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Case studies

Brought to you by Diabetes & Primary Care, the four mini-case studies presented below will help you to consider what constitutes hypoglycaemia, what its causes and risk factors are in type 2 diabetes, how to detect and manage it in primary care, and strategies for minimising the risk. Each scenario provides a different set of circumstances that you could meet in your everyday practice. By actively engaging with them, you will feel more confident and empowered to manage effectively such problems in the future.

References

  1. European Medicines Agency (2018) Guidelines on clinical investigations of medicinal products in the treatment of diabetes mellitus. EMA, Amsterdam, the Netherlands. Available at: https://bit.ly/3jlqTgC (accessed 04.08.21)
  2. Heller S, Amiel SA, Khunti K; International Hypoglycaemia Study Group (2015) Hypoglycaemia, a global cause for concern. Diabetes Res Clin Pract 110: 229–32
  3. American Diabetes Association (2021) 12. Older adults. Standards of Medical Care in Diabetes – 2021. Diabetes Care 44(Suppl 1): S168–79
  4. Chan SP, Colagiuri S (2015) Systematic review and meta-analysis of the efficacy and hypoglycaemic safety of gliclazide versus other insulinotropic agents. Diabetes Res Clin Pract 110: 75–81
  5. Buse JB, Wexler DJ, Tsapas A et al (2019) 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 43: 487–93
  6. DVLA ( 2019) A guide to insulin treated diabetes and driving (INF294). Available at: https://bit.ly/2TZ9wtq (accessed 04.08.21)
  7. Diggle J (2015) In the consultation room. Tacking hypoglycaemia in type 2 diabetes. Diabetes & Primary Care 17: 44–7
  8. Diabetes UK (2021) Having a hypo. Available at: https://www.diabetes.org.uk/guide-to-diabetes/complications/hypos/having-a-hypo (accessed 04.08.21)
  9. Heller SR (2011) Hypoglycaemia: Its pathophysiology in insulin treated diabetes and hypoglycaemic unawareness. Br J Diabetes Vasc Dis 11: 6–11
  10. Gupta PS, Green AN, Chowdhury TA (2011) Hypoglycaemia. BMJ 342: d567
  11. Wild D, von Maltzah R, Brohan E et al (2007) A critical review of the literature on fear of hypoglycaemia in diabetes: implications for diabetes management and patient education. Patient Educ Couns 68: 10–15
  12. Khunti K, Davies M, Majeed A et al (2015) Hypoglycaemia and risk of cardiovascular disease and all-cause mortality in insulin-treated people with type 1 and type 2 diabetes: a cohort study. Diabetes Care 38: 316–22
  13. James J (2013) Managing diabetes emergencies. Diabetes & Primary Care 15: 29–37

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