Reduction of Severe Hypoglycaemia in People with Type 2 Diabetes after a Structured Inpatient Intervention

Kloos, C; Burghardt, K; Müller, Ulrich; Kramer, G; Müller, N; Wolf, Günter; Kuniß, Nadine

doi:10.1055/a-0983-1559

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…The frequency of severe hypoglycemia in T2D can be significantly reduced after participation in structured interventions that include patient education. 52 We advocate the training of providers (including primary care providers), staff, people with diabetes and their families on the creation of an action plan for timely and appropriate treatment of hypoglycemia. The International Hypoglycaemia Study Group provides several resources to assist HCPs in the understanding of hypoglycemia causes and treatments.…”

Section: Treatment and Prevention Educationmentioning

confidence: 99%

Hypoglycemia in patient with type 2 diabetes treated with insulin: it can happen

Heller

Peyrot

Oates

et al. 2020

BMJ Open Diab Res Care

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There are many misconceptions about the prevalence and effects of hypoglycemia in people with type 2 diabetes (T2D), including hypoglycemia does not occur or does not have adverse consequences in T2D. This narrative review aims to help dispel these myths. Around 25% of people with T2D taking insulin for >5 years were found to have severe hypoglycemic events, which is comparable to the severe hypoglycemia rate in adults with type 1 diabetes (T1D) diagnosed within 5 years. The total number of hypoglycemic events among insulin-treated T2D, including severe hypoglycemia, is as high or higher than among those with T1D. Recent evidence suggests serious consequences of hypoglycemia may, in some respects, be greater in individuals with T2D, particularly regarding effects on the cardiovascular system. Hypoglycemia is generally patient-reported. Issues with hypoglycemia unawareness, limited glucose testing, limited recall, lack of event logging and fear of failure or shaming limits the number of hypoglycemic episodes reported by people with diabetes. Barriers to healthcare provider inquiry and reporting include lack of knowledge regarding the problem’s magnitude, competing priorities during patient visits, lack of incentives to report and limitations to documentation systems for adequate reporting. All people with diabetes should be encouraged to discuss their experiences with hypoglycemia without judgment or shame. Glucose targets, testing schedules (blood glucose or continuous glucose monitoring) and treatment plans should be reviewed often and individualized to the minimize risk of hypoglycemia. Finally, people with T2D on insulin should always be encouraged to have oral glucose and rescue medication immediately available.

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Section: Treatment and Prevention Educationmentioning

confidence: 99%

Hypoglycemia in patient with type 2 diabetes treated with insulin: it can happen

Heller

Peyrot

Oates

et al. 2020

BMJ Open Diab Res Care

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“…The decrease in non-severe hypoglycaemia in T2DM outpatients may be explained by less of a use of insulin therapy or less stringent target ranges for glycaemic control. Additionally, teaching programmes help to prevent hypoglycaemia [24,43,44]. Interestingly, the frequency of hypoglycaemia in patients with T2DM did not change significantly in TC, although insulin and sulfonylureas were used less frequently during the study period.…”

Section: Complications and Comorbiditymentioning

confidence: 99%

Metabolic Control, Diabetic Complications and Drug Therapy in a Cohort of Patients with Type 1 and Type 2 Diabetes in Secondary and Tertiary Care between 2004 and 2019

Roth

Kloos

Scheer

et al. 2023

IJERPH

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This paper studies the features of metabolic parameters, diabetic complications and drug therapy of a single-centre cohort of patients with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) in secondary care and tertiary care over a 15-year period. Methods: Retrospective cross-sectional analysis of four single-centre cohorts between 2004 and 2019. All patients with T1DM or T2DM in secondary care (n = 5571) or tertiary care (n = 2001) were included. Statistical analyses were performed using linear mixed models. Results: Diabetes duration increased in both patients with T1DM and T2DM in secondary care and tertiary care (p < 0.001). Patients in secondary care consistently showed good glycaemic control, while patients in tertiary care showed inadequate glycaemic control. All four cross-sectional cohorts showed a significant increase in the prevalence of nephropathy over time and three out of four cohorts (T1DM and T2DM in secondary care and T2DM in tertiary care) showed an increase in the prevalence of neuropathy (all p < 0.001). The incidence of severe hypoglycaemia was consistently low. The use of insulin pumps and insulin analogues in the therapy of T1DM increased significantly. Conclusions: The increased prevalence of complications is likely due to older age and longer diabetes duration. Low rates of hypoglycaemia, lower limb amputations and good glycaemic control in secondary care patients indicate a good structure of patient care.

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“…Several experiences demonstrated that structured interventions that included patient education could significantly reduce the frequency of severe hypoglycemia in T2DM [45].…”

Section: Do Not Fail To Train the Patient In The Management Of Hypoglycemia When Prescribing Hypoglycemic Therapymentioning

confidence: 99%

Identification of the Inappropriate Clinical Actions (DON'T) to Improve the Management of Patients with Type 2 Diabetes Failing Basal Insulin Supported Oral Treatment: Results of Survey for a Panel of Diabetes Specialists in Italy

Leto

Barchetta

Candia³

et al. 2021

Diabetes Ther

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Reduction of Severe Hypoglycaemia in People with Type 2 Diabetes after a Structured Inpatient Intervention

Cited by 8 publications

References 21 publications

Hypoglycemia in patient with type 2 diabetes treated with insulin: it can happen

Hypoglycemia in patient with type 2 diabetes treated with insulin: it can happen

Metabolic Control, Diabetic Complications and Drug Therapy in a Cohort of Patients with Type 1 and Type 2 Diabetes in Secondary and Tertiary Care between 2004 and 2019

Identification of the Inappropriate Clinical Actions (DON'T) to Improve the Management of Patients with Type 2 Diabetes Failing Basal Insulin Supported Oral Treatment: Results of Survey for a Panel of Diabetes Specialists in Italy

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