News

New resource for emergency management of hyperglycaemia


Morgan Liotta


25/05/2018 2:16:51 PM

The RACGP and Australian Diabetes Society have collaborated to release a new resource designed to assist GPs and practice teams in the assessment and management of hyperglycaemic emergencies.

The jointly-produced RACGP and Australian Diabetes Society resource aims to assess and manage hyperglycaemic emergencies and prevent potential adverse outcomes.
The jointly-produced RACGP and Australian Diabetes Society resource aims to assess and manage hyperglycaemic emergencies and prevent potential adverse outcomes.

Following concern raised by two coroners’ reports of potentially avoidable patient deaths, the coroners’ court presented the RACGP with recommendations to highlight the importance of recognising hyperglycaemic emergencies.
 
These reports and subsequent recommendations shone a light on the lack of guidance on how to best manage hyperglycaemic emergencies in primary care, and the need to increase awareness and upskill general practice management of such emergencies.
 
Emergency management of hyperglycaemia in primary care, jointly produced by the RACGP and Australian Diabetes Society (ADS), provides information for general practice teams to effectively detect and manage hyperglycaemia, and avoid associated emergencies. The overall goal of the new document is to prevent a patient’s condition from escalating to harmful and facilitate the urgent transfer to emergency services.
 
‘An emergency crisis indicates that swift and prompt actions are required,’ Dr Gary Deed, co-Chair of the working group of this new resource and Chair of the RACGP Specific Interests Diabetes network, told newsGP.
 
‘This resource shows that some of the tools and processes in general practice can easily adapt to these crises so patients remain safe and GPs feel confident in managing these patients, rather than feeling like they don’t have those skills, when in fact they probably do.’
 
Dr Deed believes that Emergency management of hyperglycaemia in primary care is a much-needed resource for GPs and practice teams, one that will provide simple and timely assessment and management of hyperglycaemia.
 
Professor Sophia Zoungas is Dr Deed’s co-Chair on the working group, ADS President, and Head, Division of Metabolism, Ageing and Genomics at the School of Public Health, Monash University. She told newsGP the resource can be used as a practical tool to guide the assessment and triage of acute diabetes presentations in general practice.
 
‘It is critical for GPs to understand the different acute presentations of diabetes, both at diagnosis and during its management, so the symptoms and signs can be recognised, patients quickly assessed and triaged and sent to hospital for acute management to prevent serious adverse outcomes,’ Professor Zoungas said.
 
‘This is particularly true where acute metabolic decompensation may be present and not evident due to the lack of recognition of the symptoms of ketoacidosis and hyperosmolar hyperglycaemic state.’
 
The resource includes two flowcharts – for people known to have diabetes and for people not known to have diabetes.
 
Dr Deed recommends these flowcharts be prominently displayed where patients who present with acute crises are managed in general practice, and to have the resource available to all practice staff, including practice nurses, so it is used wisely and appropriately.
 
The resource also includes definitions of hyperglycaemic emergencies for accurate assessment, presenting symptoms, and necessary management. Risk factors associated with potential hyperglycaemic emergencies are also detailed, along with clinical assessment of these factors.
 
‘This is a resource that fits into the complexity of general practice by making it simpler to manage these complex patients,’ Dr Deed said.
 
‘The outcome is about creating simplicity with an easily-available resource.’
 
Emergency management of hyperglycaemia in primary care is available on the RACGP website.



diabetes hyperglycaemia hyperglycaemic-emergency metabolic-crisis primary-care



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