Disease Management

New Recommendations on How to Manage Hypoglycemia in People With Diabetes

The Endocrine Society recently issued updates to the diabetes-specific parts of their Clinical Practice Guideline that addresses the management of patients with diabetes who may be at high risk for hypoglycemia.1

The panel—made up of multidisciplinary clinician experts, patients, and methodologists—developed updates to the 2009 guideline titled “Evaluation and Management of Adult Hypoglycemic Disorders: Endocrine Society Clinical Practice Guideline.”2 The panel’s review and updates focused on hypoglycemia in adult and pediatric patients living with diabetes. Importantly, the full report also includes each panel member’s financial disclosures.

Ten clinical questions related to hypoglycemia in people living with diabetes were identified and prioritized by the expert panel, and systematic reviews were conducted to address the questions presented.

In total, 10 recommendations were made by the panel. These include recommendations on:

  • The use of continuous glucose monitoring (CGM) and algorithm-driven insulin pumps in patients with type 1 diabetes
  • The use of CGM for outpatients at risk for hypoglycemia who have type 2 diabetes
  • The use of long-acting and rapid-acting insulin analogs
  • The beginning utilization and continuation of CGM for a specific inpatient population who are considered high risk for hypoglycemia

Additionally, the panel strongly recommended a structured education program for patients with type 1 diabetes and type 2 diabetes who may be at a high risk of hypoglycemia. The patient program, according to the panel, is critical to helping patients avoid repeated hypoglycemia.

“The recommendations are based on the consideration of critical outcomes as well as implementation factors such as feasibility and values and preferences of people with diabetes,” the authors concluded. “These recommendations can be used to inform clinical practice and health care system improvement for this important complication for people living with diabetes.”


—Jessica Ganga


  1. McCall AL, Lieb DC, Gianchandani R, et al. Management of individuals with diabetes at high risk for hypoglycemia: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. Published online December 7, 2022. doi:10.12.10/clinem/dgac596
  2. Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and management of adult hypoglycemic disorders: and Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009;94(3):709-728. doi:10.1210/jc.2008-1410