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Don’t forget sex and hypo education!

Hypoglycaemia is a challenging problem associated with glycaemic management in diabetes, in particular type 1 diabetes. Hypoglycaemic episodes cause unpleasant symptoms that can affect lifestyle at home and in the work place, and there is now evidence of an association between severe hypoglycaemia and cardiovascular disease (Goto et al, 2013).

Hypoglycaemia is a challenging problem associated with glycaemic management in diabetes, in particular type 1 diabetes. Hypoglycaemic episodes cause unpleasant symptoms that can affect lifestyle at home and in the work place, and there is now evidence of an association between severe hypoglycaemia and cardiovascular disease (Goto et al, 2013).

Participating in sex results in significant energy expenditure (2–6 METs*), thereby increasing the risk of hypoglycaemia. In the current article summarised alongside, Pinhas-Hamiel et al explore the fear of hypoglycaemia in people with type 1 diabetes. Unsurprisingly, hypoglycaemic fear is not uncommon – one-third of people feared a hypoglycaemic event would occur during sex. These individuals had typically experienced a hypoglycaemic episode during or after sexual activity previously. More than two-thirds of those studied did not undertake any measures to mitigate the increased risk of hypoglycaemia. As a healthcare professional, we recognise the need to educate our patients about hypoglycaemic management and its relationship with exercise. This study highlights the need to specifically address with people with diabetes the subject of glycaemic control in relationship to sexual activity. Often it is a subject avoided by patients and clinicians; however, this article identifies that it is a concern to patients and impacts on patients’ psyche (even though minimal action seems to be taken by the individual to avoid this risk), and there is a role for the clinician to play in educating and raising awareness.

*METs=metabolic equivalent of task. For comparison, walking one mile on the flat in 20 minutes consumes 3-4 METs (Wilson et al, 1981).

To read the article summaries, please download the PDF

Goto A, Arah OA, Goto M et al (2013) Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis. BMJ 347: f4533
Wilson PK, Farday PS, Froelicher V (1981) Cardiac Rehabilitation: Adult Fitness and Exercise Testing (2nd edition). Lea and Fabiger, Philadelphia, USA

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