Other Considerations

There are a number of further considerations when a patient presents with hypoglycaemia:

Cause

It is important to establish why this episode of hypoglycaemia occurred and why the patient ended up in the emergency department. Clinicians should be satisfied they have addressed the cause in order to prevent recurrence (Does the patient need prolonged observation eg hypoglycaemia caused by sulphonlyurea)

Patient education

Patient education – how to recognise it and what to do, should be part of each diabetes review. It is important to check the patient’s understanding of the issues before discharge from the ED.

Driving

Patients with a loss of warning symptoms should not drive. It is the doctor’s duty to inform the patient of this and to explain their responsibility to notify the DVLA. This should be documented in the patient notes and wherever possible, written advice should be provided and the patient’s GP informed.

Patients who have attended hospital following hypoglycaemia should have OP follow up with diabetes team or diabetes liaison nurse arranged prior to discharge. Changes to treatment and patient education may prevent future episodes. This is particularly important for those who have hypoglycaemic unawareness. Awareness may be restored by meticulous avoidance of hypoglycaemia requires the close supervision by the diabetes team.