Hypoglycémie et diabète de type 2: mythe ou réalité?

Iatrogenic hypoglycemia is an acute complication of insulin treatment in type 1 (T1DM) and type 2 (T2DM) diabetes mellitus, and occurs more frequently in insulin-deficient states (T1DM) and advanced T2DM. Recent surveys confirmed that iatrogenic hypoglycemia is a major concern in insulin-treated patients with diabetes in a real-life setting. The most important predictive factors of hypoglycemia in T2DM were a history of severe or non-severe hypoglycemia, increased number of daily injections and duration of insulin therapy, as well as sulfonylurea and glinides use. Importantly, HbA1c was not predictive of hypoglycemia in T2DM. The relatively high frequency of hypoglycemia reported underlines the importance of optimizing patients' insulin regimens in order to successfully control glycemia while minimizing the occurrence of hypoglycemia. The high frequency of hypoglycemia in T2DM supports the concept of a patient-centered approach for managing diabetes, in which hypoglycemia risk evaluation is critical.