Hypoglycemia natural history, complications and prognosis

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Hypoglycemia Microchapters


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Historical Perspective




Differentiating Hypoglycemia from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]


If left untreated, patients with hypoglycemia may progress to develop anxietynervousnesstremor, palpitations, and sweating. Common complications of hypoglycemia include psychomotor retardation, epilepsy and prematurity in neonates. Complications in adults include increased risk of dementia, cardiovascular complications and may be death. Prognosis is generally good. Four to ten percent of death in patients with type 1 diabetes are due to hypoglycemia.

Natural History


Complications that can develop as a result of neonatal hypoglycemia are:

Complications that may develop as a result of hypoglycemia in adults are:

  • It depends on:
    • Duration of the attacks
    • Age of the patients
  • Older patients show more complications than younger patients.[3]
  • Increased risk of dementia[4]
  • Episodes of dizziness increase the risk of falls and fractures.
  • Severe hypoglycemia may increase the risk of cardiovascular complications in type 2 diabetes patients.[5]


  • Prognosis of hypoglycemia is generally good with treatment. Without treatment, hypoglycemia may be fatal.
  • Four to ten percents of deaths of patients with type 1 diabetes are due to hypoglycemia.[6]


  1. Alsahli, Mazen; Gerich, John E. (2013). "Hypoglycemia". Endocrinology and Metabolism Clinics of North America. 42 (4): 657–676. doi:10.1016/j.ecl.2013.07.002. ISSN 0889-8529.
  2. Meissner T, Wendel U, Burgard P, Schaetzle S, Mayatepek E (2003). "Long-term follow-up of 114 patients with congenital hyperinsulinism". Eur J Endocrinol. 149 (1): 43–51. PMID 12824865.
  3. Zammitt NN, Frier BM (2005). "Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities". Diabetes Care. 28 (12): 2948–61. PMID 16306561.
  4. Yaffe K, Falvey CM, Hamilton N, Harris TB, Simonsick EM, Strotmeyer ES; et al. (2013). "Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus". JAMA Intern Med. 173 (14): 1300–6. doi:10.1001/jamainternmed.2013.6176. PMC 4041621. PMID 23753199. Review in: Evid Based Med. 2014 Apr;19(2):77
  5. Goto A, Arah OA, Goto M, Terauchi Y, Noda M (2013). "Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis". BMJ. 347: f4533. doi:10.1136/bmj.f4533. PMID 23900314.
  6. Patterson CC, Dahlquist G, Harjutsalo V, Joner G, Feltbower RG, Svensson J; et al. (2007). "Early mortality in EURODIAB population-based cohorts of type 1 diabetes diagnosed in childhood since 1989". Diabetologia. 50 (12): 2439–42. doi:10.1007/s00125-007-0824-8. PMID 17901942.