Hypoglycemia in patients with insulin-treated diabetes

Hypoglycemia is the major barrier for optimal glycemic control in patients on maintenance insulin therapy. It is widely known that good glycemic control leads to prevention of or delay in the development of microvascular complications, and can reduce macrovascular events. It is thought that hypoglycemia may predispose patients to cognitive deterioration and may negatively affect the cardiovascular system. Hypoglycemia per se can contribute to a blunted counterregulatory response and disabling hypoglycemia, while hypoglycemia avoidance restores normal response to low blood glucose levels. There are some new approaches to reducing the incidence of hypoglycemia occurrence, including education programs, insulin regimens, the type of insulin used, as well as new technologies for insulin delivery and blood glucose measurement. However, none of these approaches have been able to eliminate the incidence of hypoglycemia completely. The current paper summarizes the physiology and major aspects of hypoglycemia-related health consequences and possible ways to avoid hypoglycemia.