Only 1 in 3 discussed symptoms of high blood glucose levels (hyperglycaemia) with their nurse or doctor, according to a new survey of 200 people living with type 1 or type 2 diabetes, who need mealtime insulin to control their blood glucose levels. This is despite the negative impact hyperglycaemia has on their day-to-day physical and mental wellbeing.
Reported symptoms of hyperglycaemia ranged from tiredness, thirst and needing to urinate frequently to difficulty concentrating, reduced productivity and irritability.
When asked why they chose not to discuss these symptoms with their healthcare professional, the reasons cited included; fear of being chastised for not taking their insulin properly and belief that they should be experienced enough to handle this chronic condition themselves.
Dr Lalantha Leelarathna, Consultant Diabetologist and Honorary Senior Lecturer at Manchester Diabetes Centre, Manchester Royal Infirmary, commented:
The fact that many patients choose not to discuss their symptoms with their healthcare team suggests that we, as clinicians, need to be more proactive in asking about hyperglycaemia and better educate our patients on the importance of good mealtime control.
Of those surveyed, a third of people said they took their insulin during or after a meal. However, NICE guidance says that mealtime insulins should be taken before meals to control a post-prandial glucose (PPG) ‘spike’.
As well as causing unpleasant short-term symptoms regular hyperglycaemia after meals increases the risk of serious long-term complications, such as amputation and blindness.
Dr Leelarathna continued:
achieving good post-meal glucose control is challenging for many patients even when they follow current advice. As healthcare professionals, we need to better educate our patients and provide treatment strategies and solutions to minimize post meal glucose excursions.
Dr Ponnusamy Saravanan, Associate Clinical Professor & Honorary Consultant Physician, Warwick Medical School, University of Warwick & George Eliot Hospital, commented:
We need to get people thinking seriously about the impact of high blood glucose after meals. In addition to immediate and sometimes dangerous symptoms such as blurred vision and extreme tiredness, regular high blood glucose levels could lead to serious long-term complications, including heart disease, blindness, nerve damage and amputation. The survey results show a lack of education and awareness of the consequences of poorly controlled blood glucose levels around mealtimes, leaving people at real risk of developing irreversible complications. If we don’t get this message out to our patients and peers now then we will continue to spend billions each year on treating these complications on the NHS, in addition to significant social costs to the individuals affected and their families.
While the survey showed that people with diabetes generally have a good understanding of HbA as an important blood glucose measurement in the management of their diabetes, half didn’t understand what post-prandial glucose (PPG) levels were or that the symptoms they experienced after eating were related to hyperglycaemia, underlining the need for better patient education.
‘Greater awareness is our best defense against diabetes-related complications and I welcome these latest survey results as an opportunity to highlight these important issues,’ concluded Dr Leelarathna.