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Experts Target Hypoglycemia at ADA Conference


Jul 14, 2013

Hypoglycemia remains a complex issue for diabetes patients and their healthcare providers, according to the focus of a recent symposium.

Experts from across the globe spoke as part of an American Diabetes Association program, bringing to light some of the key concerns for those managing hypoglycemia in diabetes patients.

From inadequate use of continuous glucose monitoring systems to dangerous low blood sugar at night, experts weighed in on the top causes of hypoglycemia as well as the best treatments.

While continuous glucose monitoring has been a big step toward helping those with diabetes prevent hypoglycemia, it is not perfect, experts say.

"It has improved from earlier generations," said Dr. Irl B. Hirsch, Professor of Medicine at the Washington University School of Medicine. "But like many aspects of diabetes therapy, patients need to be active participants."

Learning how to properly use the device is the key toward its success, Hirsch added.

"Accuracy is lowest on its first day of use," he said. "It's been that way and it continues that way. Hopefully the technology will improve that."

Nocturnal hypoglycemia is a common- and dangerous- concern for diabetic patients using insulin, according to Dr. Stephanie Amiel, Professor of Diabetic Medicine at King's College London in the United Kingdom.

Surprisingly, the occurrence of nocturnal hypoglycemia is more likely if morning glucose levels are low, and does not appear to be related to bedtime glucose readings, she said.

Nocturnal hypoglycemia can result in coma, seizures, or death, and can also impact mood and fatigue levels the next day, she added. Treatment options include taking last doses of insulin before bed, rather than before the evening meal.

But diabetes is not always the cause of incidents of hypoglycemia.

Gastric bypass surgery can also result in hypoglycemia, said Dr. F. John Service, Professor of Medicine at the Mayo Clinic.

According to previous research, 10 to 15 percent of those who have gastric bypass surgery to lose weight experience hypoglycemia, which can be controlled by lifestyle changes including eating small meals spread evenly throughout the day to prevent spikes and drops in blood sugar levels, or with varied courses of drug treatments.


Categories: Continuous Glucose Monitoring, Gastric bypass surgery, Glucose Levels, Hypoglycemia, Insulin, Low Blood Sugar



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Comments

Posted by Anonymous on 18 July 2013

I have been on insulin since 1956. I use a CGM and it has made all the difference with scary nighttime lows. Because of hearing loss and the fact that the alarm pitch is so high, I cannot always hear the tone. But it wakes my wife up and she wakes me up and I deal with it. I have had nighttime lows as low as under 40. BUT I am very upset that Medicare won't pay for the sensors and I must pay over $35 each for them out of my own pocket. And they only last three days (although I can get some to last a couple of days longer). The CGM is no longer experimental, but it is essential and keeps me alive at night.

Posted by buzz on 30 January 2014

I'm a type one of forty-five years' duration. I use insulin pens for Humalog nd Lantus. I used a pump for six years but didn't like it. I don't want to use CGM, since testing 4-6 times/day works perfectly well for me.

I've devised a mental test for lows: I count 100-zero by sevens; then zero-156 by thirteens; then 100-zero by thirteens. I wonder how many others sometimes do this, and whether anyone in the medical professional might weigh in on the utility of this. I always test when I can, but occasionally it's difficult, e.g. when on the stationary bike at the gym.

What do others think?


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