Published on 21 September 2021

People with diabetes in East Midlands reported “significantly” lower hypoglycaemic episodes as result of awareness drive.

An education campaign has helped to “significantly” reduce the number of repeated emergency call-outs to people with diabetes experiencing hypoglycaemic episodes across the East Midlands. 

Research behind the initiative aimed to raise awareness of hypoglycaemia to healthcare professionals in the UK and Ireland with hospitals across the UK and Ireland taking part. 

A hypoglycaemic episode, or hypo, can happen when blood sugar levels drop too low. 

Research shows that around one in 10 people who have a severe hypo will have another one within a fortnight, and an education campaign was developed. 

The Hypos can strike twice booklet was issued by paramedics following a hypoglycaemic event to try to prevent the need for subsequent ambulance attendances. 

In addition to the booklet, ambulance staff also provided patients with information on accessing follow-up care by GPs or specialised diabetes teams. 

Research carried out by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East Midlands, in collaboration with the East Midlands Ambulance Service NHS Trust, found that the Hypos can strike twice intervention had a positive impact. 

The study of 4,825 patients experiencing hypoglycaemic events attended by the ambulance service over the course of two years indicated a significant decrease in repeat attendances for hypoglycaemia, compared to the pre-intervention trend. 

The Hypos can strike twice booklets cost around £3.70 to issue, including staff time using it, compared to an ambulance attendance costing up to £257. 

The resource has also been shown to provide a significant improvement in the information, advice and treatment given for hypoglycaemia delivered by ambulance staff. 

Professor Niro Siriwardena, a Professor of Primary and Prehospital Health Care at the University of Lincoln, who led the study, said: “Although hypoglycaemia can be serious if left untreated, it is possible to treat the condition and prevent a future episode, if action is taken early. Prevention, instead of reaction is always favourable, so we wanted to see what impact the Hypos can strike twice booklet has on people when it comes to dialling 999 for hypoglycaemia. 

“The new process of care was found to work, was easy to use, acceptable to patients and prevented recurrent hypos. By reducing potentially unnecessary calls to the ambulance service, it may also decrease hospital attendances, thereby reducing pressures and costs for ambulance services and hospitals.” 

Professor Kamlesh Khunti, who is the Director of NIHR ARC East Midlands and Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, said: “This is an important study because it shows that by improving education, we can ease the pressure on the NHS and improve the quality of life for people experiencing severe hypos. This study is also another example of how we are working to bridge the gap between research and frontline healthcare, ensuring evidence is adopted sooner leading to improvements to services and people’s lives.” 

It is estimated there are up to 100,000 emergency call-outs annually for hypoglycaemia in the UK, costing £13.6 million per year to the NHS, with each admission to hospital costing about £1,000. 

Patient education has been identified as being important for maintaining glycaemic control and preventing recurrent hypoglycaemia. 

The East Midlands Ambulance Service reported that: “The Hypos can strike twice patient information leaflet has assisted the EMAS clinician to give up to date, detailed and effective safety netting advice which can be left with the patient. It has encouraged collaborative working with referral to the specialist services when required, to ensure the patient gets the advice they need to manage their condition.” 

Download the Hypos can strike twice free booklet – also available for all ambulance services to use and provide to their staff and patients 
Read the report in Diabetic Medicine 
The research was shared to coincide with Hypo Awareness Week - running from 13th to 19th September 
Read more: Are you having a hypo? Know the symptoms 

DRWF offers our diabetes awareness necklace together with a diabetes check-up card FREE to anyone requesting them. We distribute more than 3,500 necklaces per year and as part of our outreach programme, receive no government funding. If you would like to enable us to continue providing a necklace, a small donation of £2 will help us to cover the cost. Please donate now and support DRWF to ensure that people are "staying well until a cure is found..." Thank you. 

To order your FREE necklace/medical check-up card please email or call 023 9263 7808. If you are a healthcare professional and would like to receive a supply of Diabetes Awareness Necklaces and Diabetes Check-up Cards for distribution to patients please call us on 023 9263 6136 to discuss your requirements. 

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