Avoiding Low Blood Glucose

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Hypoglycemia in type 2 diabetic patients randomized to and maintained on monotherapy with diet, sulfonylurea, metformin, or insulin for 6 years from diagnosis: UKPDS73, by A.D. Wright and colleagues. J Diabet Compl 20:395–401, 2006.

What is the problem and what is known about it so far?

Aggressive treatment of diabetes helps limit the impact of the disorder and prevent complications. But one problem with aggressive treatment is low blood glucose, which can be dangerous. While almost any diabetes therapy can cause low blood glucose, it’s unknown whether the problem is more likely with one drug than with another.

Why did the researchers do this particular study?

The researchers wanted to see how frequent low blood glucose is in people who take some of the most commonly prescribed diabetes drugs—sulfonylurea, metformin, and  insulin—and those treated by diet alone.

Who was studied?

The study included 5,063 people with type 2 diabetes who participated in the UK Prospective Diabetes Study (UKPDS).

How was the study done?

Researchers kept track of participants who were prescribed only one drug—sulfonylurea, metformin, or insulin—or were treated with dietary changes. Cases of low blood glucose were categorized as transient, temporarily incapacitating, requiring help, and requiring medical attention. Participants were followed for 6 years.

What did the researchers find?

Overall, low blood glucose did not happen often, but was more common in people who are younger, female, were closer to normal body weight, or had blood glucose levels that were lower than others.

Low blood glucose was most common among people who took insulin and was least common in people treated by diet alone. People who received the other drugs fell between the two extremes.

What were the limitations of the study?

Cases of low blood glucose were based on what people remembered and reported, which may not be accurate. There could have been cases of low blood glucose that were not reported.

What are the implications of the study?

Low blood glucose isn’t a common problem, and should not have a major impact on diabetes treatment.