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Hypoglycaemia is considered to be the most significant complication when treating diabetes. The most important is its association with cardiovascular risk. Rigorous self-monitoring, lifestyle changes and the use of insulin analogues reduce the risk significantly in type 1 diabetes patients. Combined insulin and incretin therapy appears to be useful. Individualized therapy and incretin treatment in particular represent considerable risk reduction in type 2 diabetes patients. It is crucial to change therapy in a patient who underwent hypoglycaemia. Modern antidiabetic therapy helps to surmount the risk of hypoglacaemia and it is possible at any stage of type 2 diabetes treatment to select therapy with lover risk of hypoglacaemia: incretin therapy is the most suitable following metformin treatment failure, incretin analogues are the most suitable when oral antidiabetic agents fail, and insulin analogues are the most appropriate when insulin therapy is to be initiated. Key words: cardiovascular risk - insulin therapy - incretin therapy - oral antidiabetic medication - insulin analogues.

Acute diseases in seniors suffering from diabetes significantly influence their nutritional status which is one of the factors participating in the development of acute hyperglycaemic decompensation of diabetes or hypoglycaemia. Inadequately compensated diabetes in seniors is conversely associated with nutritional disorders and the patient is at greater risk of an acute intercurrent disease. Ensuring optimal nutrition in old diabetics is one of the basic provisions in the treatment of intercurrent acute disease.

The author described a case of protracted hypoglycaemia in a young type I insulin treated diabetic, associated at first with neurological symptomatology imitating a cerebrovascular attack. After three days, when it was necessary to administer repeatedly glucose by the i.v. route on account of low blood sugar levels, the carbohydrate metabolism deteriorated and called for administration of similar insulin doses as before. In the discussion the author deals with pathogenetic possibilities of the described condition.