Practical strategies to normalize hyperglycemia without undue hypoglycemia in type 2 diabetes mellitus

Development of an Educational Program on Prevention of Hypoglycemic Events Among Elderly Veterans With Type 2 Diabetes

PURPOSE

The purpose of this project was to develop an evidence-based educational program to reduce hypoglycemic events in elderly veterans with type 2 diabetes mellitus who are enrolled in the Veterans Healthcare Administration system. Updated guidelines have emphasized the importance of hypoglycemia prevention, and they recommend individualized and less stringent glycemic control.

METHODS

A comprehensive literature review was conducted, which led to the development of evidence-based content for an educational program. Several categories and subcategories of content were identified and subsequently evaluated by a panel of experts in the field of diabetes management.

RESULTS

Experts were unanimous on the importance and relevance of the categories and provided insight into the priority of subcategories of content.

CONCLUSIONS

Developing an evidence-based educational program for health care providers on prevention of hypoglycemia has important clinical implications. Diabetes educators can use the topical outline for patient and family teaching. This project may also serve as an example for diabetes educators on developing evidence-based educational programs.

Breaking down patient and physician barriers to optimize glycemic control in type 2 diabetes

Approximately half of patients with type 2 diabetes (T2D) do not achieve globally recognized blood glucose targets, despite the availability of a wide range of effective glucose-lowering therapies. Failure to maintain good glycemic control increases the risk of diabetes-related complications and long-term health care costs. Patients must be brought under glycemic control to improve treatment outcomes, but existing barriers to optimizing glycemic control must first be overcome, including patient nonadherence to treatment, the failure of physicians to intensify therapy in a timely manner, and inadequacies in the health care system itself. The reasons for such barriers include treatment side effects, complex treatment regimens, needle anxiety, poor patient education, and the absence of an adequate patient care plan; however, newer therapies and devices, combined with comprehensive care plans involving adequate patient education, can help to minimize barriers and improve treatment outcomes.