Tailored Targets – When to loosen the reins on glucose control

2018-07-29T19:00:46+00:00Glucose Control, HbA1C, Hypoglycaemia, Individualized Therapy|

By: Kamlesh Khunti, Prof. MBChB, PhD, MD, FRCGP, DCH, DRCOG |Date: Thursday 28 June 2018| Categories: Hypoglycaemia, Glucose Control, Individualized Therapy, HbA1C
Tight glucose control improves clinical outcomes. While this evidence-based principle continues to guide diabetes management, the truth is not so simple.
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Hypoglycaemia on the Road

2018-07-04T14:43:46+00:00Driving performance, Hypoglycaemia, Impaired Awareness, Insulin-treated|

By: Brian Frier, MD, FRCPE |Date: Thursday 29 March 2018| Categories: Hypoglycaemia, Driving performance, Insulin-treated, Impaired Awareness
Driving is a complex activity that requires cognitive integrity, and hypoglycaemia impairs cognition across a range of domains. The inevitable result? Impaired driving performance.
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Severe Hypoglycaemia in Children: A Shifting Landscape

2018-07-04T14:43:46+00:00Diabetes in Children, Hypoglycaemia, Type 1 Diabetes|

By: Tim Jones, MD, DCH, FRACP|Date: Friday 26 January 2018| Categories: Diabetes in Children, Hypoglycaemia, Type 1 Diabetes
Many clinicians perceive the risk of severe hypoglycaemia as firmly tethered to the level of glucose control: the tighter the control, the greater the risk. This perception has its roots in the historical association between A1C and hypoglycaemia risk, established in several studies. As a frequently cited example, the DCCT trial found a 3-fold increased risk of severe hypoglycaemia in patients randomized to the intensive management arm of the study.
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Hypoglycaemic Mortality in Diabetes

2018-07-04T14:43:47+00:00Diabetes, Hypoglycaemia, Mortality|

By: Philip E. Cryer, MD & Simon R. Heller, DM, FRCP|Date: Tuesday 12 September 2017| Categories: Diabetes, Hypoglycaemia, Mortality|

Abstract

Iatrogenic hypoglycaemia is the limiting factor in the glycaemic management of diabetes, particularly with insulin. That hypoglycaemia can kill experimental animals has been known since the discovery of insulin. There are now numerous reports of deaths of patients with diabetes associated with hypoglycaemia. Since hypoglycaemia can kill, and hypoglycaemia at the time of death has been documented by continuous glucose monitoring in a patient with diabetes, it is reasonable to conclude that these are causal associations.
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