Oral glucose, normal consciousness reduces the risk of poor results in severe hypoglycemia


September 21, 2021

2 minutes to read

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Disclosures: Uduku does not report any relevant financial disclosure. Please see the study for relevant financial information from all other authors.

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According to study data, people with diabetes who need emergency assistance due to hypoglycemia were less likely to need parenteral therapy if they had higher glucose levels. , normal consciousness, or oral glucose therapy, according to study data.

“Parenteral therapy can save lives and is often reserved for severe cases of hypoglycemia, particularly when the ability to ingest glucose by mouth is compromised.” Chukwuma Uduku, MBBS, B.Sc., MRCP, a clinical researcher in endocrinology, diabetes and internal medicine at Imperial College London, and his colleagues wrote in a study published in Diabetes medicine. “Our results suggest that early non-invasive interventions such as oral glucose may reduce the need for invasive parenteral rescue therapy. This is also reflected by the finding that with oral glucose therapy, higher blood sugar levels and intact consciousness at the end of on-site treatment are negative predictors for transport to hospital.

People with diabetes who have higher blood sugar levels, normal consciousness, or who receive oral glucose therapy have a reduced likelihood of hospitalization due to severe hypoglycemia. Data were derived from Uduku C, et al. Diabet Med. 2021; doi: 10.1111 / dme.14654.

Researchers carried out a retrospective review of cases in which the London Ambulance Service NHS Trust responded to calls for adult or pediatric hypoglycemia from January 1 to June 30, 2018. People with confirmed type 1 or type 2 diabetes have been included in the analysis. Data on age, gender, emergency medical services (EMS) response time, seizures, respiratory rate, pulse rate, systolic and diastolic blood pressure, use of drug therapy. oral glucose, parenteral glucose or glucagon therapy, capillary blood glucose and intact consciousness on arrival and before leaving the premises were obtained from the ambulance service clinical database.

There were 2,862 cases of emergency hypoglycemia included in the analysis, with 1,503 people with type 1 diabetes and 1,359 with type 2 diabetes. People with type 1 diabetes were younger than the group with type 2 diabetes (median age, 55 years versus 75 years) and had a shorter average EMS response time (10.9 minutes versus 12.1 minutes). The median glycemia at the onset of EMS was slightly lower in the type 1 diabetic group compared to the type 2 diabetics (2.3 mmol / L vs. 2.5 mmol / L).

The rate of incidents labeled as hypoglycemia by the EMS call manager was 19% higher in type 1 diabetics than in type 2 diabetics, and the hospitalization rate was 28% lower in those with diabetes. type 1. The percentage of people with type 1 diabetes receiving parenteral therapy was higher than that with type 2 diabetes (53.6% versus 46.2%).

People with type 1 diabetes were less likely to require hospitalization compared to people with type 2 diabetes (OR = 0.37; 95% CI: 0.21-0.66; P <.01 a longer ems response interval was negative predictor of receipt parenteral therapy ci:>P = .03).

People with higher capillary blood glucose (OR = 0.22; 95% CI: 0.16-0.31; P P P = 0.04) and normal consciousness (OR = 0.08; 95% CI: 0.03-0.21; P <.01>

People who received oral glucose therapy were less likely to need parenteral therapy (OR = 0.02; 95% CI: 0.01-0.07; P P <.01 parenteral treatment increased the likelihood of hospitalization ci:>P <.01>

The researchers said the findings could be used to help improve early intervention, education and accessibility or risk prevention strategies to reduce the need for parenteral treatment and hospitalization in people with dementia. emergency hypoglycemia.

“A greater allocation of resources providing access to hypoglycemia prevention tools in both categories of diabetes, with more emphasis on identifying and self-treating hypoglycemia, is needed to reduce the economic burden of emergency hypoglycemia, ”the researchers wrote.

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