Hypoglycemia in type 2 diabetes: a critical review.
Hypoglycemia is the most important barrier to tight glycemic control. Although severe hypoglycemia is uncommon, milder events can occur so often that they represent a deterrent to intensifying treatment. High-risk patient behaviors are the most important cause for episodes for which a cause can be identified. Because symptoms are an unreliable way of establishing the diagnosis, SMBG should be considered for the patients at highest risk, particularly as they approach their glycemic targets. SMBG is superior to HbA1c in forecasting the hypoglycemia rate because it provides information about glucose variability--an independent risk factor. Patient education and medication changes are potential ways of reducing the hypoglycemia rate. However, it remains to be proven that patient education is beneficial in this regard.
Murata
Glen H
GH
New Mexico VA Health Care System (111GIM) , 1510 San Pedro Drive SE, Albuquerque, NM 87108, USA. glen.murata@med.va.gov
Duckworth
William C
WC
Hoffman
Richard M
RM
Wendel
Christopher S
CS
Mohler
M Jane
MJ
Shah
Jayendra H
JH
D002940:Circadian Rhythm / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000150:complications* / Q000503:physiopathology