Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2024; 15(2): 129-132
Published online Feb 15, 2024. doi: 10.4239/wjd.v15.i2.129
Balancing act: The dilemma of rapid hyperglycemia correction in diabetes management
Ke-Xin Zhang, Cheng-Xia Kan, Xiao-Dong Sun
Ke-Xin Zhang, Cheng-Xia Kan, Xiao-Dong Sun, Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China
Author contributions: All the authors contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Dong Sun, PhD, Chief Physician, Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, No. 2428 Yuhe Road, Weifang 261031, Shandong Province, China. xiaodong.sun@wfmc.edu.cn
Received: October 23, 2023
Peer-review started: October 23, 2023
First decision: December 8, 2023
Revised: December 9, 2023
Accepted: January 12, 2024
Article in press: January 12, 2024
Published online: February 15, 2024

The global diabetes surge poses a critical public health challenge, emphasizing the need for effective glycemic control. However, rapid correction of chronic hyperglycemia can unexpectedly trigger microvascular complications, necessitating a reevaluation of the speed and intensity of glycemic correction. Theories suggest swift blood sugar reductions may cause inflammation, oxidative stress, and neurovascular changes, resulting in complications. Healthcare providers should cautiously approach aggressive glycemic control, especially in long-standing, poorly controlled diabetes. Preventing and managing these complications requires a personalized, comprehensive approach with education, monitoring, and interdisciplinary care. Diabetes management must balance short and long-term goals, prioritizing overall well-being. This editorial underscores the need for a personalized, nuanced approach, focusing on equilibrium between glycemic control and avoiding overcorrection.

Keywords: Diabetes, Hyperglycemia correction, Management, Microvascular compli-cations, Glucose control

Core Tip: Rapid glycemia corrections may unexpectedly lead to microvascular complications in diabetes. Balancing glycemic control is crucial in diabetes management. Prioritizing an individualized, comprehensive care approach is essential to ensure long-term well-being.