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Severe hypoglycemia can happen any day. For Karen, it was today


Diabetes Canada guidelines for hypoglycemia

For individuals with diabetes who are at increased risk for severe hypoglycemia, Diabetes Canada recommends that support persons be taught how to administer glucagon should it be needed.1


Autonomic symptoms are present. The individual is able to self-treat.


Autonomic and neuroglycopenic symptoms are present. The individual is able to self-treat.


Typically <2.8 mmol/L

Individual requires assistance of another person. Unconsciousness may occur.


Major risk factors for severe hypoglycemia

For patients with Type 1 diabetes:1

  • Prior episode of severe hypoglycemia
  • Current low A1C (<6.0%)
  • Hypoglycemia unawareness
  • Long duration of diabetes
  • Autonomic neuropathy
  • Children unable to detect and/or treat mild hypoglycemia on their own
  • Adolescence

For patients with Type 2 diabetes:1

  • Advancing age
  • Severe cognitive impairment
  • Poor health literacy
  • Food insecurity
  • Increased A1C
  • Hypoglycemia unawareness
  • Duration of insulin therapy
  • Renal impairment
  • Neuropathy

Events are more common in those with a history of hypoglycemia and those with longer duration of insulin treatment1

For the full Diabetes Canada guidelines please click here


Data on the prevalence of severe hypoglycemia in Canada

Visit the links below to download studies in the prevalence of severe hypoglycemia in Canadians with Type 1 and Type 2 diabetes2,3

Download Aronson et al. Download Leiter et al.


References: 1. Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2018;42 (Suppl 1):S1-S325. 2. Leiter LA, Yale J-F, Chiasson J-L, et al. Assessment of the impact of fear of hypoglycemic episodes on glycemic and hypoglycemia management. Can J Diabetes 2005;29(3):00-00. 3. Aronson R, Goldenberg R, Boras D, et al. The Canadian hypoglycemia assessment tool program: insights into rates and implications of hypoglycemia from an observational study. Can J Diabetes 2018;42(2)11-17. 4. Data on file. Eli Lilly Canada Inc.



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