Hypoglycemia Consequences

Acute Consequences of Severe Hypoglycemia

There are multiple acute consequences that are of concern with severe hypoglycemia.

Acute changes in body functions can result, including

• cognitive impairment

• mood changes

• hypothermia

• neuroglycopenia

• autonomic changes, and

• general malaise.¹

Activities that can be affected or impaired include

• work performance

• driving performance, and

• social functions.¹

Increased mortality and acute morbidity can also occur, as well as increased risk of

• accidents and falls

• injuries

• comas and seizures

• cardiovascular events, and

• cerebrovascular events.^1,2

Long-term Consequences of Severe Hypoglycemia

There are multiple long-term consequences that are of concern with severe hypoglycemia.

Personal repercussions of severe hypoglycemia include

• hypoglycemia fear

• decreased quality of life, and

• weight gain due to defensive eating to avoid hypoglycemia.^1,3

Repeated hypoglycemia events cause an impaired awareness of hypoglycemia. These repeated hypoglycemia events results in a reduction in the glucose level that triggers the counterregulatory response during subsequent hypoglycemia events.^1,2

Many social and personal activities can be affected, including

• social, educational, and sporting activities

• personal relationships, and

• employment and driving restrictions.¹

Possible worsening of diabetic and vascular complications may occur, as well as increased cardiovascular complications, including

• MI

• myocardial ischemia, and

• cardiac arrythmia.¹

Increased neurological complications may occur, including

• cognitive function and impairment of development

• coma

• seizures

• stroke or TIA

• cognitive decline and possible onset or worsening of dementia, and 

• brain damage.¹

Increased all-cause mortality is also a long-term consequence of severe hypoglycemia.^4-6

References

The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).

1. Frier BM. Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications. Nat Rev Endocrinol. 2014;10(12):711-722. http://dx.doi.org/10.1038/nrendo.2014.170

2. Seaquist ER, Anderson J, Childs B, et al. Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care. 2013;36(5):1384-1395. http://dx.doi.org/10.2337/dc12-2480

3. Jodar-Gimeno E, Alvarez-Guisasola F, Avila-Lachica L, et al. Quality of life and fear for hypoglycemia in patients with type 2 diabetes mellitus. Rev Clin Esp. 2015;2:91-97. http://dx.doi.org/10.1016/j.rce.2014.07.009

4. Bonds DE, Miller ME, Bergenstal RM, et al. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ. 2010;340:b4909. http://dx.doi.org/10.1136/bmj.b4909

5. Pieber TR, Marso SP, McGuire DK, et al. DEVOTE 3: temporal relationships between severe hypoglycaemia, cardiovascular outcomes and mortality. Diabetologica. 2018;61:58-65. http://dx.doi.org/10.1007/s00125-017-4422-0

6. Cryer PE. Severe hypogycemia predicts mortality in diabetes. Diabetes Care. 2012;35:1814-1816. http://dx.doi.org/10.2337/dc12-0749

Glossary

MI = myocardial infarction

TIA = transient ischemic attack