By: Brenda Neugent
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.