Team medical effort to safely perform diabetes treatment

Intervention study to prevent severe hypoglycemia

Abstract

With the goal of reducing the severe hypoglycemia episode in type 2 diabetes patients, we launched a diabetes team of multidisciplinary cooperation for diabetic patients in our community to prevent severe hypoglycemic unconsciousness. The outcome of our study is to investigate whether it is possible to reduce the incidence of severe hypoglycemia, and improve knowledge to counter-act hypoglycemia through multidisciplinary education. We studied 82 patients with type 2 diabetes brought in by ambulance for severe hypoglycemia in our hospital between April, 2010 to March, 2013. Age, HbA1c, e-GFR, treatment regimen and the relations with the season at the time of the onset was investigated. We found that elderly diabetic patients over 70 years of age on sulfonilurea drugs to maintain HbA1c at 7.0% or less showed higher risk of severe hypoglycemia. We then conducted an investigation regarding their knowledge against hypoglycemia on doctors, nurses and diabetic patients. The results showed a lack of nocturnal hypoglycemia in all three groups. To mitigate this, we distributed coping manuals and brochures compiled by physicians, nurses, pharmacists, administrative dietitian and physical therapists to all related persons. We were able to reduce the occurrence of severe hypoglycemia. Diabetes team approach was effective in decreasing the number of patients with serious hypoglycemic unconsciousness by improving knowledge against the nocturnal hypoglycemia using a brochure. The team medical care, working together and complementing each other, is believed to benefit type 2 diabetic patients.