Position statement: Hypoglycemia management in patients with diabetes mellitus. Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition

Mezquita-Raya, Pedro; Reyes-García, Rebeca; Moreno-Pérez, Óscar; Muñóz-Torres, Manuel; Merino-Torres, Juan Francisco; Gorgojo-Martínez, Juan J.; Jódar-Gimeno, Esteban; Martín, Javier Escalada San; Gargallo-Fernández, Manuel; Soto-González, Alfonso; Villar, Noemí González Pérez de; Fernández, Antonio B.; Guerrero, Diego Bellido; Botella-Serrano, Marta; Gómez-Peralta, Fernando; Casares, Martín López de la Torre

doi:10.1016/j.endoen.2013.11.009

Cited by 7 publications

(6 citation statements)

References 147 publications

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“…Enforcement of hypoglycemia prevention practices in the management of diabetes mellitus and identifying the associated factors with hypoglycemia prevention practices such as optimization of insulin treatment, improved access to blood glucose testing, patient education and developing good knowledge on hypoglycemia, and promoting favorable attitude towards diabetes mellitus may help patients more effectively to delay the onset and reduce the development of complication that leads to a prolonged hospitalization and reduced quality of life [12,13].…”

Section: Introductionmentioning

confidence: 99%

Hypoglycemia Prevention Practice and Associated Factors among Diabetic Patients on Follow-Up at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018

Gebremichael

Mariye

2020

International Journal of Endocrinology

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Background. Hypoglycemia is an acute medical situation that occurs when blood glucose level falls below 70 mg/dl. Although prevention of hypoglycemia is one cornerstone in the management of diabetes mellitus, its prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. Methods. Hospital-based cross-sectional study design was employed from March 1 to April 1, 2018, in the central zone of Tigray regional state of Ethiopia. A total of 272 diabetes mellitus patients selected by a systematic random sampling method were included in the study. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for further analysis. The binary logistic regression model (AOR, 95% CI, and p value < 0.05) was used to determine the predictors of hypoglycemia prevention practice. Results. The mean age of respondents was 43.62 years, and about 100 (63.2%) participants had good hypoglycemia prevention practice. Good knowledge on hypoglycemia (AOR = 10.34; 95% CI [5.41, 19.89]), having a glucometer at home (AOR = 3.02; 95% CI [1.12, 8.12]), favorable attitude towards diabetes mellitus (AOR = 2.36 CI [1.26, 4.39]), and being governmental employee (AOR = 5.19, 95% CI [1.63, 16.58]) were positive predictors of good hypoglycemia prevention practice. However, being divorced (AOR = 0.13, 95% CI [0.32, 0.53]) was found negatively associated with good hypoglycemia prevention practice. Conclusion. Only two-thirds of the study participants were found to have good hypoglycemia prevention practices. Healthcare personnel and Ethiopian diabetic association should promote patients’ attitude towards DM and knowledge on hypoglycemia by strengthening information, education, and communication program. Stakeholders should also try to provide glucometers to diabetic patients.

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Section: Introductionmentioning

confidence: 99%

Hypoglycemia Prevention Practice and Associated Factors among Diabetic Patients on Follow-Up at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018

Gebremichael

Mariye

2020

International Journal of Endocrinology

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“…Additionally, diabetic people may also be in risk of having a low level of sugar in blood (hypoglycemia) as a result of, for example, a wrong dose of insulin or too much physical exercise, and with the following symptoms: sweating, sickness, heart palpitations, blurred vision, tremors, etc. In severe cases it can lead to loss of consciousness [ 23 , 24 , 25 ]. In fact, there are works focused on relating hypoglycemia with the risk of suffering cardiovascular diseases [ 25 , 26 , 27 ].…”

Section: Distributed Applications Management Platform (Damp)mentioning

confidence: 99%

“…In severe cases it can lead to loss of consciousness [ 23 , 24 , 25 ]. In fact, there are works focused on relating hypoglycemia with the risk of suffering cardiovascular diseases [ 25 , 26 , 27 ].…”

Section: Distributed Applications Management Platform (Damp)mentioning

confidence: 99%

A Component-Based Approach for Securing Indoor Home Care Applications

Agirre

Armentia

Estévez

et al. 2017

Sensors

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eHealth systems have adopted recent advances on sensing technologies together with advances in information and communication technologies (ICT) in order to provide people-centered services that improve the quality of life of an increasingly elderly population. As these eHealth services are founded on the acquisition and processing of sensitive data (e.g., personal details, diagnosis, treatments and medical history), any security threat would damage the public’s confidence in them. This paper proposes a solution for the design and runtime management of indoor eHealth applications with security requirements. The proposal allows applications definition customized to patient particularities, including the early detection of health deterioration and suitable reaction (events) as well as security needs. At runtime, security support is twofold. A secured component-based platform supervises applications execution and provides events management, whilst the security of the communications among application components is also guaranteed. Additionally, the proposed event management scheme adopts the fog computing paradigm to enable local event related data storage and processing, thus saving communication bandwidth when communicating with the cloud. As a proof of concept, this proposal has been validated through the monitoring of the health status in diabetic patients at a nursing home.

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“…This Renal impairment reduces the renal clearance of insulin,21 which may result in higher levels of premixed insulin being retained in this subgroup of participants, possibly resulting in the observed improvement in glycaemic control. However, impaired kidney function is a well-known risk factor for hypoglycaemia,22,23 and therefore other insulin therapy regimens with a lower hypoglycaemia risk may be more suitable in some cases. A history of chronic kidney disease has been shown to be one of the factors that increases the probability of treatment intensification with insulin therapy in people with T2D uncontrolled on non-insulin antidiabetic drugs 24.…”

mentioning

confidence: 99%

Effectiveness of premixed insulin to achieve glycaemic control in type 2 diabetes: A retrospective UK cohort study

Jude

Trescolí

Emral

et al. 2021

Diabetes Obesity Metabolism

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Aim To investigate the effectiveness of premixed insulin for achieving glycaemic outcomes in clinical practice in the UK. Materials and Methods Electronic medical record data from The Health Improvement Network database were captured for adults with type 2 diabetes (T2D) uncontrolled (HbA1c ≥9%) on two or more oral antihyperglycaemic drugs (OADs) initiating premixed insulin. Effectiveness of premixed insulin was assessed by the probability and incidence of achieving glycaemic outcomes (target HbA1c <7.5% [<58 mmol/mol] and a ≥1% or ≥2% HbA1c reduction) over 24 months. Results Data from 974 participants (mean age 62 years; 56% male; 52% obese or extremely obese; mean HbA1c 11.3% [100 mmol/mol]; hypertension 64%, dyslipidaemia 23% and nephropathy 21%) were analysed. The probability of achieving HbA1c <7.5% was highest during months 3‐6 (18.2%), while the cumulative probability of achieving this target plateaued between months 15‐24 (15.7%‐16.0%). Incidence of achieving all glycaemic outcomes plateaued after 12 months and differed by baseline HbA1c, but not OAD use. Factors affecting some glycaemic outcomes included a body mass index >40 kg/m2 and co‐morbidities including nephropathy and stroke. Conclusions In people with uncontrolled T2D (HbA1c ≥9%), glycaemic outcome achievement on premixed insulin was low at 6 months with little additional clinical benefit beyond 12 months, suggesting a high unmet need for early, timely treatment changes with more effective, simpler therapies.

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Position statement: Hypoglycemia management in patients with diabetes mellitus. Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition

Cited by 7 publications

References 147 publications

Hypoglycemia Prevention Practice and Associated Factors among Diabetic Patients on Follow-Up at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018

Hypoglycemia Prevention Practice and Associated Factors among Diabetic Patients on Follow-Up at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018

A Component-Based Approach for Securing Indoor Home Care Applications

Effectiveness of premixed insulin to achieve glycaemic control in type 2 diabetes: A retrospective UK cohort study

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