Scientific advisory on nocturnal hypoglycemia in insulin-treated patients with diabetes: Recommendations from Indian experts

Diabetes Metab Syndr. 2022 Sep;16(9):102587. doi: 10.1016/j.dsx.2022.102587. Epub 2022 Aug 23.

Abstract

Introduction: Insulin is one of the commonly prescribed glucose lowering agents in diabetes. Hypoglycemia is the most common complication, and severe hypoglycemia is the most serious complication of insulin therapy. Almost half of all severe hypoglycemia episodes (HEs) occur at night. However, patients are often unaware of their nocturnal hypoglycaemia (NH) risk. Additionally, both healthcare professionals and patients find it difficult to manage NH. The purpose of this expert group meeting is to improve NH awareness and provide guidance for the physicians to recognize and manage NH.

Method: The panel of experts in an e-board deliberated extensively upon the available literature and guidelines on hypoglycemia and NH discussed the consensus on definition, detection, reporting, monitoring, treatment, and optimization of therapy in NH.

Result: & Conclusion: Though there are many guidelines on the management of HEs in patients with diabetes, very few touch the topic of NH. This scientific advisory on management of NH in insulin treated patients with diabetes is formulated to address this gap in understanding regarding management of NH. The experts provide recommendations for the nocturnal window, defining NH based on blood glucose values, recognition, prevention and management of NH.

Keywords: CGM; Choice of insulin; HAQ; Hypoglycemia awareness questionnaire; Hypoglycemia unawareness; Nocturnal hypoglycemia; SMBG.

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring / adverse effects
  • Diabetes Mellitus, Type 1* / complications
  • Glucose
  • Humans
  • Hypoglycemia* / chemically induced
  • Hypoglycemia* / prevention & control
  • Hypoglycemic Agents / adverse effects
  • Insulin / adverse effects

Substances

  • Insulin
  • Blood Glucose
  • Glucose
  • Hypoglycemic Agents