Barriers and solutions for the management of severe hypoglycaemia in people with diabetes in Spain: A Delphi survey

Orozco-Beltrán, Domingo; Pineda, Adriana López; Quesada, José Antonio; Artime, Esther; Díaz-Cerezo, Silvia; Redondo-Antón, Jennifer; Santos, Miriam Rubio-de; Spaepen, Erik; Munuera, María Concepción Carratala

doi:10.1016/j.pcd.2023.11.007

Cited by 1 publication

(2 citation statements)

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“…FoH contributes to the increased frequency of anxiety and depression in PWD and must be evaluated with a structured approach that includes specific screenings. Training must be individualized and take into account that those who have limited access to food due to cost also have limited options for dealing with hypoglycemia ( 90 ). A careful evaluation must also consider the coexistence of FoH in disadvantaged families ( 90 ).…”

Section: Fear Of Hypoglycemia and Psychological Impactmentioning

confidence: 99%

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Recommendations for recognizing, risk stratifying, treating, and managing children and adolescents with hypoglycemia

Zucchini,

Tumini,

Scaramuzza

et al. 2024

Front. Endocrinol.

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There has been continuous progress in diabetes management over the last few decades, not least due to the widespread dissemination of continuous glucose monitoring (CGM) and automated insulin delivery systems. These technological advances have radically changed the daily lives of people living with diabetes, improving the quality of life of both children and their families. Despite this, hypoglycemia remains the primary side-effect of insulin therapy. Based on a systematic review of the available scientific evidence, this paper aims to provide evidence-based recommendations for recognizing, risk stratifying, treating, and managing patients with hypoglycemia. The objective of these recommendations is to unify the behavior of pediatric diabetologists with respect to the timely recognition and prevention of hypoglycemic episodes and the correct treatment of hypoglycemia, especially in patients using CGM or advanced hybrid closed-loop systems. All authors have long experience in the specialty and are members of the Italian Society of Pediatric Endocrinology and Diabetology. The goal of treating hypoglycemia is to raise blood glucose above 70 mg/dL (3.9 mmol/L) and to prevent further decreases. Oral glucose at a dose of 0.3 g/kg (0.1 g/kg for children using “smart pumps” or hybrid closed loop systems in automated mode) is the preferred treatment for the conscious individual with blood glucose <70 mg/dL (3.9 mmol/L), although any form of carbohydrate (e.g., sucrose, which consists of glucose and fructose, or honey, sugary soft drinks, or fruit juice) containing glucose may be used. Using automatic insulin delivery systems, the oral glucose dose can be decreased to 0.1 g/kg. Practical flow charts are included to aid clinical decision-making. Although representing the official position of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED), these guidelines are applicable to the global audience and are especially pertinent in the era of CGM and other advanced technologies.

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Section: Fear Of Hypoglycemia and Psychological Impactmentioning

confidence: 99%

“…Training must be individualized and take into account that those who have limited access to food due to cost also have limited options for dealing with hypoglycemia ( 90 ). A careful evaluation must also consider the coexistence of FoH in disadvantaged families ( 90 ).…”

Section: Fear Of Hypoglycemia and Psychological Impactmentioning

confidence: 99%