1. This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More.
  2. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  3. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2019 »
    Dismiss Notice
  4. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Every diabetes appointment should check for potential hypoglycemia, say US specialists

Discussion in 'Diabetes News' started by DCUK NewsBot, Aug 17, 2019.

  1. DCUK NewsBot

    DCUK NewsBot · Well-Known Member

    Messages:
    3,997
    Likes Received:
    672
    Trophy Points:
    133
    Healthcare providers have been urged to do a hypoglycemia (low blood glucose) assessment every time they have an appointment with someone with diabetes. Debbie Hinnen, an advanced diabetes nurse and certified diabetes educator with the University of Colorado Health, and Diana Isaacs, an endocrine clinical pharmacy specialist with the Cleveland Clinic Diabetes Center, say there are several steps diabetes care and education specialists can take to help people avoid dangerously low blood glucose. Speaking during the annual meeting of the American Association of Diabetes Educators, Hinnen warned of the dangers of "pseudohypoglycemia" - when a person with diabetes experiences a rapid drop in glucose that is well above the hypoglycemic range. The physiologic responses to low blood glucose are vast, Hinnen said, so helping patients to assess hypo symptoms and patterns can help to prepare them for future incidences of low blood glucose. "It's frightening," she said. "Sometimes people will have a seizure, and that is what triggers the counterregulatory hormones. The care partners are terrified. We are probably the people that have some of the greatest impact in treating and hopefully preventing hypoglycemia." Isaacs noted that many people with diabetes underestimate their hypoglycemia, or do not connect their symptoms with episodes of very low blood glucose. "That is another reason why I really like people to check [blood glucose] when it is happening," Isaacs said. "I'm sure we have all had that patient who mistakes feeling very tired for a low blood sugar, and then treat it, and they were actually at 13.9 mmol/L (250 mg/dL)." Isaacs also highlighted the importance of preventing hypoglycemic episodes by reminding patients of the three types of medication that can cause low blood glucose: insulin, sulfonylureas and glinides "That is important as you are looking at someone's medication list and trying to identify causes and prevent hypoglycemia." The American Diabetes Association, working alongside the European Association for the Study of Diabetes, has issued new guidance dividing hypoglycemia into three levels, with level 3 the most severe and described as 'assistance required'. In cases such as these, the new guidelines state there is no specific glucose threshold. The person with diabetes will experience severe cognitive impairment and require third-party help to recover. Visit Diabetes Digital Media's Hypo Program for information on managing blood glucose levels, avoiding hypos and conversing with your doctor, nurse or dietitian about how they can help you to understand your hypo symptoms in greater detail.

    Continue reading...
     
  2. Mel dCP

    Mel dCP Type 1 · Well-Known Member

    Messages:
    4,408
    Likes Received:
    6,514
    Trophy Points:
    198
    They’d be doing more good long term by looking at persistent hyPERglycaemia tbh. That’s the one that does the real damage long term. A low might possibly harm you, but persistent high BG certainly will.
     
    • Agree Agree x 1
  3. ickihun

    ickihun Type 2 · Master

    Messages:
    12,936
    Likes Received:
    18,160
    Trophy Points:
    298
    Mine has done for years.
    Hypos are the biggest threat to fatalities in diabetics! Scary, but true.
    The disease's conditions need good management.
     
  4. Lamont D

    Lamont D Reactive hypoglycemia · Master

    Messages:
    11,430
    Likes Received:
    15,002
    Trophy Points:
    298
    Testing insulin levels as well as glucose levels would prevent many prediabetic becoming type two!
     
  5. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

    Messages:
    3,017
    Likes Received:
    1,872
    Trophy Points:
    198
    No information on how you would do this assessment, though.
    Also no indication on types of diabetes or medication regimes.
    Nor what defines a rapid drop in glucose.
    I can see an insulin response via my Libre which is pretty rapid at times, but how would you know if you weren't continually monitoring?

    Every diabetes appointment?
    "Do you think you may have had a fake hypo with no symptoms?
    At any time?
    No, I don't know either but it is one of the mandatory questions!"
     
  6. kitedoc

    kitedoc Type 1 · Well-Known Member

    Messages:
    4,804
    Likes Received:
    3,348
    Trophy Points:
    198
    Hyperglycaemia in TIDs can beget hypoglycaemia by overcorrection particularly on high carb diets.
    US physicians have anecdotally said that they prefer to keep patients BSLs higher as they may be sued if a patient suffers from a hypo. The likelihood of being sued for the patient developing diabetes complications in the future is much less. \
    Yesiree, watch for hypos you US docs 'cos they are going to happen with your typical dietary recommendations, insulin scripts and the BSL ranges you set.
     
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook