Patients receiving insulin are particularly at risk.
Alcohol, particularly without food, can also cause hypoglycaemia. Hypoglycaemia occurs in the insulin-treated patient particularly after omission of meals or after exercise. In the latter case, extra carbohydrates should be taken beforehand or insulin should be decreased. Behavioural disturbances and other unusual symptoms are frequent in the elderly patient during hypoglycaemia. Hypoglycaemia does not occur during dietary, a-glucosidase inhibitor or metformin therapy.