Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, 17033, USA.
Analysis Group, Boston, Massachusetts, 02199, USA.
Diabet Med. 2023 Jun;40(6):e15084. doi: 10.1111/dme.15084. Epub 2023 Mar 27.
Severe hypoglycaemia among people with diabetes who use insulin can be a life-threatening complication if left untreated. Although glucagon has been approved for treatment of hypoglycaemia since the 1960s, it has been underutilized. We aimed to understand the perceptions of people with diabetes and their caregivers about glucagon.
We conducted in-depth, one-on-one telephone interviews with people with diabetes and their caregivers in the United States. The interviews included questions around general awareness of glucagon, reasons for owning or not owning glucagon, and suggestions for improving understanding of glucagon as treatment for severe hypoglycaemia. Initial synopsis and inductive codebook schema were used to analyse the responses by two independent researchers. Themes were developed from the codes, and codes were re-mapped back to the themes.
There were 60 dyads of people with diabetes and their caregivers (N = 120). Four themes developed from the interviews: (1) for most participants, the stated reasons for not owning or renewing a prescription for glucagon included unawareness of the medication, its advantages and its value; (2) misperceptions about glucagon occurred frequently; (3) caregivers often lacked confidence in administering reconstituted injectable glucagon; and (4) education and training from healthcare providers about glucagon would be welcomed.
This study emphasizes the need for healthcare providers to discuss hypoglycaemia prevention and events at each clinical visit, including the use of glucagon in the case of severe hypoglycaemia. Healthcare providers are encouraged to assess the knowledge of people with diabetes and their caregivers regarding treatment and prevention of hypoglycaemia.
在使用胰岛素的糖尿病患者中，严重低血糖如果得不到治疗可能是一种危及生命的并发症。尽管自 20 世纪 60 年代以来，胰高血糖素已被批准用于治疗低血糖，但它的应用一直不足。我们旨在了解糖尿病患者及其护理人员对胰高血糖素的看法。
我们在美国对糖尿病患者及其护理人员进行了深入的一对一电话访谈。访谈内容包括对胰高血糖素的一般认识、拥有或不拥有胰高血糖素的原因，以及对改善对胰高血糖素作为严重低血糖治疗的理解的建议。两名独立研究人员使用初始综合分析和归纳式编码手册方案来分析这些回复。从这些编码中开发了主题，并将编码重新映射到主题上。
有 60 对糖尿病患者及其护理人员（N=120）参加了研究。访谈中得出了四个主题：（1）对于大多数参与者来说，不拥有或不更新胰高血糖素处方的原因包括对药物的不了解、其优势和价值；（2）对胰高血糖素存在误解的情况经常发生；（3）护理人员通常对管理已配制的注射用胰高血糖素缺乏信心；（4）医疗保健提供者提供有关胰高血糖素的教育和培训将受到欢迎。
这项研究强调了医疗保健提供者在每次临床就诊时都需要讨论低血糖预防和事件，包括在严重低血糖的情况下使用胰高血糖素。鼓励医疗保健提供者评估糖尿病患者及其护理人员对低血糖症治疗和预防的了解程度。
