New Guidelines Published for Managing Hypoglycemia

Guidelines include recommendations for patients with or without diabetes
By A. Agrawal, PhD
HealthDay Reporter

THURSDAY, April 2 (HealthDay News) -- Hypoglycemia should only be evaluated and managed in patients with documented hypoglycemia, and hypoglycemia in the absence of diabetes should be investigated for the root causes, according to guidelines published in the March issue of the Journal of Clinical Endocrinology & Metabolism.

Philip E. Cryer, M.D., from Washington University School of Medicine in St. Louis, and colleagues reviewed and evaluated the available evidence on the evaluation and management of adults with hypoglycemic disorders, including diabetes mellitus.

The authors recommend that hypoglycemia should be evaluated and managed only in patients with documented symptoms and/or signs of hypoglycemia, low plasma glucose levels, and resolution of these conditions after raising glucose levels (Whipple's triad). In patients without diabetes, physicians should investigate possible reasons for the hypoglycemia, and in cases of endogenous hyperinsulinism, doctors should measure markers of glucose metabolism as well as insulin antibodies. In patients with diabetes mellitus, treatment with insulin or insulin secretagogues are the most common cause of hypoglycemia, they note.

"We recommend the practice of hypoglycemia risk factor reduction -- addressing the issue of hypoglycemia, applying the principles of intensive glycemic therapy, and considering both the conventional risk factors and those indicative of compromised defenses against falling plasma glucose concentrations -- in persons with diabetes," Cryer and colleagues write.

Several of the study authors have disclosed consulting relationships with pharmaceutical companies including Amgen, Merck, Novo Nordisk, Novartis, and Eli Lilly.

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