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Hypoglycaemia

Prevalence
Causes
Clinical features
Investigations
Therapy
Prevention
Prognosis
Clinical features

Ask about 
  • glycaemic control a b and HbA1c levels b
  • any previous episodes of hypoglycaemia  b

Why?

  • Frequently low blood glucose levels a or HbA1c b help predict patients at increased risk for hypoglycaemia

Diabetes: history of hypoglycaemia or a low HbA-1c increase the risk of hypoglycaemia

Patient Prognostic Factor Outcome CER OR
(95% CI)
NNF+
(95% CI)
type 1 diabetes b history of hypoglycaemia at 6.5 years
independent
hypoglycaemia requiring assistance
at 6.5 years
41%
(38% to 45%)
1.33
(1.17 to 1.52)
14
(10 to 26)
  fall in HbA1c by 10% (at baseline of 9%)
independent
    1.53
(1.43 to 1.64)
9
(8 to 11)

Diabetes: poor glycaemia control may increases the risk of severe hypoglycaemia

Outcome Risk Factor PEER OR
(95% CI)
NNH
(95% CI)
severe hypoglycaemia b poor glycaemic control
independent
30% 3.0
(1.0 to 9.0)
4
(2 to infinity)

Expiry date: April 2004
Levels of Evidence used in grading these guides

Author   CM   Ball
Reviewer   D   Matthews
CAT Writers   M   Taylor , RS   Phillips , CM   Ball , R   Harden