Can certain factors predict low blood glucose levels in insulin-treated diabetics?

This study examined the number of insulin-treated patients who experience hypoglycemia and the predictive factors for hypoglycemia.

Hypoglycemia occurs when the blood glucose (sugar) levels drop below 3.9 mmol/L. In patients with diabetes, insulin use can cause low blood glucose levels. Patients with type 1 diabetes (T1D) are dependent on insulin. Only some patients with type 2 diabetes (T2D) will require insulin. All insulin-treated diabetics have a high risk of experiencing hypoglycemia. 

Hypoglycemia may be severe or non-severe. Patients experiencing severe hypoglycemia may have a seizure and, if left untreated, this may result in death. Memory impairment is known to occur in patients who frequently experience hypoglycemia. Therefore, it is important to prevent such episodes. Identifying factors which may predict whether a patient will develop hypoglycemia is necessary for prevention.

This study aimed to determine the prevalence and predictive factors of hypoglycemia in insulin-treated diabetics.

3048 patients completed daily questionnaires for 30 days reporting the daily frequency of hypoglycemia over 30 days. 3743 patients completed a questionnaire reporting the frequency of hypoglycaemia over the prior year.

85.3% of T1D patients experienced at least one hypoglycemic episode over 30 days. 43.6% of T2D patients experienced at least one hypoglycemic episode over 30 days. 31.5% of T1D patients and 21.7% of T2D patients experienced severe hypoglycemia in the previous year.

Patients who had previous hypoglycemia were more likely to have another episode. Patients who took more than two daily injections were also more likely to experience low blood glucose levels. A body mass index (BMI – measure of body fat based on weight and height) less than 30 kg/m² could predict hypoglycemia. A longer duration of insulin use (more than 10 years) could also predict hypoglycemia.

This study concluded that hypoglycemia has a high frequency in insulin-treated diabetics. Previous hypoglycemia, the number of daily injections, BMI and duration of insulin use increase the risk of hypoglycemia.

The frequency of hypoglycemia was based on patient self-reporting. It is also likely that the patients recruited had a higher risk of experiencing hypoglycemia. This indicates that the true prevalence of hypoglycemia may be lower. 

Consult your physician regarding the measures which can be taken reduce the risk of hypoglycemia.