Treatment of hypoglycemia in diabetes patients: Updated clinical practise guideline from Endocrine Society

According to a Clinical Practice Guideline published by the Endocrine Society, people with diabetes are benefitting from improvements in drugs and technological advancements to reduce their risk of hypoglycemia.

The Endocrine Society's (ES) Journal of Clinical Endocrinology & Metabolism (JCEM), which released the guideline, will print it in the print edition of the March 2023 issue under the title "Management of Individuals with Diabetes at High Risk for Hypoglycemia: An ES Clinical Practice Guideline."

In diabetics, bouts of extremely low blood sugar are referred to as hypoglycemia. Severe hypoglycemia may have serious effects on a person's quality of life, social life, capacity to work productively, and ability to drive safely. Patients may suffer unconsciousness or seizures. Since many individuals do not feel or identify the symptoms, it is frequent in persons with type 1 diabetes, as well as in people with type 2 diabetes who are taking insulin or sulfonylureas.

This recommendation specifically addresses patients with hypoglycemia caused by diabetes and replaces the Society's 2009 inpatient hypoglycemia recommendation. It includes suggestions for employing novel glucagon and insulin formulations, as well as improvements in continuous glucose monitoring (CGM) and insulin pump technologies, to treat and control hypoglycemia more successfully.

In the last ten years, individuals with diabetes, including children, have utilised CGMs and insulin pumps significantly more often, and new types of glucagon are now readily accessible. In order to reflect these advancements in the diabetes sector, we have to alter our guidelines. Our guideline will provide a better knowledge of optimal practises and interventions for people with diabetes, their carers, and diabetes experts.

The guideline makes many important suggestions such as the following:

Giving patients with type 1 diabetes easier-to-use glucagon formulations;

Using CGM rather than self-monitoring of blood glucose by fingerstick;

Conducting inpatient glycemic surveillance and management programmes using electronic health record (EHR) data for inpatients at risk for hypoglycemia; and using organised patient education programmes for people with type 1 or type 2 diabetes who are undergoing insulin treatment.

References –

Anthony L McCall, David C Lieb, Roma Gianchandani, Heidemarie MacMaster, Gregory A Maynard, M Hassan Murad, Elizabeth Seaquist, Joseph I Wolfsdorf, Robin Fein Wright, Wojtek Wiercioch, Management of Individuals With Diabetes at High Risk for Hypoglycemia: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, 2022;, dgac596, https://doi.org/10.1210/clinem/dgac596

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