Abstract
Hypoglycemia is one of the major barriers in optimizing glycemic control. In type 2 diabetes, hypoglycemia is associated with multiple morbidities (eg, myocardial ischemia, cardiac arrhythmia, stroke, dementia, psychosocial dysfunction, obesity, microvascular complications, cancer, and diseases of respiratory, digestive, and dermatological systems). Risk factors associated with hypoglycemia in patients with type 2 diabetes include old age, long disease duration, low body mass index, high baseline glycated hemoglobin (HbA1c), treatment with insulin and sulphonylurea, renal dysfunction, albuminuria, reduced level of low density lipoprotein cholesterol, low triglyceride and depression. There are considerable overlaps between phenotypes associated with severe hypoglycemia and all-site cancer suggesting that hypoglycemia may be a marker of vulnerability. In patients with severe hypoglycemia, comprehensive assessment is recommended to detect silent conditions, such as renal dysfunction, cancer, depression as well as review of treatment strategies including drug use to prevent morbidities and mortality.
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Alice P.S. Kong has received honorarium for consultancy or giving lectures from Abbott, Astra Zeneca, Sanofi, Novo-Nordisk, Eli-Lilly, Merck Serono, Pfizer, and Nestle. Juliana C.N. Chan has received research grant and/or honorarium for consultancy or giving lectures, from Bayer, Boehringer Ingelheim, Daiichi-Sankyo, Eli-Lilly, GlaxoSmithKline, Merck Sharp and Dohme, Merck Serono, Pfizer, Astra Zeneca, Sanofi, Novo-Nordisk, and/or Bristol-Myers Squibb. The proceeds have been partially donated to the Chinese University of Hong Kong, American Diabetes Association, and other charity organizations to support diabetes research and education.
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This article is part of the Topical Collection on Pharmacologic Treatment of Type 2 Diabetes
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Kong, A.P.S., Chan, J.C.N. Hypoglycemia and Comorbidities in Type 2 Diabetes. Curr Diab Rep 15, 80 (2015). https://doi.org/10.1007/s11892-015-0646-x
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DOI: https://doi.org/10.1007/s11892-015-0646-x