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A joint study from Yale University School of Medicine and Kaiser Permanente discovered that certain types of medications can incite severely low blood sugar levels in Type 2 diabetics, regardless of how well or poorly they manage their condition.
Lab tests will reveal whether a patient has diabetes - The American Diabetes Association reported that Type 2 diabetes occurs when the body is unable to use insulin normally, otherwise known as insulin resistance. This makes the patient's blood sugar levels erratic and hard to control. To avoid further medical complications, diabetics need to monitor their insulin and glucose levels regularly.
According to the Mayo Clinic, increased physical activity can help people control their diabetes, as well as lose weight, lower blood glucose and increase the body's sensitivity to insulin. The source also suggested implementing more fiber into the diet to improve blood sugar levels, in addition to lowering the risk of heart disease and promoting weight loss. People who are at risk for diabetes can use fiber as a potential preventative measure.
Researchers noted that their findings challenge the common belief that severely low blood sugar, or hypoglycemia, is most often an issue for patients who have well-controlled diabetes, or low-average blood sugar levels. Hypoglycemia can cause some discomfort, but is often fixed with some food or drink. However, severe hypoglycemia will usually result in the patient needing assistance. It can incite dizziness, mental confusion, injury, car accident, coma, and, in some rare cases, death.
"Many clinicians may assume that hypoglycemia is not much of a problem in poorly controlled Type 2 diabetes given their high average blood sugar levels," said Andrew Karter, senior author of the report. "This study suggests that we should pay much closer attention to hypoglycemia, even in poorly controlled patients. Providers should explain the symptoms of hypoglycemia, how to treat it, and how to avoid it - for example, by not skipping meals."
Kasia Lipska, lead author of the study noted that hypoglycemia is the most common medical complication of diabetes medications. In clinical trials, those who were heavily medicated and were aiming for perfect control of blood glucose were much more likely to experience the condition. Lipska went on to say that it was not glucose levels that caused hypoglycemia, but rather the medications used to treat it.
Methods used in the study
The report used surveys completed by almost 9,000 Type 2 diabetes patients who were taking medications that lowered their blood glucose levels. The surveys focused primarily on the subjects' history with hypoglycemia. Previous studies have shown that hypoglycemia patients are at a higher risk for falls, fractures, heart attacks and dementia when compared with diabetics who have not experienced severely low blood sugar levels.
Out of the 9,000 surveyed, 11 percent reported having severe hypoglycemia within the past year. That number included diabetics at all levels of blood glucose control. The respondents were categorized by blood tests that determined their blood sugar levels. In the five categories, which were sorted from lowest to highest, the report found that those at the more extreme ends of the spectrum were most likely to have experienced hypoglycemia. The researchers noted that the differences were not necessarily significant, and that the condition had been experienced at all levels.
"While aggressive treatment of high blood sugar was once considered a hallmark of better care, recent clinical trials have raised concerns about the risks of tight control, particularly in the frail and elderly," said Karter.
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