Hypoglycaemia: difference between revisions
Diff·revision 7 → 8·07:33, 28 Nov 2024
Difference between revision 7 and revision 8 of Hypoglycaemia. 11 lines changed; the page grew by 844 bytes.
| Revision 7 — 10:17, 30 Oct 2024 SarcopeniaSefa (talk) expand §Why glucose dependence matters 2,490 bytes ±0 | Revision 8 — 07:33, 28 Nov 2024 ChainCustodyChad (talk) add the contraindication with its rationale 3,334 bytes +844 | ||
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| 1 | {{Infobox concept | 1 | {{Infobox concept |
| 2 | | name = Hypoglycaemia | 2 | | name = Hypoglycaemia |
| + | 3 | | subtitle = Adverse effect | |
| 3 | | Common threshold = Below 3.9 mmol/L (70 mg/dL) | 4 | | Common threshold = Below 3.9 mmol/L (70 mg/dL) |
| 4 | | Level 2 = Below 3.0 mmol/L (54 mg/dL) | 5 | | Level 2 = Below 3.0 mmol/L (54 mg/dL) |
| ⋮ | ⋮ | ||
| 20 | This is a mechanistic argument rather than a guarantee. Reported hypoglycaemia rates on incretin monotherapy are low but not zero, and the residual reflects other contributors — missed meals, alcohol, renal impairment, and concurrent agents.{{r|drucker2018}} | 21 | This is a mechanistic argument rather than a guarantee. Reported hypoglycaemia rates on incretin monotherapy are low but not zero, and the residual reflects other contributors — missed meals, alcohol, renal impairment, and concurrent agents.{{r|drucker2018}} |
| 21 | 22 | ||
| + | 23 | == Recognition and classification == | |
| + | 24 | | Level | Threshold | Interpretation | | |
| + | 25 | |---|---|---| | |
| + | 26 | | 1 | 3.0–3.9 mmol/L | Alert value; action advised | | |
| + | 27 | | 2 | Below 3.0 mmol/L | Clinically significant | | |
| + | 28 | | 3 | Any, with impaired cognition requiring assistance | Severe | | |
| + | 29 | ||
| + | 30 | Level 3 is defined by the need for assistance rather than by a number, because the glucose concentration at which cognition is impaired varies with prior exposure. Repeated hypoglycaemia lowers the threshold at which symptoms appear, a phenomenon termed impaired awareness.{{r|ada2024,seaquist2013}} | |
| + | 31 | ||
| 22 | == References == | 32 | == References == |
| 23 | {{reflist}} | 33 | {{reflist}} |
| ⋮ | ⋮ | ||
| 25 | <ref name="nauck2016">Nauck MA, Meier JJ. "The incretin effect in healthy individuals and those with type 2 diabetes." ''The Lancet Diabetes & Endocrinology'' 4(6):525–536 (2016). PMID 26876794.</ref> | 35 | <ref name="nauck2016">Nauck MA, Meier JJ. "The incretin effect in healthy individuals and those with type 2 diabetes." ''The Lancet Diabetes & Endocrinology'' 4(6):525–536 (2016). PMID 26876794.</ref> |
| 26 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> | 36 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> |
| + | 37 | <ref name="seaquist2013">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'' 36(5):1384–1395 (2013). PMID 23589542.</ref> | |
| 27 | 38 | ||
| 28 | {{DEFAULTSORT:Hypoglycaemia}} | 39 | {{DEFAULTSORT:Hypoglycaemia}} |