On the Cutting Edge: The Spectrum Of Hypoglycemia From Fear to Confidence (Vol. 41, No. 2)

This issue will present additional considerations to the basic 15:15 rule for the treatment of hypoglycemia in special populations and to accommodate advances in technology.

CPEU: 4.0
CPE Level: 2
Performance Indicators: 10.2.1, 4.2.8, 8.3.1

The first article, Understanding, Assessing and Treating Fear of Hypoglycemia in Youth With Type 1 Diabetes and Their Parents, highlights the human elements of the hypoglycemia experience. For young persons with diabetes and their parents the fear of hypoglycemia (FOH) can significantly impact how diabetes is managed and the level of stress associated with the diagnosis of type 1 diabetes (T1D). This article, written by Clary and her team, offers a tool to identify FOH and describes programs to connect these individuals with additional support.

McElwee Malloy and Singh explore advances in insulin pumps and continuous glucose monitors (CGMs) in their article Diabetes Technology: Importance of Evaluating Both the Clinical and Psychosocial Impact of Hypoglycemia in People With Diabetes. They highlight the essential role of the registered dietitian nutritionists in discussing not only glucose data patterns but also the psychosocial impact of hypoglycemia.

In their article, Medication-Related Hypoglycemia: Causes and Treatments, Isaacs and Zolna present an overview of glucagon products available for hypoglycemia treatment, including instructions for use. They also highlight additional medications that influence blood glucose levels.

Lois Maurer, RDN details how impaired awareness of hypoglycemia can develop and describes educational programs that aim to restore awareness of low glucose levels in the article Educational Programs to Restore Hypoglycemia Awareness.

In the article, Hypoglycemic Confidence in People with Diabetes and their Loved Ones: The Dietitian's Role in Accentuating the Positive, Beebe and Polonsky present a case study and overview of how to use the Hypoglycemia Confidence scale to initiate discussion with individuals and their loved ones.

Burani details risk factors and suggests adjusted glucose targets and presents the broader scope of challenges older adults face as they manage diabetes care along with other comorbidities in The Uniqueness of Hypoglycemia in Elderly Individuals with Diabetes.

Post-bariatric hypoglycemia (PBH) is a potentially disabling complication of bariatric surgery that may not emerge until years after the procedure. In the article, Post-Bariatric Hypoglycemia: The Essential Role of the Registered Dietitian Nutritionist, Sheehan and the Joslin Diabetes Center Hypo Clinic team review etiology and treatment of PBH and highlight the essential role of RDNs.

The Hypoglycemia Prevention Initiative is conducting a study to identify approaches to assess hypoglycemia risk and incidence in the clinical setting. The study will also explore educational approaches to prevention. Warshaw interviews two researchers to share more about this study, and the targeted outcomes in The Endocrine Society's Efforts to Reduce the Burden of Hypoglycemia: An Interview with Drs. Lash and Boord Conducted by Hope Warshaw MMSc, RD, CDCES, BC-ADM.