Université Côte d'Azur, Centre Hospitalier Universitaire, INSERM, C3M, Nice, France.
Service d'endocrinologie, diabétologie et maladies métaboliques, Centre Hospitalier Sud Francilien, Corbeil-Essonnes Cedex, Université Paris-Saclay, France.
Ann Endocrinol (Paris). 2022 Feb;83(1):16-26. doi: 10.1016/j.ando.2021.11.003. Epub 2021 Dec 3.
The objective of the CRASH (Conversations and Reactions Around Severe Hypoglycemia) survey was to further our understanding of the characteristics, experience, behavior and conversations with healthcare professionals (HCPs) of people with diabetes (PWD) receiving insulin, and of caregivers (CGs) caring for such people, concerning hypoglycemia requiring external assistance (severe hypoglycemic events [SHEs]).
CRASH was an online cross-sectional survey conducted across eight countries. PWD with self-reported type 1 (T1D) or insulin-treated type 2 (T2D) diabetes were aged≥18 years and had experienced one or more SHEs in the past 3 years; CGs were non-medical professionals aged ≥18 years, caring for PWD meeting all the above criteria except for PWD age (≥4 rather than ≥18 years). The present report is a descriptive analysis of data from France.
Among PWD who had ever discussed SHEs with an HCP, 38.9% of T1D PWD and 50.0% of T2D PWD reported that SHEs were discussed at every consultation; 26.3% and 8.8%, respectively, had not discussed the most recent SHE with an HCP. In total, 35.7% of T1D PWD and 53.8% of T2D PWD reported that glucagon was not available to them at the time of their most recent SHE. Only 16.9% of T1D PWD and 6.5% of T2D PWD who had discussed their most recent SHE with an HCP reported that the HCP recommended obtaining a glucagon kit or asked them to confirm that they already had one. High proportions of PWD and CGs reported that the most recent SHE had made them feel unprepared, scared and helpless and had affected mood, emotional state and activities.
CRASH survey data from France identify a need for greater discussion about SHEs between HCPs and PWD and the CGs of such people, and reveal gaps in the diabetes education of PWDs and CGs.
CRASH(严重低血糖相关对话与反应)调查的目的是进一步了解接受胰岛素治疗的糖尿病患者(PWD)及其照护者(CG)在需要外部协助的低血糖(严重低血糖事件[SHE])方面的特征、经历、行为和与医护人员(HCP)的对话。
CRASH 是一项在 8 个国家进行的在线横断面调查。年龄≥18 岁且过去 3 年内有过一次或多次 SHE 经历的自我报告为 1 型(T1D)或胰岛素治疗 2 型(T2D)糖尿病的 PWD ;年龄≥18 岁、照护符合上述所有标准但 PWD 年龄(≥4 岁而非≥18 岁)不符的非医疗专业 CG 参与了此项研究。本报告为法国数据的描述性分析结果。
曾与 HCP 讨论过 SHE 的 PWD 中,38.9%的 T1D PWD 和 50.0%的 T2D PWD 报告称每次就诊均讨论 SHE;分别有 26.3%和 8.8%的 T1D PWD 和 T2D PWD 未与 HCP 讨论最近一次 SHE。总共 35.7%的 T1D PWD 和 53.8%的 T2D PWD 报告称在最近一次 SHE 时他们无法获得胰高血糖素。仅 16.9%的 T1D PWD 和 6.5%的 T2D PWD 报告称在与 HCP 讨论了最近一次 SHE 后,HCP 建议他们购买胰高血糖素套件或要求他们确认已经拥有一个。相当比例的 PWD 和 CG 报告称,最近一次 SHE 让他们感到毫无准备、恐惧和无助,并影响了他们的情绪、情绪状态和活动。
法国 CRASH 调查数据表明,HCP 与 PWD 和此类患者的 CG 之间需要进一步讨论 SHE,并且还揭示了 PWD 和 CG 的糖尿病教育存在差距。