Hypoglycemia Risk Factors and Management

Patient Populations at High Risk

Elderly patients with reduced ability to recognize symptoms are at increased risk of hypoglycemia 1
Young children with type 1 diabetes who cannot effectively communicate symptoms are at higher risk of hypoglycemia 1
Patients with cognitive impairment have a bidirectional association with hypoglycemia 2
Patients with food insecurity are at increased risk of hypoglycemia-related emergency visits 1
Low household income, socioeconomic deprivation, underinsured, or homeless status are associated with increased hypoglycemia risk 1
Cultural practices such as religious fasting may contribute to hypoglycemia risk 1

The American Diabetes Association recommends adjusting insulin doses by 25-50% in patients with renal impairment to prevent hypoglycemia 5
Avoid overly tight glycemic control during workup, keeping glucose levels above 70 mg/dL 5
Administer 15-20 grams of oral glucose when blood glucose is <70 mg/dL, and recheck glucose after 15 minutes 4
Prescribe glucagon for all patients at risk of severe hypoglycemia, and educate patients to carry glucose tablets at all times 4