Patients with type 1 diabetes have an average of two symptomatic hypoglycemias in a week and at least one severe hypoglycemia in a year. The most common causes of hypoglycemia are overcorrection of hyperglycemia, excessive basal insulin dose, and physical exercise. Fear of hypoglycemia is common and leads to poor control of diabetes. On the other hand, recurrent hypoglycemias are often caused by fear of complicating diseases and overcorrection with additional insulin of even a mild hyperglycemia. Active inquiry about hypoglycemias should be made during a medical consultation. Insulin pump therapy should be considered if recurrent symptomless hypoglycemias cannot be resolved some other way.
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