Hypoglycemia in Type 2 Diabetes Mellitus patients: A review article

Tourkmani, Ayla M.; Alharbi, Turki; Rsheed, Abdulaziz M. Bin; AlRasheed, Abdulrhamn N.; Albattal, Saad; Abdelhay, Osama; Hassali, M.A.; Alrasheedy, Alian A.; Harbi, Nouf G. Al; Alqahtani, Abdulaziz

doi:10.1016/j.dsx.2018.04.004

Cited by 37 publications

(32 citation statements)

References 17 publications

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“…We used a feasibility study design to examine study procedures, as well as measures and instruments to be used in an upcoming larger observational study. The study does not focus on the outcome of the data itself (14).…”

Section: Designmentioning

confidence: 99%

“…Studies reporting on hypoglycemic incidents in older people with diabetes are often based on severe hypoglycemia in hospitalized patients and does not describe the situation in a home dwelling older population with diabetes (13)(14)(15)(16). In line with this, we have designed an observational study to investigate the feasibility of continuous glucose monitoring (CGM) and use of standardized questionnaires on issues associated with increased risk of hypoglycemia among older home-dwelling individuals ≥ 75 years with diabetes type 2 receiving home care.…”

Section: Introductionmentioning

confidence: 99%

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Hypoglycemia in older people with diabetes receiving home care: A feasibility-study

Larsen

Hermann

Graue

2020

Preprint

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Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidence of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to investigate the feasibility of using continuous glucose monitoring (CGM) and standardized questionnaires on issues associated with increased risk of hypoglycemia among older home dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data were collected by a study nurse in the individuals’ home.Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study inform an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals, were we will reconsider the use of the MMSE questionnaire. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

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Section: Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypoglycemia in older people with diabetes receiving home care: A feasibility-study

Larsen

Hermann

Graue

2020

Preprint

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“…The presentation of symptoms, in diabetes, is closely related to the degree of deterioration of the counterregulatory mechanism in patients with diabetes. 51 It should be considered that older patients have an increased risk of hypoglycemia 23 related to multiple factors such as deterioration of renal function, increased deterioration of the counterregulatory mechanism, polypharmacy, frailty and appetite alteration. 14 In the scenario of patients in end-oflife care, the risk is substantial due to its association with anorexia, nausea or vomiting and reduced quality of life.…”

Section: Glycemic Controlmentioning

confidence: 99%

“…50 It is associated with increased use of hospital services and cognitive impairment. 51 Also, patients with end-of-life care may present with liver and kidney failure, which impacts on the dose and management of drugs 49 considering that the combination of different hypoglycemic drugs and the use of Insulin are risk factors for hypoglycemia. 23 On the other hand, monitoring the development of hyperglycemia is necessary to avoid the complications of polyuria, polydipsia, nausea and dehydration that accompany it; which reduces the quality of life of patients.…”

Section: Glycemic Controlmentioning

confidence: 99%

“…53 Patients with type 2 diabetes have a lower risk of complications such as hypoglycemia and ketoacidosis compared to patients with type 1 diabetes. 51 The main difficulty of hyperglycemia is the hyperosmolar state 54 with higher risk in older adults, 14 so the adjustment of medications in end-of-life care is essential. 50 Treatment with insulin could be simplified or discontinued if symptomatic hypoglycemia occurs and according to clinical status, 45 with attention in patients with clinical and unstable detergency and those close to death.…”

Section: Patients With Type 2 Diabetesmentioning

confidence: 99%

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Perspective and general approach of diabetes in palliative care

Javier¹

2018

HPMIJ

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ObjectiveThe objective of this review is to provide an overview of palliative care in patients with diabetes. Describe the relationship between diabetes and co-morbidity, its impact on the prognosis and the different strategies to carry out the treatment plan for patients who enter the end-of-life scenario. AbstractThe progressive aging of the population and the increase in chronic diseases means that we are facing more and more patients who require palliative care. It is necessary to reinforce the multidisciplinary work and the coordination between first level care and hospital care. In addition to changes in health policies, it is required to train health professionals more in communication skills and in the ethical and humanitarian perspective of the care of patients in the process of dying. For patients with diabetes, adequate assessment of their prognosis and the adequacy and management of their medications should be reinforced in all patients who enter the care phase at the end of life to minimize the side effects and complications derived from them. Medications and maintain comfort and quality of life as best as possible. Properly communicate changes to family members and patients to decide together the best treatment strategy.

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