Recurrent hypoglycemia in Diabetes Type 1: a case report

Main Article Content

Irene Martinotti
Piero Emanuele Cirla

Keywords

Diabetes type 1; hypoglycemic episodes; office worker; occupational health

Abstract

Introduction: Insulin as diabetes therapy, if not well accepted by the patient, can worsen life quality and lead to compromised glucose control. Diabetic emergencies, such as hypoglycemia, can occur. According to social responsibility, corporate actions plays a relevant role in supporting the well-being of diabetic workers. Objectives: To report a case of management of severe recurrent hypoglycemic crises. Results: An advanced tertiary sector office worker (health risks: VDU, organization and stress, no company car use), suffering from Diabetes Type 1 with recurrent severe hypoglycemic crisis during the working time was brought to the attention of the occupational physician. The patient was followed by a high-level specialized diabetic center, but an unusual personality and bizarre ideas on self-regulation of diabetes resulted in rejection of continuous infusion with insulin pump in favor of multiple daily insulin injections therapy. Discussion: Advanced tertiary sector, characterized by a space-time expansion of the working time, didn’t facilitate acceptance of the regularity in insulin therapy and meals. Company prevention system intervention is useful to achieve a satisfactory balance: social support, availability of a refrigerator for medicines and an infusion pump. Conclusions: A constructive action of the “company system” can be useful to provide effective support in the management of diabetic therapy, with real positive implications on health status.

Abstract 146 | PDF Downloads 40

References

1.Bonora E, Monami M, Bruno G, et al: Attending diabetes clinics is associated with a lower all-cause mortality. A meta-analysis of observational studies performed in Italy. Nutr Metab Cardiovasc Dis 2018; 28:431-435
2.Choudhary P, Olsen BS, Conget I, et al: Hypoglicemia prevention and user acceptance of an insulinpump system with predictive low glucose management. Diabetes Technol Ter 2016; 18:288-291
3.Cirla PE, Martinotti I: Criticità e prospettive per il miglioramento della salute e della sicurezza nel terziario avanzato: conoscere per rinnovare la prevenzione. Med Lav 2015; 106:94-95
4.Heinemann L, Freckmann G, Ehrmann D, et al: Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomized controlled trial. Lancet 2018; 391:1367-1377
5.Strawbridge L, Lloyd J, Meadow A, et al: One-year outcomes of diabetes self-management training among Medical beneficiaries newly diagnosed with diabetes. Med Care 2017; 55:391-397