Adherence to guidelines for self-treatment of mild hypoglycaemia in type 1 diabetes
DOI:
https://doi.org/10.1002/edn.71Keywords:
Type 1 diabetes, hypoglycaemia, fear of hypoglycaemia, glycated haemoglobin, treatmentAbstract
AbstractAim: To compare self-treatment of mild symptomatic hypoglycaemia in people with type 1 diabetes with national Danish guidelines recommending 10–20 g of refined carbohydrate initially followed by unrefined carbohydrates.
Methods: A cohort of 201 patients with type 1 diabetes filled in a questionnaire including self-treatment of mild symptomatic hypoglycaemia and occurrence of mild and severe hypoglycaemia. Initial intake of less than 10 g of refined carbohydrate was defined as under treatment and intake of 20 g or more as over treatment.
Results: A total of 147 patients (73%) answered both questions about initial and follow-up self-treatment of hypoglycaemia. Fifty per cent of patients treated themselves with 10–20 g refined carbohydrates (female:male = 59%:43%; p<0.05), whereas 37% over treated (female:male = 34%:39%; not significant) and 13% under treated (female:male = 6%:18%; p<0.05). Initial treatment was followed by consumption of unrefined carbohydrates in 70% of the patients. Overall, 37% (female:male = 49%:28%; p<0.05) of the patients adhered to guidelines. The number of severe hypoglycaemic episodes (lifetime) and amount of carbohydrate intake were positively correlated (r=0.2; p<0.05). Adherence to guidelines was not related to occurrence of mild and severe (in the last year) hypoglycaemia, glycated haemoglobin, or fear of hypoglycaemia.
Conclusions: Only about one-third of patients with type 1 diabetes treat mild hypoglycaemia according to guidelines. Female patients show better compliance. Patients with frequent episodes of severe hypoglycaemia over treat more often.
Downloads
References
Pramming S, Thorsteinsson B, Bendtson I, et aL. Symptomatic hypoglycaemia in 411 type 1 diabetic patients. Diabet Med 1991; 8: 217–222.
Pedersen-Bjergaard U, Agerholm-Larsen B, Pramming S, et al. Activity of angiotensin-converting enzyme and risk of severe hypoglycaemia in type 1 diabetes mellitus. Lancet 2001; 357: 1248–1253.
Pedersen-Bjergaard U, Agerholm-Larsen B, Pramming S, et al. Prediction of severe hypoglycaemia by angiotensin-converting enzyme activity and genotype in type 1 dia-betes. Diabetologia 2003; 46: 89–96.
Pedersen-Bjergaard U, Pramming S, Heller SR, et aL Severe hypogly-caemia in 1076 adult patients with type 1 diabetes: influence of risk fac-tors and selection. Diab Metab Res Rev 2004; 20: 479–486.
Goldgewicht C, Slama G, Papoz L, et aL Hypoglycemic reactions in 172 type 1 (insulin-dependent) diabetic patients. Diabetologia 1983; 24: 95–99.
Macleod KM, Hepburn DA, Frier BM. Frequency and morbidity of severe hypoglycaemia in insulin-treated diabetic patients. Diabet Med 1993; 10: 238–345.
ter Braak EWMT, Appelman AMMF, van de Laak MF, et al. Clinical char-acteristics of type 1 diabetic patients with and without severe hypoglycaemia. Diabetes Care 2000; 23: 1467–1471.
Jorgensen HV, Pedersen-Bjergaard U, Rasmussen AK, et al. The impact of severe hypoglycaemia and impaired awareness of hypogly-caemia on relatives of patients with type 1 diabetes. Diabetes Care 2003; 26: 1106–1109.
Nutrition Subcommittee of the Diabetes Care Committee of Diabetes UK The implementation of nutritional advice for people with diabetes. Diabet Med 2003; 20: 786–807.
American Diabetes Association. Insulin administration. Diabetes Care 2004; 27(suppl. 1): S106–109.
Diabetes for eningen (Danish Diabetes Association). Lavt blodsukker hypo-glykxmi (Low blood sugar - hypogly-caemia). http:www.diabetes.dk/default.asp?id=2972 (Accessed 14 October 2006).
Sommerfield AJ, Ewing FME, Strachan MWJ, et aL Self-treatment of mild symptomatic hypoglycaemia by people with insulin-treated diabetes. Diabet Med 2003; 20: 686–687.
Pedersen-Bjergaard U, Pramming S, Thorsteinsson B. Recall of severe hypoglycaemia and consistency of self-estimated state of awareness in type 1 diabetes. Diab Metab Res Rev 2003; 19: 232–240.
Diabetes for eningen (Danish Diabetes Association). Mad og diabetes 6 (Food and diabetes 6). Diabetesforeningen 2002.
Brodows RG, Williams C, Amatruda JM. Treatment of insulin reactions in diabetics. JAMA 1984; 252: 3378–3381.
Slama G, Traynard PY, Desplanque N, et aL. The search for an optimized treatment of hypoglycaemia. Carbohydrates in tablets, solution, or gel for the correction of insulin reactions. Arch Intern Med 1990; 150: 589–593.
Larsen T, Banck-Petersen P, due-Anderson R, et al. Effect of carbohydrate self-treatment of mild symptomatic hypoglycaemia assessed by CGM. Eur Diabetes Nursing 2006; 3(3): 143–146.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2007 Copyright © 2007 FEND
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
