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Basics

Description
Epidemiology

Incidence

  • Rare in persons not treated for diabetes.
  • Severe hypoglycemia (episodes per 100 patients/year)
    • Type 1 diabetic: 11.5
    • Type 2 diabetic treated with oral hypoglycemic agents: 0.05
    • Type 2 diabetes treated with insulin: 11.8
    • Elderly patients: 2
  • Neonates: 1–5 per 1,000 live birth; higher incidence in large-for-gestational age, preterm, and intrauterine growth restricted (IUGR) infants, as well as those born to diabetic mothers.

Morbidity

Increased when intensive insulin therapy (IIT) in the medical intensive care unit (ICU) is implemented; particularly in patients with renal or hepatic failure.

Etiology/Risk Factors
Physiology/Pathophysiology
Prevantative Measures

Diagnosis

Differential Diagnosis

Treatment

Follow-Up

References

  1. Zammitt NN , Frier BM. Hypoglycemia in type 2 diabetes. Diabetes Care. 2005;28:29482961.
  2. Cryer PE. Management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2007;30(1):190192.
  3. Workgroup on Hypoglycemia, American Diabetes Association . Defining and reporting hypoglycemia in diabetes: A report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care. 2005;28(5):12451249.
  4. Gabriely I , Shamoon H. Hypoglycemia in diabetes: Common, often unrecognized. Cleve Clin J Med. 2004;71(4):335342.
  5. Wintergerst KA , Buckingham B , Gandrud L , et al. Association of hypoglycemia, hyperglycemia, and glucose variability with morbidity and death in the pediatric intensive care unit. Pediatrics. 2006;118(1):173179.
  6. NICE-SUGAR Study Investigators , Finfer S , Chittock DR , et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):12831297.
  7. Vann MA. Perioperative management of ambulatory surgical patients with DM. Curr Opin Anaesthesiol. 2009;22(6):718724.

Additional Reading

See Also (Topic, Algorithm, Electronic Media Element)

Codes

ICD9

251.2 Hypoglycemia, unspecified

ICD10

E16.2 Hypoglycemia, unspecified

Clinical Pearls

Author(s)

Michael S. Green , DO

Poovendran Saththasivam , MD