Journal article
Evidence-informed clinical practice recommendations for treatment of type 1 diabetes complicated by problematic hypoglycemia
P Choudhary, MR Rickels, PA Senior, MC Vantyghem, P Maffi, TW Kay, B Keymeulen, N Inagaki, F Saudek, R Lehmann, BJ Hering
Diabetes Care | Published : 2015
DOI: 10.2337/dc15-0090
Abstract
Problematic hypoglycemia, defined as two or more episodes per year of severe hypoglycemia or as one episode associated with impaired awareness of hypoglycemia, extreme glycemic lability, ormajor fear andmaladaptive behavior, is a challenge, especially for patients with long-standing type 1 diabetes. Individualized therapy for such patients should include a composite target: optimal glucose control without problematic hypoglycemia. Therefore, we propose a tiered, four-stage algorithm based on evidence of efficacy given the limitations of educational, technological, and transplant interventions. All patientswith problematic hypoglycemia should undergo structured or hypoglycemia-specific educat..
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Awarded by Diabetes Australia Research Trust
Funding Acknowledgements
P.C. is supported in part by Diabetes UK grants 14/0004865 and 13/0005643. M.R.R. is supported in part by U.S. Public Health Service research grants R01-DK-091331 and U01-DK-070430 from the National Institutes of Health. P.A.S. is supported by the Academic Alternate Relationship Plan and in part by Alberta Innovates Health Solutions and JDRF. M.-C.V. is supported by the French Ministry of Health (PHRC 2001, 2008, and 2009), European Community (Fond Europeen de Developpement Regional), Conseil Regional Nord Pas de Calais (IFR 114), European FP7, JDRF, Societ e Francophone du Diabete, Association de Recherche pour le Diabete, and Agence de Biomedecine. T.W.K. is supported by the National Health and Medical Research Council (APP1037321), JDRF, Diabetes Australia Research Trust, Operational Infrastructure Support scheme of the Victorian Government, and Nationally Funded Centres scheme. F.S. is supported in part by Ministry of Health of the Czech Republic grant NT14020-3/2013. B.J.H. is supported in part by U.S. Public Health Service research grants U01-AI- 065193 and U01-AI-102463 from the National Institutes of Health and by research grants 17-2012-527 and 17-2013-495 from JDRF.