Diabetologie und Stoffwechsel 2019; 14(S 01): S38
DOI: 10.1055/s-0039-1688216
Poster
Stoffwechselentgleisungen
Georg Thieme Verlag KG Stuttgart · New York

Conversations and reactions around severe hypoglycemia (crash): german results from a global study

E Mönnig
1   Eli Lilly and Company, Medical Department Diabetes, Bad Homburg, Germany
,
M Peyrot
2   Loyola University Maryland, Department of Sociology, Maryland, MD, United States
,
F Snoek
3   Amsterdam University Medical Center, Department of Medical Psychology, Amsterdam, Netherlands
,
B Osumili
1   Eli Lilly and Company, Medical Department Diabetes, Bad Homburg, Germany
,
B Mitchell
1   Eli Lilly and Company, Medical Department Diabetes, Bad Homburg, Germany
,
K Ihle
1   Eli Lilly and Company, Medical Department Diabetes, Bad Homburg, Germany
,
A Duenas
4   Evidera, Department of Patient-Centered Research, Evidera, London, United Kingdom, United Kingdom
,
A Holstein
5   Klinikum Lippe GmbH, Medical Clinic 1, Klinikum Lippe GmbH, Detmold, Germany, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
07 May 2019 (online)

Also available at
 

Background:

Little is known about the experience and knowledge of persons with diabetes (PWD) and their caregivers regarding severe hypoglycemic events (SHE), or therapeutic glucagon use. The CRASH cross-sectional survey addressed this research gap.

Methodology:

Approximately 200 PWD and 200 caregivers, evenly divided between type 1 [T1D] and 2 [T2D] diabetes, were recruited in each of eight countries including Germany. Inclusion criteria included: age ≥18 years, informed consent given (all participants); receiving insulin, had experienced SHE (low blood sugar and severe cognitive impairment requiring external assistance) within previous 3 years (PWD). Participants completed a 30-minute online survey examining their SHE understanding and management. Data from the most recent SHE of 222 German PWD (T1D: N = 111; T2D: N = 111) were analysed descriptively.

Results:

Impaired awareness of hypoglycemia was reported in 36.0% (T1D) and 25.2% (T2D) of PWD. Most SHE happened at home (T1D, 80.2%; T2D, 78.4%); most PWD were not alone at the time of the event (T1D, 73.9%; T2D, 65.8%). The majority of events were treated with oral carbohydrates. A few (14.4% T1D and 8.1% T2D) received glucagon; an ambulance was called in 19.8% (T1D) and 14.4% (T2D) of cases. The most common reasons for not using glucagon were glucagon unavailability/no prescription (T1D: 23.4%/26.6%; T2D: 25.0%/33.0%). After their most recent event, 67.6% (T1D) and 83.8% (T2D) of PWD discussed it with their healthcare provider and 5.4% (T1D) and 2.7% (T2D) obtained a glucagon kit.

Conclusions:

Treatment of SHE mainly occurred outside the healthcare system; glucagon was used in few cases.