What disease risk factor caused your hypoglycemia?
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Who is at risk for hypoglycemia?
While people who do not have any metabolic
problems can complain of symptoms suggestive of low blood sugar, true
hypoglycemia usually occurs in people being treated for diabetes (type 1 and
type 2). Individuals with pre-diabetes who have
insulin resistance can also have
low blood sugars on occasion if their high circulating insulin levels are further
challenged by a prolonged period of fasting. There are other rare causes for
hypoglycemia, such as insulin producing tumors (insulinomas) and certain
medications. These uncommon causes of hypoglycemia will not be discussed in this
article, which will primarily focus on the hypoglycemia occurring with diabetes
mellitus and its treatment.
Despite our advances in the treatment of diabetes, hypoglycemic episodes are
often the limiting factor in achieving optimal blood sugar control, because many
medications that are effective in treating diabetes carry the risk of lowering
the blood sugar level too much, causing symptoms of hypoglycemia. In large
scale studies looking at tight control in both type 1 and type 2 diabetes, low
blood sugars occurred more often in the patients who were managed most
intensively. This is important for patients and physicians to recognize,
especially as the goal for treating patients with diabetes become tighter blood sugar control.