ABSTRACT
Hypoglycemia is the greatest fear of patients treated with insulin. Hypoglycemia in patients with type 1 diabetes is a major source of disruption to their lives. It also occurs in patients treated with sulfonylureas, although to a lesser extent. Over 30% of insulintreated diabetic patients experience hypoglycemic coma at least once in their lives, and approximately 3% experience frequent and severe episodes. In the Diabetes Control and Complications Trial, the incidence of severe hypoglycemia was much greater and was approximately three times higher in the intensively treated group. Severe hypoglycemia occurred more often during sleep.The main causes are excessive doses of insulin or sulfonylureas, inadequate or delayed ingestion of food and sudden or prolonged exercise, although such factors caused only a minority of episodes of severe hypoglycemia in the trial.
