Psychological impact of hypoglycaemia: the hidden depths of the type 2 diabetes iceberg

Jane Speight, Christel Hendrieckx



Hypoglycaemia is a concern to many people with type 2 diabetes, particularly as it is the most common side effect of some glucose-lowering therapies. Although the immediate risks to the individual are evident and usually manageable, the psychological impact is often less visible but more pervasive, with long-term implications for both self-management and quality of life.

Key Points

  • Hypoglycaemia is a significant side effect of insulin therapy and some oral glucose-lowering agents (e.g. sulfonylureas).
  • Hypoglycaemia is often thought to be associated with type 1 diabetes only; however, twice as many people with type 2 diabetes use insulin in Australia than people with type 1 diabetes, and many more use sulfonylureas.
  • Experiencing hypoglycaemia can lead to fear of hypoglycaemia and reduced quality of life.
  • People with type 2 diabetes often apply compensatory behaviours to reduce their risk of hypoglycaemia and their fear of it. These behaviours include reducing and/or omitting medication doses, avoiding physical activities and more frequent snacking.
  • It is important for healthcare professionals to show respect, sensitivity and support to enable the person with diabetes to talk openly about their experiences and concerns regarding hypoglycaemia.
  • With specialist support, people with diabetes can address their fear of hypoglycaemia without compromising their long-term diabetes outcomes.

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