New

hypoglycemia definition could have unexpected consequences for people with diabetes In line with the American Diabetes Association guidance, the European Medicines Agency recently adopted a higher blood glucose level (3.9 mmol/l [70 mg/dl]) to define hypoglycemia.1 In the current issue of Diabetic Hypoglycemia (www.hypodiab.com), Stephanie Amiel argues that the new definition has unexpected consequences on defining hypoglycemia awareness status – it means that anyone with blood glucose below 3.9 mmol/l (70 mg/dl) at a time when they are asymptomatic would be defined as hypoglycemia unaware.2 As impaired hypoglycemia awareness is prohibitive to holding a driving licence across Europe, this could potentially have a major impact on the lives of many people. Therefore, while simple guidelines are desirable, defining hypoglycemia is not simple and a comprehensive individualized approach to assessing patients is needed. Many factors will have an impact on the prevention and management of hypoglycemia in individual patients, with some factors such as fear of hypoglycemia among patients and their family/carers needing close attention. The fear of hypoglycemia and the urgent need to develop interventions to address this burden are discussed in the current issue of the journal by Linda Gonder-Frederick.