Iatrogenic hypoglycemia in diabetic patients is underestimated problem

Abstract:

Iatrogenic hypoglycemia, often associated with oral agents such as sulphonylureas and insulin, is one of the major obstacles in achieving good glycemic control. Additionally, based on results of randomized clinical trials and observational studies, hypoglycemia has a profound short term and long term negative effect on mortality and morbidity. As the incidence of hypoglycemia is generally underestimated, there comes the belief that hypoglycemia exists primarily in patients with type 1 diabetes. According to the prevalence of type 2 diabetes and patient characteristics (age, polypharmacy, comorbidities), it seems as though hypoglycemia is a much greater economic and health related problem in this patient population. This is the reason why ADA/EASD guidelines emphasize the importance of avoiding hypoglycemia during diabetes treatment and suggest agents that help achieve good glycemic control on account of less hypoglycemia. Additionally, there have been new developments of agents such as incretins, SGT2 inhibitors and insulin analogues. Primarily, ultra-long acting basal insulin analogues are developed to overcome the problem of iatrogenic hypoglycemia. 

Key words:
diabetes; hypoglycemia; morbidity; mortality; therapy