From the Guidelines
Hypoglycemia treatment would be the most important aspect of diabetes management for EC and her family to learn. Since EC is starting on basal insulin (glargine 35 units daily), she is now at risk for hypoglycemia, which can be dangerous if not promptly recognized and treated 1. The family should learn to identify symptoms of low blood glucose (shakiness, sweating, confusion, irritability), how to check blood glucose when symptoms occur, and how to treat hypoglycemia using the 15-15 rule: consuming 15 grams of fast-acting carbohydrates, waiting 15 minutes, then rechecking blood glucose. They should keep glucose tablets, juice, or hard candies readily available at home, school, and when traveling. The family should also understand when to use glucagon for severe hypoglycemia when EC cannot safely consume oral carbohydrates. While carbohydrate counting, sick day guidelines, and foot care are important components of diabetes education, hypoglycemia treatment is most critical for immediate safety when initiating insulin therapy, as untreated hypoglycemia can lead to seizures, loss of consciousness, or even death.
Some key points to consider when educating EC and her family about hypoglycemia treatment include:
- Recognizing the symptoms of hypoglycemia, such as shakiness, sweating, and confusion 1
- Understanding how to check blood glucose levels when symptoms occur 1
- Knowing how to treat hypoglycemia using the 15-15 rule 1
- Keeping glucose tablets, juice, or hard candies readily available at all times 1
- Understanding when to use glucagon for severe hypoglycemia 1
- Being aware of the potential risks of hypoglycemia, such as seizures, loss of consciousness, or even death 1
By prioritizing hypoglycemia treatment education, EC and her family can ensure her safety and well-being while managing her diabetes. Additionally, it is essential to consider the cost-effectiveness of different antihyperglycemic agents, as the cost of insulin has been rising steadily over the past decade 1. However, the most critical aspect of diabetes management for EC and her family to learn is hypoglycemia treatment, as it directly impacts her immediate safety and well-being.
From the FDA Drug Label
During changes to a patient's insulin regimen, increase the frequency of blood glucose monitoring [see Warnings and Precautions (5. 2)]. Dosage adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), during acute illness, or changes in renal or hepatic function.
The most important aspect of diabetes management for EC and her family to learn is Hypoglycemia treatment, as the drug label mentions the risk of hypoglycemia when switching insulin therapies or adjusting dosages 2.
From the Research
Importance of Hypoglycemia Treatment in Diabetes Management
- Hypoglycemia remains a major limiting factor to successful glycaemic management, despite the availability of prevention options such as insulin analogues, continuous glucose monitoring, insulin pumps, and dogs that have been trained to detect hypoglycaemia 3.
- Education and regular review are essential between people with diabetes and their caregivers and healthcare professionals about symptoms, prevention and treatment of hypoglycemia 3.
- Awareness of the potential dangers of hypoglycaemia is fundamental to the optimal management of diabetes, particularly when therapy is intensified to achieve glycaemic targets 3.
Other Aspects of Diabetes Management
- Carbohydrate counting and sick day guidelines are important aspects of diabetes management, but the most critical aspect for EC and her family to learn would be hypoglycemia treatment, given the increased risk of hypoglycemia with insulin therapy 3, 4.
- Foot and skin care is also an important aspect of diabetes management, but it is not as directly relevant to the initiation of insulin therapy as hypoglycemia treatment 5, 6.
- Blood glucose monitoring and patient education are essential in diabetes care and management, and can help to achieve maximum benefit for the patient and diabetes care team 7, 5, 6.