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Severe Low Blood Sugar Occurs Often in Patients With Type 2 Diabetes
Date:7/30/2013

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

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

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

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

The researchers suggest that evaluations of quality of diabetes care should include adverse effects associated with treatment, such as hypoglycemia. "While aggres
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SOURCE Kaiser Permanente
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