Structural and Process Quality in the Prehospital Management of Diabetic Emergencies in Germany: A Longitudinal Nationwide Survey 2020 versus 2001

Aim To collect and analyze representative data on relevant indicators of structural and process quality in the management of diabetic emergencies in Germany.

Methods A standardized online survey was sent nationwide to senior emergency physicians. Apart from demographic data, information was obtained about diagnostic procedures and drugs carried in the emergency ambulances, indications for blood glucose measurement, treatment of severe hypoglycemia (SH), the potential use of nasal glucagon, the frequency of diabetic emergencies, and need for further diabetes-related training. Results from 2020 were compared with those from a similar study performed in 2001.

Results The return rate of the questionnaires represented 126 emergency medical service districts (EMSDs) serving a total population of > 40.1 million. 5 % of ambulances carried glucagon (7 % in 2001). In 2001, blood glucose was determined in 24 % of all emergency interventions and in 15 % of suspected cardiac emergencies, in 2020 these indications had increased significantly to 71 % and 29 %, respectively. In 100 % of EMSDs SH was treated by non-medical emergency personnel before the arrival of the doctor (63 % in 2001). Treatment of SH was conducted without hospital admission in 78 % of EMDs (60 % in 2001). Cooperation for medical education between emergency teams and a diabetes centre was reported by only 14 % (41 % in 2001).

Conclusion Structural and process quality of the management of diabetic emergencies in Germany is appropriate and has markedly improved from 2001 to 2020. Persisting deficiencies could be improved by provision of better medical equipment in ambulances and ongoing education for the emergency teams.

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Publication History

Article published online:
19 August 2021