The best hypoglycaemia avoidance initiative in the UK
DOI:
https://doi.org/10.15277/bjd.2017.126Keywords:
hypoglycaemia, avoidance, initiative, UK, insulinAbstract
Introduction: The annual National Diabetes Inpatient Audit (NaDIA) in the UK continues to show a high incidence of hypoglycaemia in people with diabetes admitted to hospital. It is clear that initiatives are urgently required to address this risk.Methods: The Joint British Diabetes Societies for Inpatient Care (JBDS-IP) organised the second national Rowan Hillson Insulin Safety Award on the theme of the best hypoglycaemia avoidance initiative in the country.
Results: The Ipswich Hospital diabetes team won the award for their innovative scheme to identify patients likely to develop hypoglycaemia through network meters and prevent the risk. The Royal Cornwall Hospital diabetes team came second, securing an award for their simulation project to educate the ward staff in managing hypoglycaemia and preventing re-occurrence. There were five other high quality entries to the competition with innovations that have the potential to reduce hypoglycaemia nationally.
Conclusions: These and similar schemes need to be developed, promoted and shared to reduce hypoglycaemia in hospitalised patients with diabetes.
References
Health and Social Care Information Centre. National Diabetes Inpatient Audit 2015. http://content.digital.nhs.uk/catalogue/PUB20206/nati-diab-inp-audi-15-nat-rep.pdf (accessed 21 Sep 2016)
Tschöpe D, Bramlage P, Binz C, et al. Incidence and predictors of hypoglycaemia in type 2 diabetes – an analysis of the prospective DiaRegis registry. BMC Endocrine Disorders 2012;12:23. http://dx.doi.org/10.1186/1472-6823-12-23
Shriraam V, Mahadevan S, Anitharani M, et al. Reported hypoglycemia in type 2 diabetes mellitus patients: prevalence and practices – a hospital-based study. Indian J Endocrinol Metab 2017;21:148-53. http://dx.doi.org/10.4103/2230-8210.196002
Timmons JG, Cunningham SG, Sainsbury CA, Jones GC. Inpatient glycemic variability and long-term mortality in hospitalized patients with type 2 diabetes. J Diabetes Complications 2016;31:479-82. http://dx.doi.org/10.1016/j.jdiacomp.2016.06.013
Yeh JS, Sung SH, Huang HM, et al. Hypoglycemia and risk of vascular events and mortality: a systematic review and meta-analysis. Acta Diabetol 2016;53:377-92. http://dx.doi.org/10.1007/s00592-015-0803-3
Turchin A, Matheny ME, Shubina M, Scanlon JV, Greenwood B, Prendergrass ML. Hypoglycemia and clinical outcomes in patients with diabetes hospitalized in the general ward. Diabetes Care 2009;32:1153-7. http://dx.doi.org/10.2337/dc08-2127
McEwan P, Thorsted BL, Wolden M, et al. Healthcare resource implications of hypoglycemia-related hospital admissions and inpatient hypoglycemia: retrospective record-linked cohort studies in England. BMJ Open Diabetes Res Care 2015;3:e000057. http://dx.doi.org/10.1136/bmjdrc-2014-000057
Royal College of Physicians. Underfunded, underdoctored, overstretched: the NHS in 2016. https://www.rcplondon.ac.uk/guidelines-policy/underfunded-underdoctored-overstretched-nhs-2016?utm_source=Communications&utm_medium=email&utm_campaign=7552127_Underfunded%20report%20-%2021%20September%202016&utm_ content=UnderfundedReport&dm_i=1V12,4HV9B,JCEEBM,GM8NB,1 (accessed 21 Sep 2016).
Dashora U, Sampson M, Castro E, Stannisstreet D, Hillson R, on behalf of the Joint British Diabetes Societies for Inpatient Care. Rowan Hillson Insulin Safety Award ‘best in class’ insulin prescription chart competition. Br J Diabetes 2015;15:135-8. http://dx.doi.org/org/10.15277/bjdvd.2015.028
Sampson M. Best in class insulin prescription charts. http://www.diabetologists-abcd.org.uk/JBDS/insulin_chart_winners.pdf (accessed 21 Sep 2016)
Gregory R. Rowan Hillson Insulin Safety Award 2015. http://www.diabetologists-abcd.org.uk/Lists/Announcements/DispForm.htm?ID= 218&Source=http%3a%2f%2fwww%2ediabetologists%2dabcd%2eorg%2euk%2fhome%2ehtm. (accessed 21 Sep 2016).
Rajendran R, Kerry C, Rayman G, et al. Temporal patterns of hypoglycaemia and burden of sulfonylurea-related hypoglycaemia in UK hospitals: a retrospective multicentre audit of hospitalised patients with diabetes. BMJ Open 2014;4:e005165. http://dx.doi.org/10.1136/bmjopen-2014-005165
Kerry C, Mitchell S, Sharma S, Scott A, Rayman G. Diurnal temporal patterns of hypoglycaemia in hospitalized people with diabetes may reveal potentially correctable factors. Diabet Med 2013;30:1403-06. http://dx.doi.org/10.1111/dme.12256
Jones S, Castro E, Dashora U. Management of inpatients with diabetes undergoing surgery using pre-printed variable rate intravenous insulin infusion prescriptions. J Diabetes Nursing 2016;20:202-06.
Dashora U, Castro E. Best in class insulin prescription charts. http://www.diabetologists-abcd.org.uk/Posters/Autumn2014/ Dashora.pdf
George S, Dale J, Stanisstreet D. A guideline for the use of variable rate intravenous insulin infusion in medical inpatients. Diabet Med 2015;32:706-13. http://dx.doi.org/10.1111/dme.12756
Barker P, Creasey PE, Dhatariya K, et al. Peri-operative management of the surgical patient with diabetes 2015. Anaesthesia 2015;70:1427-40. http://dx.doi.org/10.1111/anae.13233
American Diabetes Association. Diabetes care in the hospital. Diabetes Care 2017;40(Suppl 1):S120-7. http://dx.doi.org/10.2337/dc17-S017
Published
Issue
Section
License
Publish & Transfer of Copyright Agreement
For the mutual benefit and protection of the Author and the Journal Owner/Publisher it is necessary that the Author provides formal written Consent to Publish and Transfer of Copyright before publication of the Work.
