Endocrine Abstracts

Introduction: Therapeutic education is very important in any patient with a chronic disease such as diabetes. The objective of our study is to evaluate the knowledge of diabetic patients already educated about hypoglycemia.

Materials and methods: This is a prospective study conducted on 50 diabetic patients hospitalized for equilibration of their diabetes in the “C” service of the Tunis National Institute of Nutrition and who were educated beforehand on hypoglycaemia. These patients’ knowledge of the defining value of hypoglycaemia and severe hypoglycaemia, signs of hypoglycemia, and their behavior were assessed if they experience hypoglycaemic discomfort.

Results: The mean age of the patients was 68.6+/−11.2 years. The average body mass index (BMI) was 37.9+/−3.3 kg/m². Diabetes was insulin-dependent in 100% of cases that had been on the move for 16.8+/−8.3 years on average. Diabetes was poorly balanced in all patients with mean HbA1C of 9.2%+/−1.1. Only 30% of patients had a glucometer and regularly monitored their blood glucose. Hypoglycemia was defined by the majority of patients (78%) as having a blood glucose level below 1 g/l. severe hypoglycaemia was defined as glucose lower than 0.5g/L by 86% of patients. The signs of hypoglycemia mentioned by patients are in order of frequency: hunger (100%), palpitations (100%), cold sweats (100%), tremors (96%), neuropsychic disorders (86%) and coma and death (52%) 86% of patients say that clinical signs are a function of the severity of hypoglycaemia.38% only know that if hypoglycaemia recurs, they may not be felt anymore.84% do not know that severe or repeated hypoglycaemia can cause neurologic sequelae. 80% reshape at the slightest malaise without confirming that it is hypoglycemia, even those with a glucometer. They ate bread (37.5%), fruit (30%), a dairy product (25%), chocolate (22.5%) and only 10% re-vegetated properly after confirmation of hypoglycaemia.

Conclusion: The fact of transmitting only information to diabetic patients is not enough to educate them. Therapeutic education must be well structured and patient centered to benefit it.