Current view of treatment of hypoglycemia.

Hypoglycemia is a side effect of the therapy primarily with insulin, sulphonylurea derivates and glinides. Its therapy is based on the immediate ingestion of sacharides, preferably glucose. Amount of 15-20 g is recommended as its optimal dose, although several recent studies are suggesting amount related to the patient´s weight. The therapy of severe hypoglycemia in the non-professional settings is based on glucagon injection, in the professional ones intravenous administration of glucose is preferable option.

Ethanol and risk of hypoglycemia in patients with type 1 diabetes mellitus: a brief overview for clinical practice.

Alcoholic drinks are one of the risk factors for hypoglycemia. Ethanol inhibits gluconeogenesis, decreases a level of growth hormone and impairs hypoglycemia awareness. The risk of hypoglycemia while drinking alcohol can be reduced by parallel ingestion of food (saccharides). Some recommendations also mention the change of insulin doses.

Lessons Learned from Implementing a New Testing/Educational Tool for Patients Using an Insulin Pump.

BACKGROUND: To improve insulin pump therapy results, a special test for patients was devised. The model successfully used to achieve a license to operate different machines was followed. METHODS: The test (a practice and a full run, with a time limit) contained 42 questions, each with four optional choices, and could be answered online. Patients could familiarize themselves with the whole question pool first. Patients could repeat a full run attempt if they failed and were offered focused remedial education. The study group composed of adults, 46 females, and 54 males, all treated for type 1 diabetes, 38/100 newly introduced to insulin pump therapy. RESULTS: Eighty-five of 100 patients successfully completed their first full run attempt (80% or higher correct answers) and 3 of 100 on their second full run attempt; 12 of 100 patients were not able to succeed. The median of the test score was 2 mistakes (range 0-17 mistakes). The most problematic topics were diet and insulin regimens and their application. The crucial factor influencing the test score was the willingness to try practice run(s). Those who practiced had a significantly higher total test score with better results in 5 of 8 tested knowledge domains. Age and diabetes existing >15 years had an impact on the result, too. Both patients' and caregivers' opinions on the test were predominantly positive (or neutral). CONCLUSIONS: The type of test introduced is a good tool for checking a patient's theoretical knowledge and indirectly revealing a patient's level of motivation.