Hypoglycemia revisited in the acute care setting

Shih Hung Tsai, Yen Yue Lin, Chin Wang Hsu, Chien Sheng Cheng, Der Ming Chu

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Hypoglycemia is a common finding in both daily clinical practice and acute care settings. The causes of severe hypoglycemia (SH) are multi-factorial and the major etiologies are iatrogenic, infectious diseases with sepsis and tumor or autoimmune diseases. With the advent of aggressive lowering of HbA1c values to achieve optimal glycemic control, patients are at increased risk of hypoglycemic episodes. Iatrogenic hypoglycemia can cause recurrent morbidity, sometime irreversible neurologic complications and even death, and further preclude maintenance of euglycemia over a lifetime of diabetes. Recent studies have shown that hypoglycemia is associated with adverse outcomes in many acute illnesses. In addition, hypoglycemia is associated with increased mortality among elderly and non-diabetic hospitalized patients. Clinicians should have high clinical suspicion of subtle symptoms of hypoglycemia and provide prompt treatment. Clinicians should know that hypoglycemia is associated with considerable adverse outcomes in many acute critical illnesses. In order to reduce hypoglycemia-associated morbidity and mortality, timely health education programs and close monitoring should be applied to those diabetic patients presenting to the Emergency Department with SH. ED disposition strategies should be further validated and justified to achieve balance between the benefits of euglycemia and the risks of SH. We discuss relevant issues regarding hypoglycemia in emergency and critical care settings.

Original languageEnglish
Pages (from-to)898-908
Number of pages11
JournalYonsei Medical Journal
Volume52
Issue number6
DOIs
Publication statusPublished - Nov 2011
Externally publishedYes

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Keywords

  • Anti-diabetic agents
  • Diabetes mellitus
  • Emergency medicine
  • Hyperglycemia
  • Hypoglycemia
  • Insulin
  • Intensive care unit

ASJC Scopus subject areas

  • Medicine(all)

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