Patients with diabetes remain at greatly increased risk of cardiovascular disease (CVD). Hypoglycemia from glucose-lowering medications, especially if severe, compounds the risk. While totally eliminating all diabetes-related hypoglycemia may be an overly ambitious goal, we could be doing more to reduce its occurrence.
Dead in bed syndrome understandably strikes terror in the hearts of people with type 1 diabetes and their families. Clinicians, for their part, may find it difficult to discuss the syndrome with patients and thus avoid the topic. Fortunately, the syndrome is rare enough that the key message to patients is reassurance.
An awareness of hunger prompts people to open the refrigerator. The same process alows people to limit the damage of hypoglycaemia: a mental awareness of symptoms gives people a chance to take corrective action.
There is a line in the sand between mild and severe hypoglycaemia (SH). While mild hypoglycaemia is not trivial, it does not threaten life and health as SH does. For people who depend on insulin and other glucose-lowering drugs associated with hypoglycaemia, clinicians often consider a degree of SH “the cost of doing business” in diabetes management—in other words, an unwanted but unavoidable corollary of treatment.