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Hypoglycemia: Frequency, Severity, and Consequences

RESEARCH DESIGN AND METHODS— Prospective study of all patients with insulin-dependent diabetes mellitus (IDDM) who consistently received outpatient diabetes care at the Joslin Clinic from 1 January 1986 to 31 December 1987. Interval histories were obtained and more detailed information about the hypoglycemic events. Severe hypoglycemia was defined as an episode of hypoglycemia associated with any of the following: loss of consciousness, seizure, administration of glucagon, or intravenous glucose to treat the hypoglycemia. Asymptomatic hypoglycemia was defined as a failure or inability to recognize or perceive symptoms of hypoglycemia when self-monitoring of blood glucose revealed that the blood glucose concentration was <3.3 mM. Total glycosylated hemoglobin was measured at each clinic visit.