Negotiating the Barrier of Hypoglycemia in Diabetes

Hypoglycemia is the limiting factor in the glycemic management of diabetes. It is a barrier to quality of life and even survival in the short term and to true glycemic control, with its established microvascular and potential macrovascular benefits, in the long term. Although it is possible to both improve glycemic control and minimize the risk of hypoglycemia in many patients with currently available regimens—by applying the principles of aggressive therapy and practicing hypoglycemia risk reduction—people with diabetes need treatment methods that provide glucose-regulated insulin secretion or replacement if euglycemia is to be maintained safely over a lifetime of diabetes.