencies Usually Go Unreported in Medical Records – Kaiser Permanente Division of Research

  https://divisionofresearch.kaiserpermanente.org/low-blood-sugar-emergencies-usually-go-unreported-in-medical-records/

  Severe episodes of hypoglycemia occur far more often than is captured in electronic medical records, according to research published today in a JAMA Internal Medicine research letter by Kaiser Permanente and Yale School of Medicine researchers. […] The new study, Surveillance of Hypoglycemia Limitations of Emergency Department and Hospital Utilization Data, showed that medical records captured about one in twenty of the severe hypoglycemic events reported by 13,359 Kaiser Permanente Northern California members with diabetes who participated in a survey conducted by the Diabetes Study of Northern California (DISTANCE). […] National monitoring of severe hypoglycemia is based on data for emergency department and hospital utilization, which clearly underestimates the scope of this growing public health problem.

• #24 Low Blood Sugar Emergencies Usually Go Unreported in Medical Records – Kaiser Permanente Division of Research

  https://divisionofresearch.kaiserpermanente.org/low-blood-sugar-emergencies-usually-go-unreported-in-medical-records/

  The new findings point to the need for a way to reliably capture a patients experience of severe hypoglycemic events. […] It is important to continue monitoring severe hypoglycemia using electronic medical records, as this is the only way to currently gauge national hypoglycemia trends. […] Funded by the National Institutes of Health, this research adds to a growing body of insights gleaned from DISTANCE, which launched in 2003 as a multifaceted effort to better understand social disparities in outcomes for diabetes patients. […] Our study shines a spotlight on a key area that is ripe for improvement, and we are hopeful that improved tracking of low blood sugar emergencies will enhance public health policy and clinical decision-making.

• #25 JMIR Diabetes – Diabetes Management Experience and the State of Hypoglycemia: National Online Survey Study

  https://diabetes.jmir.org/2020/2/e17890/

  Our findings suggest that while tremors are perceived to be less noticeable, frequent, or severe than other hypoglycemic symptoms such as sweating, changes in body temperature, and headache, in line with the literature, such hypoglycemic tremors occur at moderate frequency and are being noticed by most patients. Indeed, our study shows that more than 50% of the respondents encountered hypoglycemic events at least once a week. This is in line with the established evidence suggesting the rate of one to two mild episodes per week among patients with diabetes. Given this prevalence, there is a timely need for the detection and mitigation of mild hypoglycemia before becoming severe. […] In addition to these aggregate trends, our findings show gender- and age-specific differences. Although evidence suggests similar occurrence rates of severe hypoglycemia among males and females, our findings suggest that males perceive their hypoglycemic tremors more than females. These results are in line with previous findings, which suggest that men were found to have a higher level of adrenaline, which is believed to trigger hypoglycemic tremors. In addition, the younger population reported noticing their tremors significantly more than the older population. Similarly, those who had diabetes for a year or less reported noticing their tremors significantly more than those who had diabetes for a longer period. This evidence posits that recurrent hypoglycemia delays the onset of symptoms to lower levels of blood sugar and corroborates previous evidence that patients with a longer history of diabetes may lose sensitivity to hypoglycemic symptoms or perceive such symptoms less.

• #26 Hypoglycemia, Diabetic | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116305/all/Hypoglycemia_Diabetic?q=Gastroenteritis

  According to American Diabetic Association (ADA), hypoglycemia is defined as any blood sugar level 70 mg/dL. […] Most commonly found in patients with long-standing T1DM and children aged 7 years. […] From the ACCORD study, the annual incidence of hypoglycemia was the following: 3.14% in the intensive treatment group, 1.03% in the standard group, Increased risk among women, African Americans, those with less than high school education, aged participants, and those who used insulin at trial entry. […] RECAP-DM study: Hypoglycemia was reported in 35.8% of patients with T2DM who added a sulfonylurea or thiazolidinedione to metformin therapy during the past year.

• #27 Hypoglycaemia: A Diabetic Emergency | Ausmed

  https://www.ausmed.com/learn/articles/hypoglycaemia-a-diabetes-emergency

  Hypoglycaemia is a significant contributor to morbidity and mortality. In US hospitals, admission trends between 1999 to 2011 showed a reduction in hyperglycaemia presentations but an increase in hypoglycaemia. English hospital admission data for hypoglycaemia between 2005 and 2014 shows that 72% (72,568 admissions) occurred in people aged 60 years or older, whilst nearly one in five people had more than one admission during this nine-year period. […] The fear and anticipation of hypoglycaemia impacts the self-management of a person with diabetes and often prevents them from achieving optimal glycaemic control. […] For inpatients with diabetes, hypoglycaemia risks can be significant and may include: […] Patients with insulin-treated type 2 diabetes are more likely to require hospital admission for a severe hypoglycaemic episode compared to those with type 1 diabetes. […] Severe hypoglycaemia is estimated to be associated with an increased future mortality risk of 50 to 600%.

• #28 Hypoglycemia Prevention Initiative | Endocrine Society

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

  Average incidence of hypoglycemia among people with T2D on insulin is 23 mild or moderate events and 1 severe episode per year. […] Among Medicare-aged individuals, hospitalization for hypoglycemia is associated with a 30-day readmission rate of 18.1%. […] Primary care clinicians provide the majority of care for people with T2D.

• #29 The Lowdown On Low Blood Sugar | American Association of Clinical Endocrinology

  https://www.aace.com/disease-and-conditions/diabetes/lowdown-low-blood-sugar

  Low blood sugar, or hypoglycemia, is a potentially dangerous condition thats most common in people with diabetes. […] Low blood sugar, or hypoglycemia, causes approximately 100,000 emergency room visits per year in the U.S.

• #30 Diabetes Canada | Clinical Practice Guidelines

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

  Structured educational and psycho-behavioural programs (e.g. BG awareness training) may help improve detection of hypoglycemia and reduce the frequency of severe hypoglycemia (4043). […] People with diabetes who continue to have frequent and severe hypoglycemia and/or impaired awareness of hypoglycemia, despite educational interventions, may benefit from continuous subcutaneous insulin infusion (CSII) therapy or continuous glucose monitoring (CGM) or both (i.e. a sensor augmented pump), to reduce the risk of severe hypoglycemia (4447). […] Islet cell transplantation, which has been shown to reduce hypoglycemia (48) and restore glucose counter-regulation (49), should be considered for people with type 1 diabetes who experience recurrent severe hypoglycemia (50) (see Diabetes and Transplantation chapter, p. S145). […] Similarly, pancreas transplantation has been shown to reduce hypoglycemia and restore glucose counter-regulation (43,5153).

• #31 JMIR Diabetes – Diabetes Management Experience and the State of Hypoglycemia: National Online Survey Study

  https://diabetes.jmir.org/2020/2/e17890/

  The evidence presented in this paper also supports the need for wearable continuous monitoring tools beyond CGMs that are affordable, nonintrusive, and easy to use. Work is in progress to design and evaluate a hypoglycemia monitoring technology that utilizes sensors to detect hypoglycemic tremor and mobile health apps to enable self-management.

• #32 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 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. […] 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.

• #33 Food insecurity doubles rate of severe hypoglycemia in diabetic adults: Study  

  https://news.westernu.ca/2023/10/food-insecurity-doubles-rate-of-severe-hypoglycemia-in-diabetic-adults-study/

  Adults living with diabetes who can’t afford to put food on the table are at more than twice the risk of severe hypoglycemia. […] Severe hypoglycemia was 2.3 times as frequent in people taking insulin and/or secretagogues who reduced or skipped meals altogether compared to those not exposed to food insecurity. […] While food insecurity is known to impact health, its effect on level 3 hypoglycemia is unquantified in the U.S., said Ratzki-Leewing. […] We have shown that food insecurity is prevalent across this population in the U.S. and it more than doubles the rate of severe hypoglycemia. […] Not only does severe hypoglycemia cause dangerous acute symptoms, but it can also set the stage for long-term neurologic and cardiac harm, leading to premature death. […] The impact of the pandemic on the results is not clear, said Ratzki-Leewing, „but at the very least, we know that food insecurity can have a lasting effect on severe hypoglycemia rates even in the aftermath of the pandemic.” […] Ratzki-Leewing called for more research into these issues to better understand the population health impact of food insecurity.

• #34 Ozempic is growing in popularity — it’s also sending people to the ER | The Independent

  https://www.the-independent.com/news/health/ozempic-wegovy-side-effects-er-b2742812.html

  Now, research led by the scientists at the Centers for Disease Control and Prevention has found that tens of thousands of Americans have ended up in the emergency room after taking semaglutide: the active ingredient in GLP-1 drugs, including drugmaker Novo Nordisk’s Ozempic and Wegovy. […] Some people also came into emergency rooms with allergic reactions and hypoglycemia, which is also known as low blood sugar. […] Cohen said researchers didn’t expect to see so many patients seeking care for low blood sugar. […] Clinicians could counsel patients when initiating semaglutide about the potential for severe gastrointestinal adverse effects and adjust coprescribed antidiabetic medications to decrease hypoglycemia risk, they wrote. Additionally, when evaluating patients with new-onset gastrointestinal symptoms or hypoglycemia, clinicians could consider recent semaglutide use.

• #35 DeSantis signs 8 bills into law

  https://mynews13.com/fl/orlando/news/2025/05/01/desantis-signs-8-bills-into-law

  HB 597: Diabetes Management in Schools […] House Bill 597 gives school districts, and individual schools, the ability to maintain a supply of glucagon so they can respond during an emergency situation involving someone with diabetes. […] According to information U.S. National Institutes of Health, glucagon is used to treat hypoglycemia (low blood sugar levels) as opposed to insulin, which is used to treat hyperglycemia (high blood sugar levels). […] HB 597 amends Florida Statutes Section 1002.20 to include: „A school district or public school may acquire and maintain a supply of undesignated glucagon for the purpose of treating a student with diabetes experiencing a hypoglycemic emergency. Undesignated glucagon must be stored in a secure location on the school’s premises that is immediately accessible to a school nurse or other school personnel trained to administer glucagon pursuant to this paragraph.” […] The bill also lays out procedures for the district or school to acquire glucagon including standards for accepting donated glucagon allows health care practitioners to prescribe glucagon to school districts or individual public schools, and regulates who is authorized to give a glucagon injection during an emergency. […] HB 597 also gives any trained and authorized individual who gives, or tries to give, a glucagon injection and the district that employs them immunity from any civil or criminal liability that may arise from their actions.

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