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Local health research could change international guidelines

28 March 2018

Local health research could change international guidelines

Years of research by Wellington doctors and nurses may see a change in how hypoglycaemia – where blood glucose becomes too low – is treated around the world.

Hypoglycaemia symptoms include fatigue, dizziness, blurred vision and confusion and can be resolved within 10-12 minutes if treated correctly and quickly.

Current international guidelines are to give children 10 grams of glucose, and adults 15 grams, no matter their size. Research from Capital & Coast DHB and the University of Otago Wellington looked at whether this was the best method.

“The guidelines are based on expert opinion, rather than practical first-hand experience and knowledge,” said clinical nurse specialist diabetes Lindsay McTavish (image attached) who conducted the research with Drs Brian Corley, Mark Weatherall, Esko Wiltshire and Jeremy Krebs.

“We carried out four clinical trials over 10 years to try to find whether there is a faster and more effective way to treat hypoglycaemia in children and adults with diabetes.”

The research has found that a weight-based method is the best way of managing a hypoglycaemia event. As such, both Capital & Coast and Hutt Valley DHBs switched to a weight-based approach 10 years ago for children and five years ago for adults.

“The evidence is clear for type 1 diabetes, and there is a subtle difference for type 2. The weight-based protocol is better than the standard dose recommended internationally, but is similar to a bigger fixed dose of 30g of glucose used on CCDHB wards.

“We’ve demonstrated that larger people need more glucose to overcome hypoglycaemic events resolve an event – in contrast to the international guidelines that don’t take a patient’s size into account.

“If reviewed and adopted, these studies could change how hypoglaecemia is treated and managed internationally – giving doctors and patients clearer direction about how to resolve symptoms faster.”

Read more about the clinical trials – study one, study two, study three, and study four.

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