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Recurrent severe hypoglycemia in Type 1 diabetes: potential for prevention?

Marie Moth Henriksen, Rikke Due-Andersen, Birger Thorsteinsson & Ulrik Pedersen-Bjergaard

Aim: To compare characteristics of solitary and recurrent episodes of severe hypoglycemia in order to explore the potential for prevention of recurrent severe hypoglycemia (SH) in a cohort of patients with Type 1 diabetes.
Methods: 230 patients with Type 1 diabetes were followed prospectively for 1 year and reported characteristics of SH within 24 h.
Results: 239 episodes of SH were reported by 86 patients, corresponding to 1.0 episode per patient year; 82% of the episodes were recurrent (≥2 episodes per patient year). Compared with solitary SH, recurrent SH occurred more often during daytime, primarily in subjects with reduced hypoglycemia awareness, and were characterized by absence of warning symptoms.
Conclusion: A large proportion of SH in Type 1 diabetes is recurrent and thereby potentially preventable. Focus should be directed towards patients with reduced hypoglycemia awareness.