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aTaking assigned medication.

b Requiring medical assistance or admission to hospital.

c Compared with severe hypoglycemia (that requiring the assistance of another individual) in 65% of type 1 diabetes over 6.5 years in the DCCT1.

Abbreviation: UKPDS, U.K. Prospective Diabetes Study.

aTaking assigned medication.

b Requiring medical assistance or admission to hospital.

c Compared with severe hypoglycemia (that requiring the assistance of another individual) in 65% of type 1 diabetes over 6.5 years in the DCCT1.

Abbreviation: UKPDS, U.K. Prospective Diabetes Study.

those treated with a sulfonylurea suffered a hypoglycemic event requiring medical assistance over 6 years (Table 2) (7). Stated differently, the data indicate a relative risk of major hypoglycemia, as defined in the UKPDS, of six during treatment with metformin, 22 during treatment with a sulfonylurea and 75 during treatment with insulin (Table 2).

Population-based data indicate that the severe hypoglycemia event rate in insulin-treated type 2 diabetes is approximately 30% of that in type 1 diabetes (35 vs. 115 per 100 patient-years) (8) and that event rates for hypoglycemia requiring emergency medical treatment in insulin-treated type 2 diabetes range from 40% (9) to 100% (10) of those in type 1 diabetes. Since type 2 diabetes is approximately 20-fold more prevalent than type 1 diabetes, and since more than half of people with type 2 diabetes ultimately require treatment with insulin, most episodes of severe iatrogenic hypoglycemia occur in people with type 2 diabetes.

The frequency of hypoglycemia is highest in type 2 diabetes patients treated with insulin (Table 2) (7). That may well be because of the greater glucose-lowering potency of that drug— given in sufficient doses—relative to that of the other drugs, and its pharmacokinetic imperfections. However, it may also be because many patients who ultimately require treatment with insulin have advanced, insulin-deficient type 2 diabetes with the resulting compromised defenses against falling plasma glucose concentrations (5,6) discussed later in this chapter.

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

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