Outcomes
a) Reduction in the number of people with diabetes requiring ED attendance or admission as a result of a hypoglycaemic episode.
b) Reduction in the rate of recurrence of an episode of hypoglycaemia requiring medical attention over 12 months.
A workgroup of the American Diabetes Association and the Endocrine Society reviewed recent evidence about the impact of hypoglycaemia on people with diabetes. To assist in an efficient assessment of the person at risk of hypoglycaemia, a two-fold process is recommended. To begin with, the person with diabetes completes a questionnaire prior to the consultation detailing how often they experience symptomatic and asymptomatic hypoglycaemia. Secondly, the patient is made aware of how to appropriately treat hypoglycaemia and reminded of the risks associated with driving (Seaquist et al 2013). To ensure that hypoglycaemia is effectively managed, the health provider could use a Hypoglycaemia Provider Checklist.
This ensures the provider:
reviews the hypoglycaemia patient questionnaire
discusses circumstances surrounding hypoglycaemic episodes
discusses strategies to avoid hypoglycaemia
makes medication changes where appropriate
recommends carrying treatment and provides instruction on how to take it
prescribes glucagon if appropriate.
A copy of the questionnaire is available here: http://care.diabetesjournals.org/content/36/5/1384.full.pdf+html.
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