Acute complications of diabetes mellitus - proper diabetes education

ABSTRACT

The incidence and mortality of diabetic ketoacidosis (DKA) have hardly changed in recent years. Recurrent DKA in particular is characterised by a high mortality rate of about 23%. Young people with type 1 diabetes are more often hospitalised for DKA than for severe hypoglycaemia. COVID-19 probably leads to a higher incidence of DKA - especially in people with type 2 diabetes. Major risk factors for recurrent DKA include female gender, age between 13 and 25 years, higher HbA (1c) , migrant background and mental illness. Education on DKA should create awareness of the dangers of DKA and develop a concrete plan of action in case of emergency. Hypoglycaemia is the limiting factor of insulin therapy and is associated with increased diabetes-related distress and increased risk of cardiovascular events. The incidence of severe hypoglycaemia over 12 months is around 8%. The effective use of diabetes technologies should be an integral part of diabetes education. The most important technology-related education content includes alarm setting limits, the correct use of trend arrows, training in pattern recognition in the ambulatory glucose profile (AGP) and knowledge of automatic (predictive) low glucose suspend functions in automated insulin delivery (AID) systems. Hypoglycaemia unawareness occurs when the body becomes accustomed to low glucose levels and the autonomic response to low glucose levels weakens. The basis of hypoglycaemia-awareness training is systematic self-observation of one's own physical symptoms at different glucose levels.