Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 1997
Frequency of severe hypoglycemia in patients with non-insulin-dependent diabetes mellitus treated with sulfonylureas or insulin.
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Bell D S, Yumuk V
Аннотация
OBJECTIVE: To assess the frequency of severe hypoglycemia in patients with non-insulin-dependent diabetes mellitus (NIDDM).
METHODS: We surveyed a single diabetologist's clinical practice of consecutive patients with NIDDM during a 3-month period.
RESULTS: Of the 262 study participants interviewed, 172 insulin-using and 90 sulfonylurea-using patients were asked whether they had ever had hypoglycemia severe enough to require the assistance of another person. Of the 90 sulfonylurea-treated patients with NIDDM, 3 (3.3%) reported experiencing severe hypoglycemia on one occasion only. Of the 172 insulin-utilizing patients, 13 (7.6%) had had severe hypoglycemic episodes--8 on one occasion only (5 of these had been iatrogenic circumstances and 3 had been precipitated by exercise or lack of food). Five insulin-requiring patients reported multiple bouts of severe hypoglycemia. With one exception, all patients were thin, and C peptide levels were low or undetectable.
CONCLUSION: On the basis of this study, we conclude that severe hypoglycemia is extremely uncommon in NIDDM. When it occurs, it is usually accidental and seldom recurs. Patients with multiple bouts of severe hypoglycemia have almost complete insulin deficiency. Thus, aggressive treatment of NIDDM to avoid diabetic complications is rarely associated with severe hypoglycemia and is usually well tolerated.
METHODS: We surveyed a single diabetologist's clinical practice of consecutive patients with NIDDM during a 3-month period.
RESULTS: Of the 262 study participants interviewed, 172 insulin-using and 90 sulfonylurea-using patients were asked whether they had ever had hypoglycemia severe enough to require the assistance of another person. Of the 90 sulfonylurea-treated patients with NIDDM, 3 (3.3%) reported experiencing severe hypoglycemia on one occasion only. Of the 172 insulin-utilizing patients, 13 (7.6%) had had severe hypoglycemic episodes--8 on one occasion only (5 of these had been iatrogenic circumstances and 3 had been precipitated by exercise or lack of food). Five insulin-requiring patients reported multiple bouts of severe hypoglycemia. With one exception, all patients were thin, and C peptide levels were low or undetectable.
CONCLUSION: On the basis of this study, we conclude that severe hypoglycemia is extremely uncommon in NIDDM. When it occurs, it is usually accidental and seldom recurs. Patients with multiple bouts of severe hypoglycemia have almost complete insulin deficiency. Thus, aggressive treatment of NIDDM to avoid diabetic complications is rarely associated with severe hypoglycemia and is usually well tolerated.