Cited by 229Diabetes Management and ResearchDiabetes Treatment and ManagementPatient Safety and Medication Errors

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Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies

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Silbert, Richard, Salcido-Montenegro, Alejandro, Rodriguez-Gutierrez, Rene, Katabi, Abdulrahman, McCoy, Rozalina G.·2018·Current Diabetes Reports

DOI 10.1007/s11892-018-1018-0PMC PMC6117835

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Abstract

Purpose of ReviewHypoglycemia is the most common and often treatment-limiting serious adverse effect of diabetes therapy. Despite being potentially preventable, hypoglycemia in type 2 diabetes incurs substantial personal and societal burden. We review the epidemiology of hypoglycemia in type 2 diabetes, discuss key risk factors, and introduce potential prevention strategies.Recent FindingsReported rates of hypoglycemia in type 2 diabetes vary widely as there is marked heterogeneity in how hypoglycemia is defined, measured, and reported. In randomized controlled trials, rates of severe hypoglycemia ranged from 0.7 to 12 per 100 person-years. In observational studies, hospitalizations or emergency department visits for hypoglycemia were experienced by 0.2 (patients treated without insulin or sulfonylurea) to 2.0 (insulin or sulfonylurea users) per 100 person-years. Patient-reported hypoglycemia is much more common. Over the course of 6 months, 1–4% non-insulin users reported need for medical attention for hypoglycemia; 1–17%, need for any assistance; and 46–58%, any hypoglycemia symptoms. Similarly, over a 12-month period, 4–17% of insulin-treated patients reported needing assistance and 37–64% experienced any hypoglycemic symptoms. Hypoglycemia is most common among older patients with multiple or advanced comorbidities, patients with long diabetes duration, or patients with a prior history of hypoglycemia. Insulin and sulfonylurea use, food insecurity, and fasting also increase hypoglycemia risk. Clinical decision support tools may help identify at-risk patients. Prospective trials of efforts to reduce hypoglycemia risk are needed, and there is emerging evidence supporting multidisciplinary interventions including treatment de-intensification, use of diabetes technologies, diabetes self-management, and social support.SummaryHypoglycemia among patients with type 2 diabetes is common. Patient-centered multidisciplinary care may help proactively identify at-risk patients and address the multiplicity of factors contributing to hypoglycemia occurrence.

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Authors: Silbert, R., Salcido-Montenegro, A., Rodriguez-Gutierrez, R., Katabi, A., & McCoy, R. G.
Affiliations: Mayo Clinic (US)
Corresponding author: McCoy, Rozalina G.
ORCID: Katabi, Abdulrahman
McCoy, Rozalina G.
Venue: Current Diabetes Reports
Publisher: Springer Science and Business Media LLC
Published: 2018-06-21
Volume: 18
Issue: 8
Pages: 53-53
ISSN: 1534-4827 (ISSN-L)
1539-0829
DOI: 10.1007/s11892-018-1018-0
PMC: PMC6117835
OpenAlex: W2809031508
Semantic Scholar: d6d2b9f681259ecdf86d479f18c51145da848f3e
Cited by: 229
References: 126
Citations by year: 2026: 15 · 2025: 34 · 2024: 42 · 2023: 47 · 2022: 36 · 2021: 24 · 2020: 15 · 2019: 14 · 2018: 1
FWCI: 2.08
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Current Diabetes Reports (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: Mayo Clinic
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK114497)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Keywords: hypoglycemia, type 2 diabetes, hypoglycemia risk factors, hypoglycemia prevention, insulin therapy, sulfonylureas, food insecurity, fasting, diabetes duration, comorbidities, clinical decision support, treatment deintensification, diabetes self-management, diabetes technology, multidisciplinary care
MeSH terms: Blood Glucose, Diabetes Mellitus, Type 2, Humans, Hypoglycemia, Risk Factors, Randomized Controlled Trials as Topic

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Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies

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