Hypoglycemia in Type 2 Diabetes

Hypoglycemia can catch many type 2s unaware.

| Oct 11, 2011


UPDATE: The American Association of Clinical Endocrinologists is addressing the issue raised below by launching a program called "Blood Sugar Basics." You can access it on an interactive website at www.BloodSugarBasics.com


Hypoglycemia, or low blood sugar, is commonly perceived as a concern for people with type 1, not type 2, diabetes. However, hypos are a potential risk for anyone using insulin, and approximately 50 percent of people with type 2 diabetes are insulin-dependent. Recent research suggests that many of these patients are unaware of the risks and symptoms of hypoglycemia.

According to new survey data released at the American Association of Clinical Endocrinologists (AACE) 20th Annual Meeting and Clinical Congress, more than half (55 percent) of Americans with type 2 diabetes report they have experienced hypoglycemia. What's more, many experienced it during typical daily activities such as working (42 percent), exercising (26 percent), and driving (19 percent).

Recognizing symptoms like nervousness, sweating, or shakiness before engaging in common activities is important to help reduce the risk of serious consequences, such as fainting or loss of consciousness.

"While most people with diabetes recognize the importance of avoiding high blood sugar, they may not know the risks of extremely low blood sugar," says Farhad Zangeneh, MD, FACP, FACE, the medical director and endocrinology consultant at the Endocrine, Diabetes and Osteoporosis Clinic (EDOC) and member of the American Association of Clinical Endocrinologists (AACE) Board of Directors. "Skipping meals, drinking too much alcohol, and changing exercise routines can all contribute to low blood sugar; patients may also need to adjust their medications and should talk with their doctor about any episodes of low blood sugar."

The online survey of more than 2,500 adults living with type 2 diabetes was designed by the American College of Endocrinology (ACE) and supported by Merck. Its results indicated the following:

· 27 percent of type 2s were unable to name the leading cause of hypoglycemia
· 35 percent did not know the diabetes medications that can cause hypos
· 46 percent were not aware that unusual increased exercise can cause hypos
· 52 percent were concerned about repeat episodes of hypoglycemia, but did not know that the most common symptoms are dizziness (22 percent) and shakiness (17 percent), and 39 percent incorrectly thought that thirst was the primary symptom of hypoglycemia.
· 6 percent of patients who responded to the online survey had been treated for hypoglycemia in the emergency room.

Kelly Love Johnson, who has lived with type 2 diabetes for six years, says, "I had to do my own research to find out that it's crucial to have a blood glucose that fluctuates less than 50 to 60 mg/dL (my ideal blood glucose range is 70 to 110 mg/dL), and it's the wide fluctuations (or highs and lows) that we need to worry about." Dr. Zangeneh agrees, saying, "Low is bad and high is bad. What we want is for our patients to have a nice flight from the East coast to the West coast with no turbulence."

The endocrinologists in the American College of Endocrinology are very concerned about the lack of knowledge that type 2s have about hypoglycemia. They are addressing the issue by launching a program called "Blood Sugar Basics," an educational program with an interactive website. The website includes fact pages that help people with diabetes, their families, and their loved ones learn about the importance of understanding and managing low and high blood sugar. Dr. Zangeneh, who is on the Blood Sugar Basics board of directors, reports that the website is user-friendly and will empower patients with knowledge. "Education, education, education," he says. "The best way to treat a low is to avoid it. You need to be an ongoing student when you have diabetes."



1. http://care.diabetesjournals.org/content/28/12/2948.full.pdf
2. Linekin, P. Present Diabetes, AACE Study::Patients with diabetes are uninformed about hypoglycemia. Retrieved from: http://www.presentdiabetes.com/etalk/AACE-StudyPatients-with-t3934.html#-1


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Categories: Blood Sugar Basics, Diabetes, Diabetes, Hypoglycemia, Hypoglycemia Unawareness, Insulin, Low Blood Sugar, Type 2 Diabetes, Type 2 Issues

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Posted by seashore on 18 October 2011

The article proclaims loudly that "Low [blood glucose] is bad and high is bad", but gives no quantitative information about what glucose reading is too low and what reading is too high. If they are unwilling to be precise, why bother to write the article.

There is definite evidence that the body is damaged when blood glucose exceeds 150 mg/dl, and probably when it exceeds 140 mg/dl. Ideally one would like to keep blood glucose above 70 mg/dl, and it is dangerous to let it fall below 60 mg/dl.

These are the limits that I follow. If the author has better limits, they should be stated.

Posted by bonnynemia on 18 October 2011

According to the American College of Sports Medicine (ACSM), a type 2 diabetic who uses exercise as his only anti-diabetes medication has zero chance of suffering from hypoglycemia.

For more than 20 years now, exercise has been my only anti-diabetes medication and I have been proving to myself that hypoglycemia will never be a problem for me.


Posted by Anonymous on 19 October 2011

I find that the first indication that my blood glucose level is low is bad temper! I feel very angry about relatively trivial annoyances such as a slow-moving queue in the supermarket or someone's silly mistakes. I always carry an emergency snack - I find a few nuts work well. I have type 2 and do not use insulin or other medication.

Posted by Anonymous on 19 October 2011

According to the American College of Sports Medicine (ACSM), a type 2 diabetic who uses exercise as his only anti-diabetes medication has zero chance of suffering from hypoglycemia.

For more than 20 years now, exercise has been my only anti-diabetes medication and I have been proving to myself that hypoglycemia will never be a problem for me.

Zero risk? That seems a little broad minded. I have had hypoglycemia since age 6 and now as an adult I have Type 2, no meds. Exercise can see my blood sugar from 170 - 54 in 20 mins, that is not zero risk!!

Posted by Brenda on 23 October 2011

My husband has type 1 diabetes after being diagnosed with type 2 for five years. Since he is now type 1, he takes much better care of himself and also takes his disease much more seriously. I, too eat healthy diet and exercise with him for support. I feel this is very important. Just in the past few months I have noticed that my glucose levels are too low. I am having test run in two weeks to find out if I too have diabetes.. GOD BLESS

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