Hypoglycemia

Iatrogenic hypoglycemia causes recurrent physical and recurrent or even persistent psychosocial morbidity, and some mortality, in patients with insulindependent diabetes mellitus (IDDM), and in some patients with non-insulin-dependent diabetes mellitus (NIDDM) (1,2). There is now compelling evidence, from the Diabetes Control and Complications Trial (DCCT), that metabolic control delays the development and progression of retinopathy, nephropathy and neuropathy in IDDM, albeit at the expense of an increased frequency of treatment-induced hypoglycemia (3). These findings will almost assuredly provide further impetus to patients and health care providers to attempt to maintain plasma glucose levels as close to the nondiabetic range as possible. If so, hypoglycemia will become an even more common problem for patients with diabetes in the near future.