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CONTENTS Why hypoglycemia is dangerous Symptoms Diagnosis Causes Investigation Treatment Prevention of hypoglycemia in the ICU patient Persistent hypoglycemic encephalopathy why hypoglycemia is dangerous why hypoglycemia is dangerous Prolonged severe hypoglycemia can cause permanent brain damage, similar to anoxic brain injury

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The most common reasons include: Gastrointestinal side effects such as nausea, vomiting and diarrhea which are the single most frequently documented reason for stopping in large health system datasets High out of pocket cost and lack of insurance coverage particularly in individuals without diabetes Medication unavailability or pharmacy supply shortages which peaked in 2023early 2024 Perceived completion of therapy once target weight is reached or weight loss plateaus Concerns about long term safety or treatment burden of injections Many cohorts show substantial discontinuation by 3 months, with further losses by 6-9 months

The 2026 Prohibited List, Section S2.2.4 (Growth Hormone Releasing Factors) tesamorelin named as a GHRH analogue

Genetic variations in CYP 2C9 (e.g., slow metabolizers) may affect phenytoin levels