Hypoglycemia in Patients With Diabetes on Antidiabetic Medications Who Fast for Laboratory Tests

We would like to report the results of a pilot study that we undertook to evaluate the risk of hypoglycemia in patients with diabetes on antidiabetic medications because of the repeated calls from our laboratory reporting critical glucose results, typically after patients who had come earlier for blood tests had already left the laboratory. We have become increasingly concerned about these occurrences and realized that our patients may not be adequately educated on the proper preparation for tests requiring overnight fasting.Patients with diabetes are generally given instructions regarding medication adjustments when they fast overnight for surgical or diagnostic procedures, but we became concerned that there may not be such instructions for overnight fasting for laboratory tests. It could be argued that some clinicians may take the initiative of providing such instructions. However, being diabetes specialists ourselves, we acknowledge that we had not paid adequate attention to this issue. Similarly, from talking with diabetes educators (S.A., personal communications), we realized that this educational piece is not included in traditional curricula. Extensive literature search retrieved no publications on this critical issue or educational guidelines on how to prepare patients with …