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Prevention

• In diabetes
  • Patient education should focus on:
    • Frequent self-monitoring of blood glucose level
    • Ensuring patient has an understanding of hypoglycemic mechanisms and precipitating factors (e.g., exercise)
    • Emphasizing the need to avoid hypoglycemia to correct hypoglycemia unawareness
    • Instruction of patient and family on treatment of severe hypoglycemia (glucagon injection)
  • Ongoing professional guidance and support
  • Flexible insulin (and other drug) regimens
  • Rational glycemic goals should balance the benefit of intensive diabetes therapy with risks of hypoglycemia.
  • Consider the use of continuous glucose monitors to evaluate for asymptomatic and/or nocturnal hypoglycemia in high-risk patients.
  • If the patient takes a beta blocker, a relatively selective β1-antagonist (e.g., metoprolol or atenolol) is preferable.
    • Nonselective beta blockers impair glycogenolysis and may attenuate recognition of hypoglycemia.
• In critical illness
  • Maintain vigilance for hypoglycemia in patients treated with insulin infusions or patients receiving total parenteral nutrition containing insulin.

The Harrison's Practice Preview allows you to view 5 FREE complete topics or conduct a search that delivers abstracts for more than 450 medical topics. For full access, please subscribe today!