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Are You at Risk for Low Blood Sugar?

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Not everyone with diabetes is at the same level of risk for low blood sugar. You are at the same risk for lows if you take insulin and/or one or more blood glucose-lowering medications listed below.

If you have type 2 diabetes and take insulin or a glucose-lowering medication you have a smaller risk of having a severe low, but still need to always be prepared. If you don’t take any glucose-lowering medications your risk of a low blood sugar episode is very low.

Research Shows
Type 1 Diabetes Type 2 Diabetes
May experience mild to moderate low blood sugar with symptoms about 43 times a year. Severe low blood sugar may occur twice a year.
If using glucose-lowering medication, may experience mild to moderate low blood sugar with symptoms about 16 times a year. Severe low blood sugar about once in five years.* (The longer you have type 2 diabetes the more likely it is that you will need several blood glucose-lowering medicines that may include insulin.)

* Source: Perlmutter LC, Flanagan BP, Shah PH, Singh SP: Glycemic Control and Hypoglycemia: Is the loser the winner? Diabetes Care 31: 2072-73 2008


Blood Glucose-Lowering Medications that May Cause Hypoglycemia*

Pills You Take by Mouth
Category Name Generic Names Brand Names
Sulfonylureas Glimepiride, Glipizide, Glyburide, Glipizide ER Amaryl, Glucotrol, Glucatrol XL, Diabeta, Micronase
Meglitinides Repaglinide Prandin
D-phenylalanine Nateglinide Starlix
Medicines You Take by Injection
Insulin All Types


Blood Glucose-Lowering Medications Unlikely to Cause Hypoglycemia*

Pills You Take by Mouth
Category Name Generic Names Brand Names
Biquanides Metformin (May cause lows, but rarely) Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet (liquid)
Glitazones (TZDs) Pioglitazone, Rosiglitazone Actos, Avandia
Alpha-glucosidase inhibitor Acarbose, Miglitol Precose, Glyset
DPP-4 inhibitors Sitagliptin Januvia
Bile sequestering agent (Removes glucose and LDL-cholesterol) Colessevatam HCL Welchol
Dopamine agonist Bromocriptine Mesylate Cycloset
Medicines You Take by Injection
Incretin mimetics (Work like gut hormones called incretins) Exenatide (May cause lows, but rarely) Byetta
Amylin analog (Works like pancreas hormone amylin) pramlintide (Approved by the FDA for use with insulin only. Insulin doses usually need to be lowered
to prevent lows.)		 Symlin (Most often used with insulin, insulin doses usually need to be cut to prevent lows)


*Read the notes below to learn more about blood glucose-lowering medicines:

1. It is common to take more than one type of blood glucose-lowering medicine. You may take two or more pills, a pill that contains a mixture of medicines, or you may take a pill and use a medicine that you take by injection, such as insulin or an incretin mimetic. None, one, or all of the medicines you take may cause hypoglycemia or be unlikely to cause it.

2. Learn the actions of your medicines from your healthcare professionals and know your risks for low blood sugar episodes. Learn the actions of your medicines from your healthcare professionals and know your risks for low blood sugar episodes. Fill out this checklist with your healthcare professional to learn more about your medicine.

3. This is not a complete list of all blood sugar-lowering medicines approved by the FDA. New blood sugar-lowering medicines may be approved by the FDA over time.

 

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