ORIGINAL ARTICLE

Emergency management of diabetes and hypoglycaemia

A Brackenridge¹, H Wallbank², R A Lawrenson³ and D Russell-Jones¹

¹ Royal Surrey County Hospital, Guildford, Surrey, UK
² Surrey Ambulance Service NHS Trust, Banstead, Surrey, UK
³ Postgraduate Medical School, University of Surrey, Guildford, UK

Correspondence to:
Correspondence to:
Professor D Russell-Jones
Department of Diabetes and Endocrinology, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK; drj{at}royalsurrey.nhs.uk

Objective: Hypoglycaemia is the commonest diabetic emergency and is associated with considerable morbidity and mortality. This study looked at the use of the emergency services by people with diabetes, with particular reference to hypoglycaemia.

Method: Data were collected on all attendances related to diabetes at accident and emergency departments at two district general hospitals in Surrey, UK, over a one year period.

Results: Hypoglycaemia was the commonest reason for attendance at accident and emergency. The management of hypoglycaemia was variable, the most frequent method of treatment being intramuscular glucagon administered by the ambulance service. Ninety per cent of patients with hypoglycaemia were either discharged or self-discharged from the accident and emergency department, and half of these patients had no follow up arranged.

Conclusions: Hypoglycaemia is the commonest diabetic emergency and current management is suboptimal. Standardised protocols and better education of healthcare professionals and patients are required.

Abbreviations: A&E, accident and emergency; CHO, carbohydrates; GCS, Glasgow Coma Scale; SAS, Surrey Ambulance Service

Keywords: diabetes mellitus; hypoglycaemia; management

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• Fitzpatrick, D, Duncan, E A S (2009). Improving post-hypoglycaemic patient safety in the prehospital environment: a systematic review. Emerg. Med. J. 26: 472-478 [Abstract] [Full Text]  
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