Severe Hypoglycemia Common Despite Blood Glucose Control

The results of a recent study show that hypoglycemia is not just a problem for patients with well-controlled diabetes but is common among type 2 DM patients across all levels of glycemic control.

The study, published online on July 30, 2013, in Diabetes Care, assessed the relationship between glycated hemoglobin (A1C) levels and self-reported severe hypoglycemia in 9094 patients with type 2 DM treated with glucose-lowering therapy. Participants were taken from a large, integrated health care system and were surveyed about episodes of severe hypoglycemia and their last A1C level collected the year before the study. Patients were categorized into 5 groups based on A1C levels, and the rates for hypoglycemia were calculated for each.

Overall, 10.8% of participants reported severe hypoglycemia. The results indicated that patients with the highest and lowest A1C values had the greatest risk of hypoglycemia compared with those who reported levels in the middle range. After adjusting for age, diabetes duration, and category of diabetes medications, the lowest rate of hypoglycemia per A1C group was 9.3%, and the highest rate was 13.8%.

“This study suggests that we should pay much closer attention to hypoglycemia, even in poorly controlled patients,” said senior author and study principal investigator, Andrew Karter, PhD, in a press release. “Providers should explain the symptoms of hypoglycemia, how to treat it, and how to avoid it—for example, by not skipping meals.”