Recommendations of the International Hypoglycaemia Study Group
| People with diabetes treated with a sulfonylurea, a glinide, or insulin should . |
|---|
| • Be educated about hypoglycemia. |
| • Treat SMPG levels ≤70 mg/dL (3.9 mmol/L) to avoid progression to clinical iatrogenic hypoglycemia. |
| • Regularly be queried about hypoglycemia, including the glucose level at which symptoms develop. Those developing symptoms at a glucose level <55 mg/dL (3.0 mmol/L) should be considered at risk. |
| When hypoglycemia becomes a problem, the diabetes health-care provider should |
| • Consider each conventional risk factor and those indicative of compromised glucose counterregulation. |
| • Avoid sulfonylureas (and glinides) if possible, using insulin analogs when insulin is required, and consider using CSII, CGM, and CSII + CGM in selected patients. |
| • Provide structured education and, in patients with impaired awareness of hypoglycemia, prescribe short-term scrupulous avoidance of hypoglycemia. |
| • Seek to achieve the lowest A1C level that does not cause severe hypoglycemia and preserves awareness of hypoglycemia with an acceptable number of less-than-severe episodes of hypoglycemia, provided that benefit from glycemic control can be anticipated. |
| People with diabetes treated with a sulfonylurea, a glinide, or insulin should . |
|---|
| • Be educated about hypoglycemia. |
| • Treat SMPG levels ≤70 mg/dL (3.9 mmol/L) to avoid progression to clinical iatrogenic hypoglycemia. |
| • Regularly be queried about hypoglycemia, including the glucose level at which symptoms develop. Those developing symptoms at a glucose level <55 mg/dL (3.0 mmol/L) should be considered at risk. |
| When hypoglycemia becomes a problem, the diabetes health-care provider should |
| • Consider each conventional risk factor and those indicative of compromised glucose counterregulation. |
| • Avoid sulfonylureas (and glinides) if possible, using insulin analogs when insulin is required, and consider using CSII, CGM, and CSII + CGM in selected patients. |
| • Provide structured education and, in patients with impaired awareness of hypoglycemia, prescribe short-term scrupulous avoidance of hypoglycemia. |
| • Seek to achieve the lowest A1C level that does not cause severe hypoglycemia and preserves awareness of hypoglycemia with an acceptable number of less-than-severe episodes of hypoglycemia, provided that benefit from glycemic control can be anticipated. |