Diabetic hypoglycemia

Severe and/or recurrent hypoglycemic episodes are associated with increased mortality, both in the acute setting and long term.[114]McCoy RG, Van Houten HK, Ziegenfuss JY, et al. Increased mortality of patients with diabetes reporting severe hypoglycemia. Diabetes Care. 2012 Sep;35(9):1897-901. https://diabetesjournals.org/care/article/35/9/1897/38354/Increased-Mortality-of-Patients-With-Diabetes http://www.ncbi.nlm.nih.gov/pubmed/22699297?tool=bestpractice.com [115]Skrivarhaug T, Bangstad HJ, Stene LC, et al. Long-term mortality in a nationwide cohort of childhood-onset type 1 diabetic patients in Norway. Diabetologia. 2006 Feb;49(2):298-305. https://link.springer.com/article/10.1007/s00125-005-0082-6 http://www.ncbi.nlm.nih.gov/pubmed/16365724?tool=bestpractice.com ​ One retrospective study showed that self-reported episodes of severe hypoglycemia are associated with a 3.4-fold increase in 5-year mortality.[114]McCoy RG, Van Houten HK, Ziegenfuss JY, et al. Increased mortality of patients with diabetes reporting severe hypoglycemia. Diabetes Care. 2012 Sep;35(9):1897-901. https://diabetesjournals.org/care/article/35/9/1897/38354/Increased-Mortality-of-Patients-With-Diabetes http://www.ncbi.nlm.nih.gov/pubmed/22699297?tool=bestpractice.com  However, it is unclear from the evidence whether many of the complications of hypoglycemia that can increase mortality are a direct result of hypoglycemia itself, or whether hypoglycemia is a marker of patients who are more at risk of complications.​