Hypoglycemia has long been considered a dangerous acute complication for individuals with diabetes who are using insulin or secretagogues. As diabetes care and education specialists, we are a critical resource to help individuals understand their risk, prevent it when possible and manage treatment options. The fall and winter holidays, from Halloween to New Year’s Day, can be a particularly difficult time to manage glucose and avoid hypoglycemia because eating patterns and activities change significantly (think shoveling snow, for example).
Here are 5 things you can do with your clients to support their success.
- Assess their risk of hypoglycemia. People with diabetes need to be aware of the factors that increase the risk of hypoglycemia, placing a special focus on medications. While the holidays look very different this year, it may still include changes to usual habits and an increase or decrease in activity and meals.
- Help them learn more about their own symptoms of hypoglycemia. Remind them of the 4 critical times for DSMES and that virtual DSMES and MNT visits are still available and being reimbursed by commercial and government insurance plans. These visits can be used to review the symptoms of hypoglycemia and how to better adjust medications, meals and physical activity to reduce the risk.
- Create a prevention plan. If possible, use CGM or increased SMBG to gain more insight into how different meals and activity levels will impact their current medication doses. Help them create a plan to adjust their doses or meals and snacks to reduce risk.
- Encourage a prescription for glucagon. This applies to every person on insulin or other medications that increase the risk of hypoglycemia. If the cost is prohibitive, be sure to discuss assistance programs or savings cards available from each company.
- Jointly create a care plan. Work with them to create a plan and ask that they share it with significant others, caregivers and anyone else who might be appropriate. A good way to create a plan that can be easily individualized is the new treatment roadmap tool from ADCES Low Blood Sugar Treatment Planning: Get Ready, Get Set, Go! It is a fillable pdf and outlines the treatment planning steps for you.
For more information on hypoglycemia, visit DiabetesEducator.org/HypoResources.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
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