Hypoglycaemic Brittle Diabetes Successfully Managed by Social Worker Intervention

Abstract

The case is presented of a 39-year-old Type 1 diabetic patient of 22 years duration with recurrent hypoglycaemic comas. He was of unusual personality and had bizarre ideas on self-regulation of his diabetes, resulting in wide variations of insulin dosage. In one 12-month period he had 88 separate admissions to an emergency department with severe hypoglycaemic coma requiring intravenous glucose administration. The cycle of admissions was eventually broken by the intervention of a social worker, who provided structured non-medical support. The patient's diabetic misconceptions remained, but he appeared to gain sufficient insight to prevent recurrent hypoglycaemia.

Effectiveness of a multidisciplinary team approach to the prevention of readmission for acute glycaemic events

“…Although medication costs were not an issue in our area, other social difficulties were common (28%) and the educators undertook aspects of social work in their case management role. Inclusion of a social worker was discussed within the team and, elsewhere, such involvement has been beneficial .…”