Hypoglycemia (Low Blood Sugar): Prevention

To prevent hypoglycemia, attention must be paid to reducing individual risk factors.

Behavioral risk factors

Diet
- Malnutrition (malnutrition) – results in a decreased supply of glucose (carbohydrate: monosaccharide; simple sugar).
Pleasure food consumption
- Alcohol – hypoglycemia triggered by alcohol during food fasting (abstaining from food intake) is due to depletion of glycogen stores (carbohydrate stores) and inhibition of gluconeogenesis (new sugar formation from non-carbohydrate precursors, e.g. amino acids). In healthy people, alcohol can cause hypoglycemia after fasting, in liver patients even after a shorter time.
Physical activity
- Increased muscle work – leads to increased consumption of glucose.

Medication

Analgesics (painkillers)
- Opioids: propoxyphene (in renal insufficiency), tramadol.
Antiarrhythmics
- Quinidine
- Disopyramide
Antibiotics
- Ciprofloxacin, clarithromycin, levofloxacin, trimethoprim/sulfamethazole (in combination with sulfonylureas).
- Trimethoprim/sulfamethazole in renal insufficiency.
Antidiabetic agents
- Glinides (nateglinide, repaglinide)
- Insulin overdose (esp. higher hypoglycemic tendency in women).
- Overdose of sulfonylureas (SH) – glibenclamide, gliclazide, glimepiride, glipizide, gliquidone, tolbutamide.
- SH (glipizide or glimepiride) in combination with a vitamin K antagonist (AVK; in this case, warfarin):
  - 22% increased risk of hypoglycemia (odds ratio [OR] 1.22); aged 65-74 years (OR 1.54) and in quarters with first-time warfarin use (OR 2.47).
  - 47% increased risk of fall-related fractures (broken bones) that brought patients to the emergency department or led to hospitalization (OR 1.47)
  - 22% increased risk for cognitive impairment (reductions in mental performance) (OR 1.22)
Quinine (a naturally occurring chemical compound in cinchona bark from the group of alkaloids).
Haloperidol (neuroleptic from the group of butyrophenones).
Combination of several antidiabetic drugs
Pentamidine (active ingredient from the group of antiparasitics).
Salicylate

Environmental pollution – intoxications (poisonings).