
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Hypoglycemia natural history, complications and prognosis
Introduction
Overview
Overview
If left untreated, patients with hypoglycemia may progress to develop anxiety,Β nervousness,Β tremor, palpitations, and sweating. Common complications of hypoglycemia include psychomotor retardation, epilepsy and prematurity in neonates. Complications in adults include increased risk of dementia, cardiovascular complications and may be death. Prognosis is generally good. Four to ten percent of death in patients with type 1 diabetes are due to hypoglycemia.
Natural History
Natural History
- The symptoms of hypoglycemia are usually developed in the second decade of life, and start with symptoms such as anxiety,Β nervousness,Β tremor, palpitations, and sweating.
- Without treatment, patient may develop symptoms of adrenergic manifestations such as confusion,Β amnesia,Β dizziness,Β delirium, double vision, slurred speech, generalized or focalΒ seizures which may eventually lead to death.
- Lower values of plasma glucose may cause the following manifestations:
- Values β€55 mg/dL causes cognitive impairment and EEG (Electroencephalogram) changes.
- Values <40 mg/dL causes drowsiness and change in behavior.
- Values <30 mg/dL can cause seizures, permanent neurological deficits and even death.[1]
Complications
Complications
Complications that can develop as a result of neonatal hypoglycemia are:
Complications that may develop as a result of hypoglycemia in adults are:
- It depends on:
- Duration of the attacks
- Age of the patients
- Older patients show more complications than younger patients.[3]
- Increased risk of dementia[4]
- Episodes of dizziness increase the risk of falls and fractures.
- Severe hypoglycemia may increase the risk of cardiovascular complications in type 2 diabetes patients.[5]
Prognosis
Prognosis
- Prognosis of hypoglycemia is generally good with treatment. Without treatment, hypoglycemia may be fatal.
- Four to ten percents of deaths of patients with type 1 diabetes are due to hypoglycemia.[6]
References
References
- β Alsahli, Mazen; Gerich, John E. (2013). “Hypoglycemia”. Endocrinology and Metabolism Clinics of North America. 42 (4): 657β676. doi:10.1016/j.ecl.2013.07.002. ISSNΒ 0889-8529.
- β Meissner T, Wendel U, Burgard P, Schaetzle S, Mayatepek E (2003). “Long-term follow-up of 114 patients with congenital hyperinsulinism”. Eur J Endocrinol. 149 (1): 43β51. PMIDΒ 12824865.
- β Zammitt NN, Frier BM (2005). “Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities”. Diabetes Care. 28 (12): 2948β61. PMIDΒ 16306561.
- β Yaffe K, Falvey CM, Hamilton N, Harris TB, Simonsick EM, Strotmeyer ES; et al. (2013). “Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus”. JAMA Intern Med. 173 (14): 1300β6. doi:10.1001/jamainternmed.2013.6176. PMCΒ 4041621. PMIDΒ 23753199. Review in: Evid Based Med. 2014 Apr;19(2):77
- β Goto A, Arah OA, Goto M, Terauchi Y, Noda M (2013). “Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis”. BMJ. 347: f4533. doi:10.1136/bmj.f4533. PMIDΒ 23900314.
- β Patterson CC, Dahlquist G, Harjutsalo V, Joner G, Feltbower RG, Svensson J; et al. (2007). “Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989”. Diabetologia. 50 (12): 2439β42. doi:10.1007/s00125-007-0824-8. PMIDΒ 17901942.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
