Abstract
Glycaemic control in patients with type 1 or
long-standing type 2 diabetes can be difficult to achieve. This is
because of the need to have the reassurance of ‘safe’ – that is, high –
blood glucose levels to lessen the risk of hypoglycaemia and its
unpleasant symptoms and risk of serious associated problems.
Article Extract
Fear of hypoglycaemia and a need for the reassurance of
‘safe’ and high glucose levels often form a major barrier to patients
with diabetes achieving glycaemic control. Hypoglycaemia is feared
because its unpleasant symptoms, sense of loss of control and risk of
serious associated problems disrupt patients’ lives. Patients may need
to remain constantly aware of the risk of hypoglycaemia, monitor blood
glucose levels (BGLs) and consume extra carbohydrate frequently. They
may be embarrassed by their symptoms, or by their need for help from
another person. The threat, demands, loss of self-esteem and increased
dependency may be associated with the further burdens of anxiety,
depression and social isolation.
This article reviews the physiology of hypoglycaemia, the different
patterns in type 1 and type 2 diabetes, the common causes and treatment
of hypoglycaemia and the six ‘red flags’ that identify patients at high
risk of severe hypoglycaemia
