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Published byEgbert Rogers Modified over 9 years ago
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Hypoglycaemia and Diabetes Senior Mandatory Training 2011-2012
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Misconception about Diabetes Not all about obesity and high sugars
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Hypoglycaemia is a lower than normal level of blood glucose. It can be defined as “mild” if the episode is self treated and “severe” if assistance by a third party is required (DCCT, 1993). For the purposes of people with diabetes requiring hospital admission, any blood glucose less than 4.0mmol/L should be treated.
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Mild, Moderate or Severe http://care.diabetesjournals.org/content/28/12/2948/F1.large.jpg
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SUI and Datix at RCHT Never events New data/evidence Widespread and effects all of us National Guidance Why are we doing it?
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SUI-1 Type 1 diabetic – mid thirties Unstable glucose control Not rousable in the morning BM checked 1 hour later- patient unconscious, low BM ITU- died
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SUI-2 Anorexic patient BM checked- less than 2.5- not repeated, not treated Patient entered terminal collapse>24 hours later Died
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SUI-3 Type 2 diabetic Glucose more than 20mmol/l so Dr gave verbal order for stat sc insulin-4units Given sliding scale sc as sliding scale chart (50 units sc infused stat)- Patient became profoundly hypoglycaemic and comatose for 36 hours- survived
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Never Events " Never events" are very serious, largely preventable patient safety incidents that should not occur if the relevant preventative measures have been put in place.
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1 definite never event 1 probable never event Multiple datix- hypoglycaemia ignored, not treated or treatment not completed
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What to look for Elderly and long term diabetics may develop hypoglycaemic unawareness so lose autonomic symptoms
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Risk factors
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Who to worry about
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In sick patient check the glucose A B C DEFG – don’t ever forget glucose Even if not diabetic
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Public awareness Check glucose and C peptide/insulin in non diabetics
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Write insulin up carefully Look at drug chart/glucose results Refer to Diabetes Nurses if hypos Ensure treatment has been treated and then glucose rechecked
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