The Rule of 15 in the Treatment of Hypoglycaemia: Are people adhering to this and does structured education make a difference?
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ackground - The adherence of people with diabetes and their carers to the rule of 15 (Wiethop and Cryer, 1993) to treat hypoglycaemia and the impact of structured diabetes education has not been fully investigated. Within this research, hypoglycaemia treatment behaviours are explored and compared, between course attendees and non-attendees. Methods - This cross-sectional study analysed responses from 60 people with diabetes and carers, from an online questionnaire, who had previously experienced and treated hypoglycaemia (n=60). Patients who had attended structured diabetes education (n=29) were compared by their compliance with the rule of 15 (Wiethop and Cryer, 1993) with those who had not attended (n=30) or were unsure (n=1). Results - Participants who had attended structured diabetes education were 7% more aware (n=15) of the rule of 15 than non-attendees (n=12) (chi-squared, p=0.516, t=3.527, df=4). Blood glucose testing compliance confirmation and re-checking was 17% more common amongst non-attendees (n=18) than attendees (n=13), as was the 15-minute wait time. Males and females were equally likely to attend a course (Chi-squared p=0.520, t=1.307, df=2). People with a diabetes diagnosis duration of 1-5 years (n=5) were least likely and 6-15 years (n=13) most likely to favour attendance. Overall, attendees did not possess improved hba1c levels when compared to non-attendees. Sweets were the most frequently used type of fast-acting carbohydrate (n=15) and mean hypoglycaemia treatment values were 21g (range 10g-40g) (One-way sample t-test, t=87.878, df=2.42, p=0.001) amongst attendees and 20g (range 9g-75g) for non-attendees (One-way sample t-test, t=-66.126, df=59, p=0.001) which was statistically significant. Conclusion - The study demonstrated that attendance on structured diabetes education increases awareness of the rule of 15, the use of fast-acting carbohydrate and blood glucose testing confirmation to manage hypoglycaemia amongst people with diabetes and carers. However, adherence, awareness and compliance are still evident amongst non-attendees through the contribution of the diabetes specialist and technology in information provision.
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