Follow up care for adults with diabetes treated for severe hypoglycemia by emergency medical Services, 2013–2019
Authors' conclusion
Interventions to prevent recurrent hypoglycemia increase with escalating levels of care but remain inadequate and inconsistent with clinical guidelines. Greater attention is needed to ensure timely diabetes-related follow-up and treatment modification for patients experiencing severe hypoglycemia.
Study context
- Population
- Adults with diabetes experiencing hypoglycemia requiring emergency medical services (EMS), 1/1/2013–12/31/20191,977 EMS calls
- Participants
- 1,028 adults
- Exposure
- Levels of care after EMS-treated severe hypoglycemia
- Outcome
- Rates of discussion of hypoglycemia, change of diabetes medications, glucagon prescribing and referral for diabetes
- Follow-up
- 7 days after EMS call
Methodological detailslinked data from a multi-state health system and an advanced life support ambulance service
- Linked data from a multi-state health system and an advanced life support ambulance service
Main finding
As reported in the abstract
Hypoglycemia discussion after EMS calls without emergency department (ED) transport or outpatient encounters
11.5 %
Hypoglycemia discussion among hospitalized patients with outpatient follow-up
98 %
EMS transport associated with higher odds of hypoglycemia discussion
OR 60
Outpatient follow-up associated with higher odds of hypoglycemia discussion
OR 22.1
Observational data: associations, not effects.
Further findings
Effect of previous severe hypoglycemia within 30 days
- Interventions were not impacted by previous severe hypoglycemia within 30 days
Glucagon prescription
- Prescription of glucagon was rare among all patients
Original publication
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