Barriers and solutions for the management of severe hypoglycaemia in people with diabetes in Spain: A Delphi survey

• Published in: Primary care diabetes Vol. 18; no. 1; pp. 65 - 73
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2024
• Subjects: Blood Glucose; Blood Glucose Self-Monitoring; Caregivers; Child; Consensus; Delivery of health care; Delphi technique; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - therapy; Environmental monitoring; Expert testimony; Glucose; Health; Humans; Hypoglycemia - chemically induced; Hypoglycemia - diagnosis; Hypoglycemia - therapy; Insulin; Nurses; Patients; Physicians; Self-management; Spain; Spain; Caregivers; Delphi technique; Health; Physicians; Delivery of health care; Glucose; Insulin; Patients; Consensus; Expert testimony; Nurses; Self-management; Environmental monitoring
• ISSN: 1751-9918; 1878-0210
• DOI: 10.1016/j.pcd.2023.11.007

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. •Severe hypoglycaemia (SH) imposes a significant burden for people with diabetes.•Using the Delphi method, expert opinion from physicians and nurses was collected.•Structured self-management training and skilled diabetes educators are needed.•Insulin delivery devices and glucose monitoring technologies should be used.