Orozco-Beltrán Domingo, Pineda Adriana López, Quesada José Antonio, Artime Esther, Díaz-Cerezo Silvia, Redondo-Antón Jennifer, Santos Miriam Rubio-de, Spaepen Erik, Munuera María Concepción Carratala
Universidad Miguel Hernández, Alicante, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain.
Universidad Miguel Hernández, Alicante, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain.
Prim Care Diabetes. 2024 Feb;18(1):65-73. doi: 10.1016/j.pcd.2023.11.007. Epub 2023 Dec 2.
Severe hypoglycaemia (SH) imposes a significant burden for people with diabetes (PwD), their caregivers (CGs), and the healthcare system. The study aimed to identify barriers and solutions in the management of SH in PwD in Spain, gathering consensus from physicians and nurses.
Expert opinion from physicians and nurses who manage PwD was collected via a 2-round online Delphi method. Consensus was predefined as ≥ 70% of the panellists agreeing or disagreeing with the statement.
Physicians (n = 25) and nurses (n = 17) reached ≥ 90% consensus on the following barriers for the management of SH: absence of symptoms, cost to the health system, lack of implementation of glucose monitoring devices, lack of patient training to identify and manage SH, and the fear of SH in children and CGs. Main solutions, identified with ≥ 70% consensus, included training, education, and psychological support using diabetes nurse educators and the use of new glucose monitoring technologies and applications.
This study provides valuable insights on the barriers and solutions in the management of SH in Spain. Structured self-management training, the support of diabetes educators, and the use of insulin delivery devices and glucose monitoring technologies is required for the management of SH.
严重低血糖（SH）给糖尿病患者（PwD）及其护理人员（CGs）以及医疗系统带来了沉重负担。本研究旨在确定西班牙糖尿病患者严重低血糖管理中的障碍与解决方案，收集医生和护士的共识。
通过两轮在线德尔菲法收集管理糖尿病患者的医生和护士的专家意见。将≥70%的小组成员同意或不同意该陈述预定义为达成共识。
医生（n = 25）和护士（n = 17）就严重低血糖管理的以下障碍达成了≥90%的共识：无症状、卫生系统成本、血糖监测设备缺乏实施、患者缺乏识别和管理严重低血糖的培训，以及儿童和护理人员对严重低血糖的恐惧。以≥70%的共识确定的主要解决方案包括使用糖尿病护士教育者进行培训、教育和心理支持，以及使用新的血糖监测技术和应用程序。
本研究为西班牙严重低血糖管理中的障碍与解决方案提供了有价值的见解。严重低血糖的管理需要结构化的自我管理培训、糖尿病教育者的支持以及胰岛素输送设备和血糖监测技术的使用。
