Hypoglycemia in Diabetes: Challenges and Opportunities in Care

Optimal glycemic control, an A1c < 7% for most patients, is necessary to reduce the risk for diabetes complications. However, tight glucose control carries a risk for hypoglycemia. Hypoglycemia can be a frightening aspect of living with diabetes, causing harmful effects to the cardiovascular system and a decrease in quality of life. This article reviews the important aspects of hypoglycemia management from both the patient and provider perspective. Nurse practitioners (NPs) should understand the physiology behind glucose homeostasis and lead evidence-based discussions regarding medication timing and dose, physical activity/exercise, alcohol consumption, symptom management, treatment, and prevention of low blood glucoses. The management of special populations such as older adults, those with renal impairment, and pregnant women is included. In light of mounting evidence that hypoglycemia is harmful and should be avoided at all costs, NPs are well positioned to assist patients in identifying, managing, and preventing hypoglycemia.