Hypoglycaemia frequency

Henderson JN, Allen KV, Deary IJ, Frier BM. Hypoglycaemia in insulin-treated type 2 diabetes frequency, symptoms and impaired awareness. Diabetic Med 2003 20 1016-21. 

Wentholt IM, Maran A, Masurel N, Heine RJ, Hoekstra JB, DeVries JH. Nocturnal hypoglycaemia in Type 1 diabetic patients, assessed with continuous glucose monitoring frequency, duration and associations. Diabetic Medicine 2007, 24, 527-532. 

Complications of diabetes. A well-controlled diabetic is less liable to ketosis and infections. It is now certain that good control of glycaemia mitigates the serious microvascular complications, retinopathy, nephropathy, neuropathy and cataract. Too tight control of glycaemia can increase the frequency of attacks of hypoglycaemia. 

It is important to prevent nocturnal hypoglycaemia, not only to protect brain function, but also to prevent insulin resistance. This may easily result in exaggerated hyperglycaemia and initiate the vicious circle -hypoglycaemia, hyperglycaemia, increase in insulin dose and risk of subsequent hypoglycaemia (Bolli and Perriello, 1990). The mechanism, frequency and even the existence of the Somogyi phenomenon, however, are all still controversial. 

Isolated cases of hypoglycaemia in patients with diabetes have also been reported for ciprofloxacin, levofloxacin and norfloxacin. The general clinical relevance of these cases is uncertain but probably minor. However, it may be prudent to consider increasing the frequency of blood glucose monitoring in the elderly, who appear more at risk. 

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