Clinical Diabetes • Volume 26, Number 4, 2008

One of the first tenants of medical practice is to “do no harm.” Treating patients with diabetes medications, however, carries a significant risk of inflicting harm and injury by causing hypoglycemia. Were it not for this potential side effect, diabetes treatment would be considerably easier.

Many treatments frequently involve augmenting insulin effects directly (injected insulin) or indirectly (increasing insulin release from the pancreatic β-cells, increasing insulin sensitivity, or inhibiting hepatic glucose production). When endogenous insulin levels are altered, hypoglycemia is always a potential side effect to therapy and, in fact, is one of the most common adverse reactions in diabetes treatment.

It is important, therefore, to be able to identify, treat, and also avoid mild and severe hypoglycemic complications of diabetes therapy. Such complications may be life-threatening and resistant to initial therapy; therefore, it is important for physicians who prescribe potent diabetes medications such as insulin to be able to identify causes of such adverse reactions and arrest them before they progress.