4
Evaluation
Table 1. Persons at High Risk for Developing Hypoglycemia
• Individuals taking medications known to cause hypoglycemia (e.g., insulin,
sulfonylureas, meglitinides)
• Individuals with impaired kidney or liver function
• Older-age patients
• Preschool-age children
• Individuals with a history of severe hypoglycemia
• Individuals with cognitive impairment or intellectual disability that may reduce
ability to respond to low blood glucose
• Individuals with impaired awareness of hypoglycemia
• Individuals with a longer duration of diabetes (including those using insulin for
≥5 years)
• Individuals who use alcohol
• Individuals with eating disorders
• Individuals with irregular eating schedules
• Persons that are fasting for religious or cultural reasons
• Individuals with a history of untreated pituitary, adrenal, or thyroid insufficiency
Adapted from American Diabetes Association Professional Practice Committee. Diabetes Care,
2022; 45(Suppl. 1): S46–S59.
Table 2. Definitions of Levels of Hypoglycemia
Level 1: Glucose <70 mg/dL (3.9 mmol/L) and glucose ≥54 mg/dL (3.0 mmol/L);
This level of hypoglycemia should alert patients that they may need to ingest
carbohydrate to prevent progressive hypoglycemia.
Level 2: Glucose <54 mg/dL (3.0 mmol/L); This level of hypoglycemia is associated
with increased risk for cognitive dysfunction and mortality.
Level 3: A severe event characterized by altered mental and/or physical status
requiring assistance; This level of hypoglycemia is life-threatening and requires
emergent treatment, typically with glucagon.
Adapted from Agiostratidou G, et al. Diabetes Care, 2017; 40(12): 1622–1630.
