Hypoglycemia: The neglected complication
Open accessAbstract
Hypoglycemia is an important complication of glucose-lowering therapy in patients with diabetes mellitus. Attempts made at intensive glycemic control invariably increases the risk of hypoglycemia. A six-fold increase in deaths due to diabetes has been attributed to patients experiencing severe hypoglycemia in comparison to those not experiencing severe hypoglycemia Repeated episodes of hypoglycemia can lead to impairment of the counter-regulatory system with the potential for development of hypoglycemia unawareness. The short- and long-term complications of diabetes related hypoglycemia include precipitation of acute cerebrovascular disease, myocardial infarction, neurocognitive dysfunction, retinal cell death and loss of vision in addition to health-related quality of life issues pertaining to sleep, driving, employment, recreational activities involving exercise and travel. There is an urgent need to examine the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this neglected life-threatening complication. Early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens with minimal or no risk of hypoglycemia and appropriate educational programs for healthcare professionals and patients with diabetes are the major ways forward to maintain good glycemic control, minimize the risk of hypoglycemia and thereby prevent long-term complications.
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Autoimmune conditions such as adrenal insufficiency and other endocrine diseases can lead to hypoglycemic episodes.
“Moreover, autoimmune conditions such as adrenal insufficiency and other endocrine diseases can lead to hypoglycemic episodes [ 9 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [9]
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- Authors
- Kalra, S., Mukherjee, J. J., Venkataraman, S., Bantwal, G., Shaikh, S., Saboo, B., Das, A. K., & Ramachandran, A.
- Affiliations
- Bharti Hospital (IN)
- Apollo Gleneagles Hospitals (IN)
- Apollo Hospitals (IN)
- St.John's Medical College Hospital (IN)
- Saifee Hospital (IN)
- Department of Diabetology, Dia Care Diabetes Care Centre, Ahmedabad, India
- Department of Endocrinology, JIPMER, Pondicherry, India
- Dr. A. Ramachandran's Diabetes Hospitals (IN)
- Corresponding author
- Kalra, Sanjay
- ORCID
- Venue
- Indian Journal of Endocrinology and Metabolism
- Published
- 2013-09
- Volume
- 17
- Issue
- 5
- Pages
- 819-834
- ISSN
- 2230-8210 (ISSN-L)
- 2230-9500
- PMC
- PMC3784865
- OpenAlex
- W2132584783
- Cited by
- 255
- References
- 168
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 22 · 2023: 24 · 2022: 35 · 2021: 31 · 2020: 44 · 2019: 21 · 2018: 24 · 2017: 9 · 2016: 10 · 2015: 8 · 2014: 6
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Indian Journal of Endocrinology and Metabolism (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- 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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- hypoglycemia, diabetes mellitus, glucose-lowering therapy, tight glycemic control, hypoglycemia unawareness, cerebrovascular disease, myocardial infarction, neurocognitive impairment, retinal cell death, health-related quality of life, self-monitoring of blood glucose, hypoglycemia risk factors, diabetes education
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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