ABCD response to Diabetes UK press release of type 2 diabetes and low blood sugar levels
People with diabetes recognise that they may suffer symptoms from low blood glucose whilst using insulin. Today's important observations in a report from Diabetes UK that people whose diabetes is being treated by tablets can also suffer these episodes frequently is of concern. As an association representing specialist doctors working for people with diabetes, ABCD welcomes any opportunity to emphasise an issue of concern to those living with type 2 diabetes, given that symptoms of low blood glucose (hypoglycaemia) can often be unpleasant and can rarely be dangerous.
ABCD believes that with access to blood glucose monitoring along with structured patient education, the likelihood of such problems can be reduced. At present access to both monitoring of blood glucose equipment and local structured education is strictly rationed or inadequate in many health districts.
ABCD also believes that all possible treatments for diabetes should be considered for each person with the disorder, so that treatments are individualised to reduce any side effects. These may include newer oral therapies for type 2 diabetes such as gliptins, which may carry less risk of hypoglycaemia than standard oral agents. ABCD would support their judicious introduction in selected cases where use of older sulphonylurea drugs has been demonstrated to be harmful, and where there are no contraindications to gliptins.
It is important to recognise that self-reported surveys have inherent limitations without blood glucose verification of hypoglycaemia, especially as the symptoms may sometimes be vague and non-specific. Furthermore we recognise that some individuals may feel as if their glucose levels are low at relatively normal levels when there has been a prompt drop from very high levels.
It is however possible that efforts to drive down glucose control targets through the QuoF primary care framework may have led to inappropriate efforts in some more vulnerable older patients with type 2 diabetes and cardiac renal and hepatic complications, where hypoglycaemia may be more likely.
ABCD supports the wider access to patient education and blood glucose monitoring as the most effective way to help people living with type 2 diabetes to reduce their risk of hypoglycaemia.
Peter H Winocour
Chairman of ABCD
Ian Gallen
Secretary of ABCD
October 5th 2009
Further details from Richard Chew0845 389 2626