Abstract
We read with interest the review article by Yosefa Bar-Dayan et al., "Hypoglycemia-simplifying the ways to predict an old problem in the general ward" that has been published online in the European Journal of Internal Medicine.Although we agree with most of the authors' conclusions, we would like to make at least two comments. First, decompensated liver cirrhosis is known as a risk factor for hypoglycemia in both diabetic and in non-diabetic subjects.
Severe hypoglycemia was reported also in connection to cardiogenic liver failure. Although a low level of albumin may indirectly point to liver failure, it could also be a part of diabetes kidney disease.
It would be interesting to see an analysis of the risk of hypoglycemia connected to elevated parameters such as bilirubin, alanine transaminase, aspartate transaminase, and g-glutamyl transferase and ammonia. Secondly, type 1 diabetes patients experience hypoglycemia more frequently compared with type 2 diabetes patients treated with multiple dose insulin regimen.
Therefore we believe that a separate analysis of data according to these two groups could throw further light into this important topic.