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Medicine Miscellaneous 8ce3da27

All are risk factors for Severe Hypoglycemia except

A
Sleep
B
Short duration of D.M
C
ACE genotype
D
Strict control of blood sugar level
High-Yield Explanation
(A) Sleep # Hypoglycemia-Associated:> Autonomic Failure(Nueropathy): The concept of hypoglycemia-associated autonomic failure (HAAF) in diabetis posts that recent antecedent iatrogenic hypoglycemia (or sleep or prior exercise) causes both defective glucose counterregulation (by reducirg the epinephrine response to a given level of subsequent hypoglycemia in the setting of absent insulin and glucagon responses) and hypoglycemia unawareness (by reducing the sympathoadrenal response to a given level of subsequent hypoglycemia).> Based on this pathophysiology, additional risk factors for hypoglycemia in diabetes include insulin deficiency that indicate; that insulin levels will not decrease and glucagon levels will not increase as plasma glucose levels fall; a history of severe hypoglyc emia or of hypoglycemia unawareness, implying recent antecedent hypoglycemia, that indicates that the sympathoadrenal response will be attenuated; and lower HbA1c levels or lower glycemic goals that, all other factors being equal, increase the probability of recent antecedent hypoglycemia

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