Management of diabetes-related hypoglycemia.(Review Article)(Disease/Disorder overview) Industry & Business Article - Research, News, Information, Contacts, Divisions, Subsidiaries, Business Associations Mortality and Morbidity of Severe Hypoglycemia Although statistics on prevalence and incidence of mortality and morbidity from hypoglycemia are lacking,
the likelihood of fatality appears low, (24) especially compared with deaths associated with diabetes. For example, the United Kingdom Prospective Diabetes Study in T2DM (4) found that each 1% reduction in A1c reduced risk of death, myocardial infarction, and microvascular complications (primarily retinopathy) by 21%, 14%, and 37%, respectively. Death due to hypoglycemia appears to be rare. When reported,
it is usually associated with the use of long-acting sulfonylureas by elderly patients, alcohol intake, unusual drug interactions, (25-27) or with the "dead-in-bed" syndrome, which has been anecdotally linked to nocturnal hypoglycemia. (28)
When hypoglycemia is severe, convulsions and coma can occur; autonomic stimulation resulting from hypoglycemia
can also have negative cardiac implications such as changes in heart rate, stroke volume, cardiac output, and myocardial contractility. (29) The neuroglycopenic symptoms of hypoglycemia may interfere with driving or other tasks requiring complex motor skills. Eye-hand coordination and decision-making can be compromised even with moderate hypoglycemia. (30,31) Blood glucose should be tested before driving and carbohydrates for self-treatment kept in vehicles. Because the effects of alcohol and hypoglycemia can be cumulative (32) and could combine with a loss of sensation from diabetes-related neuropathy, alcohol consumption represents a particular risk for individuals with diabetes who drive.
