초록 열기/닫기 버튼
Hypoglycemia is a major barrier to achieving the glycemic goal in patients withtype 2 diabetes. In particular, severe hypoglycemia, which is defined as an eventthat requires the assistance of another person to actively administer carbohydrates,glucagon, or take other corrective actions, is a serious clinical concern inpatients with diabetes. If severe hypoglycemia is not managed promptly, it can belife threatening. Hypoglycemia-associated autonomic failure (HAAF) is the mainpathogenic mechanism behind severe hypoglycemia. Defective glucose counter-regulation (altered insulin secretion, glucagon secretion, and an attenuatedincrease in epinephrine during hypoglycemia) and a lack of awareness regardinghypoglycemia (attenuated sympathoadrenal activity) are common componentsof HAAF in patients with diabetes. There is considerable evidence that hypoglycemiais an independent risk factor for cardiovascular disease. In addition,hypoglycemia has a significant inf luence on the quality of life of patients withdiabetes. To prevent hypoglycemic events, the setting of glycemic goals should beindividualized, particularly in elderly individuals or patients with complicatedor advanced type 2 diabetes. Patients at high-risk for the future development ofsevere hypoglycemia should be selected carefully, and intensive education withreinforcement should be implemented.
