Risks of a hypoglycaemic episode

Episodes of hypoglycaemia can range from uncomfortable to life-threatening.

graphic: Risks of a hypoglycaemic episode

Long-term clinical impact

People with type 1 diabetes:

  • Cognitive performance declines in older adults, but children may be at a greater risk of hypoglycaemia-related cognitive deficits4,5.
  • Blood vessel walls are stiffer during hypoglycaemia, which increases the risk of cardiovascular events, especially for individuals with a longer duration of T1D6.
People with type 2 diabetes:

  • The ACCORD, ADVANCE, and VADT trials found an association between severe hypoglycaemia and subsequent mortality7.
  • Symptomatic hypoglycaemia (mild or severe) has been linked to an increased risk of cardiovascular events8.

  • Caregiver strain has been associated with greater risk of cardiovascular disease.
  • Caregivers of people with type 2 diabetes should aim to improve their understanding of hypoglycaemia and its treatments9.


  • 1
    Cryer PE. Elimination of hypoglycaemia from the lives of people affected by diabetes. Diabetes 2011;60:24.
  • 2

    Musen G et al. Impact of Diabetes and Its Treatment on Cognitive Function Among Adolescents Who Participated in the Diabetes Control and Complications Trial. Diabetes Care. 2008; 31:1933–1938.

  • 3
    Kaira SK et al. Hypoglycemia: The neglected complication. Indian J Endocrinol Metab 2013;17:819–834.
  • 4
    Cato A & Hershey T. Cognition and Type 1 Diabetes in Children and Adolescents. Diabetes Spectr 2016;197–202.
  • 5
    Jacobson AM et al. Cognitive performance declines in older adults with type 1 diabetes: results from 32 years of follow-up in the DCCT and EDIC Study. Lancet Diabetes Endocrinol.2021;9:436-445,
  • 6
    Desouza CV et al. Diabetes Care. 2010;1389–1394.
  • 7
    Davis SN et al. Effects of Severe Hypoglycemia on Cardiovascular Outcomes and Death in the Veterans Affairs Diabetes Trial. Diabetes Care 2019;42:157–163.
  • 8
    Hsu PF et al. Association of Clinical Symptomatic Hypoglycemia With Cardiovascular Events and Total Mortality in Type 2 Diabetes. Diabetes Care 2013;36:894–900.
  • 9
    Reifergerste D & Hartleib S. Hypoglycemia-related information seeking among informal caregivers of type 2 diabetes patients: Implications for health education. J Clin Transl Endocrinol. 2016;4:7–12.