Overtreating people with diabetes increases hypoglycemia risk, researchers report

Jack Woodfield
Wed, 21 Aug 2019
Overtreating people with diabetes increases hypoglycemia risk, researchers report
Overtreating people with diabetes is leading to many incidences of hypoglycemia (low blood glucose) which could be prevented, according to US researchers.

A team from the Mayo Clinic in Minnesota carried out a study that showed intensive glucose-lowering therapy, which can sometimes lead to people receiving more medication than required, has led to thousands of diabetes-related hospital admissions.

Lead author Dr Rozalina McCoy, an endocrinologist and primary care physician, said they found evidence to suggest overtreating people for high blood glucose levels directly led to 4,774 hospitalisations over two years. In addition, there were 4,804 emergency department visits across the same period.

Dr McCoy said: "Importantly, these numbers are a large underestimation of the true scope of overtreatment-induced hypoglycemic events."

She said that while there are many reasons why people with diabetes may experience hypoglycemia, especially if caused by unmodifiable risk factors such as need for insulin therapy, some episodes may be avoidable.

Now, Dr McCoy is urging healthcare professionals to shift their focus from being overly focused on glucose-lowering, to being more about the individual person. She believes individualising treatment will lead to better outcomes for patients and less treatment in the long run.

"We need to align treatment regimens and goals with each patient's clinical situation, health status, psychosocial situation, and reality of everyday life to ensure that care is consistent with their goals, preferences and values," she said.

"It is important not only to ensure that we do not undertreat our patients with diabetes, but also that we do not overtreat them because both undertreatment and overtreatment can harm our patients."

High blood glucose levels over a long period of time can increase the risk of diabetes-related complications, such as diabetic retinopathy, kidney disease and neuropathy. Severe hypoglycemia, on the other hand, is linked with greater risks of heart disease, falls and bone fractures, and poorer quality of life. The key with medication is getting the right balance.

The study findings have been published in Mayo Clinic Proceedings.
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