Diabetes complications and comorbidities: Hypoglycemia

Severe hypoglycemia in people with type 2 diabetes is associated with later mortality from a wide range of causes, including those for which there is no obvious underlying mechanism, say researchers.

People with type 1 diabetes treated with multiple daily insulin injections struggle to achieve guideline-recommended targets for time in hypoglycemia while simultaneously reaching their glycated hemoglobin goals, researchers report.

Continuous glucose monitoring is well accepted and reduces time in hypoglycemia among older individuals with type 1 diabetes, report researchers in JAMA.

A proof-of-concept study indicates that taking some basal insulin as a single injection of degludec improves glucose control during and after exercise in people with type 1 diabetes who prefer to remove their insulin pump while exercising.

A major study of children from three continents suggests that diabetic ketoacidosis remains unacceptably high among those newly identified with type 1 diabetes and shows few signs of improving.

A large observational study reveals a strong link between reduced kidney function and increased incidence of hypoglycemia in adults with diabetes in routine clinical practice.

Fasting C-peptide levels can “provide valuable information” to guide the approach to titrating basal insulin in new users with type 2 diabetes, say researchers.

Three-quarters of people who undergo islet transplantation for type 1 diabetes have sustained graft survival with associated improvements in glucose control, insulin requirements, and hypoglycemia incidence 10 years later, research shows.

Simon Heller explains why time-in-range targets are so helpful for people with diabetes… yet handing out continuous glucose monitoring devices willy-nilly could do more harm than good.

Implementing a nursing protocol that includes point-of-care testing at triage reduces the time to diabetic ketoacidosis diagnosis and the number of unnecessary intravenous placements in the pediatric emergency department, say researchers.

Glycated hemoglobin levels correlate strongly with continuous glucose monitoring-measured average blood glucose and hyperglycemia, but poorly with hypoglycemia, say researchers.

Children with type 1 diabetes are more likely than their non-diabetic peers to seek primary care for a number of specific conditions in the year before their diagnosis, which could aid detection before the onset of diabetic ketoacidosis, say researchers.

Experts have developed consensus recommendations for minimizing diabetic ketoacidosis risk in patients with type 1 diabetes treated with SGLT inhibitors.

The hepatoselective glucokinase activator TTP399 reduces glycated hemoglobin levels without increasing the risk for hypoglycemia among patients with type 2 diabetes, suggest findings from the phase IIb AGATA trial.

The addition of empagliflozin to insulin therapy reduces glycated hemoglobin levels in patients with type 1 diabetes, indicate findings from the phase III EASE-2 and 3 trials.

Advisory Board member Theresa Smyth tackles an emergency case in a type 2 diabetes patient treated with empagliflozin. What went wrong and how should he be managed?

Editorial Board member Lori Berard discusses how the ambulatory glucose profile is quietly revolutionizing the analysis of blood glucose and glycemic control for patients and practitioners.

Lucidi P et al. Curr Diab Rep 2018; 18: 83. doi: 10.1007/s11892-018-1065-6

Research shows that starting second-line sulfonylurea treatment is associated with an increased risk for cardiovascular and hypoglycemic events among patients with type 2 diabetes in clinical practice, although the risk is less if they continue using metformin rather than switching completely.

Neither the rate of administration nor the sodium chloride content of replacement fluids given to children with diabetic ketoacidosis influences their neurologic outcomes, show the results of the PECARN DKA FLUID Study.