Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study
| dc.contributor.author | Al Hasan, Dalal | |
| dc.contributor.author | Yaseen, Ameen | |
| dc.contributor.author | Al Roudan, Mohammad | |
| dc.contributor.author | Wallis, Lee | |
| dc.date.accessioned | 2021-06-23T12:28:10Z | |
| dc.date.available | 2021-06-23T12:28:10Z | |
| dc.date.issued | 2021-05-29 | |
| dc.date.updated | 2021-06-07T12:21:14Z | |
| dc.description.abstract | Abstract Background The objective of this study was to describe the epidemiology of severe hypoglycaemia in Kuwait, aiming to provide a preliminary background to update the current guidelines and improve patient management. Method This was a prospective analysis of severe hypoglycaemia cases retrieved from emergency medical services (EMS) archived data between 1 January and 30 June 2020. The severe hypoglycaemia cases were then sub-grouped based on EMS personal initial management and compared in terms of scene time, transportation rate, complications and outcomes. The primary outcomes were GCS within 10–30 min and normal random blood glucose (RBS) within 10–30 min. Results A total of 167 cases met the inclusion criteria. The incidence of severe hypoglycaemia in the national EMS was 11 per 100,000. Intramuscular glucagon was used on scene in 89% of the hypoglycaemic events. Most of the severe hypoglycaemia patients regained normal GCS on scene (76.5%). When we compared the two scene management strategies for severe hypoglycaemia cases, parenteral glucose administration prolonged the on-scene time (P = .002) but was associated with more favourable scene outcomes than intramuscular glucagon, with normal GCS within 10–30 min (P = .05) and normal RBS within 10–30 min (P = .006). Conclusion: Severe hypoglycaemia is not uncommon during EMS calls. Appropriate management by EMS personals is fruitful, resulting in favourable scene outcomes and reducing the hospital transportation rate. More research should be invested in improving and structuring the prehospital management of severe hypoglycaemia. One goal is to clarify the superiority of parenteral glucose over intramuscular glucagon in the prehospital setting. | |
| dc.identifier.apacitation | Al Hasan, D., Yaseen, A., Al Roudan, M., & Wallis, L. (2021). Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study. <i>BMC Emergency Medicine</i>, 21(1), 65. http://hdl.handle.net/11427/33381 | en_ZA |
| dc.identifier.chicagocitation | Al Hasan, Dalal, Ameen Yaseen, Mohammad Al Roudan, and Lee Wallis "Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study." <i>BMC Emergency Medicine</i> 21, 1. (2021): 65. http://hdl.handle.net/11427/33381 | en_ZA |
| dc.identifier.citation | Al Hasan, D., Yaseen, A., Al Roudan, M. & Wallis, L. 2021. Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study. <i>BMC Emergency Medicine.</i> 21(1):65. http://hdl.handle.net/11427/33381 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Al Hasan, Dalal AU - Yaseen, Ameen AU - Al Roudan, Mohammad AU - Wallis, Lee AB - Abstract Background The objective of this study was to describe the epidemiology of severe hypoglycaemia in Kuwait, aiming to provide a preliminary background to update the current guidelines and improve patient management. Method This was a prospective analysis of severe hypoglycaemia cases retrieved from emergency medical services (EMS) archived data between 1 January and 30 June 2020. The severe hypoglycaemia cases were then sub-grouped based on EMS personal initial management and compared in terms of scene time, transportation rate, complications and outcomes. The primary outcomes were GCS within 10–30 min and normal random blood glucose (RBS) within 10–30 min. Results A total of 167 cases met the inclusion criteria. The incidence of severe hypoglycaemia in the national EMS was 11 per 100,000. Intramuscular glucagon was used on scene in 89% of the hypoglycaemic events. Most of the severe hypoglycaemia patients regained normal GCS on scene (76.5%). When we compared the two scene management strategies for severe hypoglycaemia cases, parenteral glucose administration prolonged the on-scene time (P = .002) but was associated with more favourable scene outcomes than intramuscular glucagon, with normal GCS within 10–30 min (P = .05) and normal RBS within 10–30 min (P = .006). Conclusion: Severe hypoglycaemia is not uncommon during EMS calls. Appropriate management by EMS personals is fruitful, resulting in favourable scene outcomes and reducing the hospital transportation rate. More research should be invested in improving and structuring the prehospital management of severe hypoglycaemia. One goal is to clarify the superiority of parenteral glucose over intramuscular glucagon in the prehospital setting. DA - 2021-05-29 DB - OpenUCT DP - University of Cape Town KW - Severe hypoglycemia KW - Emergency medical services KW - Glasgow coma scale KW - Random blood sugar KW - Kuwait LK - https://open.uct.ac.za PY - 2021 T1 - Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study TI - Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study UR - http://hdl.handle.net/11427/33381 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12873-021-00457-9 | |
| dc.identifier.uri | http://hdl.handle.net/11427/33381 | |
| dc.identifier.vancouvercitation | Al Hasan D, Yaseen A, Al Roudan M, Wallis L. Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study. BMC Emergency Medicine. 2021;21(1):65. http://hdl.handle.net/11427/33381. | en_ZA |
| dc.language.rfc3066 | en | |
| dc.rights.holder | The Author(s) | |
| dc.source | BMC Emergency Medicine | |
| dc.source.journalissue | 1 | |
| dc.source.journalvolume | 21 | |
| dc.source.pagination | 65 | |
| dc.source.uri | https://bmcemergmed.biomedcentral.com/ | |
| dc.subject | Severe hypoglycemia | |
| dc.subject | Emergency medical services | |
| dc.subject | Glasgow coma scale | |
| dc.subject | Random blood sugar | |
| dc.subject | Kuwait | |
| dc.title | Epidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort study | |
| dc.type | Journal Article |