Doctors need to do a better job of discussing low blood sugar with patients who take high-risk diabetes medications such as insulin, researchers say.
Low blood sugar (hypoglycemia) is the most common serious side effect of diabetes treatment. Severe cases can lead to falls, emergency department visits, and may increase the risk of stroke and death.
"For patients to have safe diabetes treatment, there needs to be open communication between them and their health care provider about medication side effects, especially hypoglycemia," said study leader Dr. Scott Pilla. He is assistant professor of medicine at Johns Hopkins University School of Medicine, in Baltimore.
The study was published recently in the Journal of General Internal Medicine.
According to the researchers, 12% of diabetes patients who participated in a 2018 survey said they had had severe hypoglycemia within the previous year.
In the new study, Pilla's team looked at 83 primary care visits by 33 patients with diabetes who took insulin or sulfonylureas, such as glipizide (Glucotrol) and glyburide (Glynase).
Low blood sugar and how to prevent it came up in less than one-quarter of those visits, the researchers found.
Even though patients were concerned about hypoglycemia, doctors rarely checked how often it occurred, its severity or how it affected patients' quality of life, according to the study authors.
"For example, we found in our study that clinicians almost never counseled against driving a car if a patient thinks his or her blood sugar is low or may become low," Pilla said in a Hopkins news release. "This is an important discussion to have because low blood sugar could cause a person to think unclearly and have an accident."
Primary care clinicians must make hypoglycemia counseling a priority for patients taking high-risk diabetes medications, he said. But it's also important for patients to raise the topic, he added.
"Primary care clinicians should work together with patients to figure out how to best prevent low blood sugar episodes and choose the safest diabetes treatment," Pilla said.
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on hypoglycemia.
SOURCE: Johns Hopkins Medicine, news release, Feb. 2, 2021