The campaign aims to raise awareness of the symptoms of hypoglycaemia and what people can do to reduce their risk of hypoglycaemia, including where appropriate, seeking timely help from their health care professionals (HCPs) if necessary.
Backed by leading healthcare professionals, Dr Sarah Jarvis and Dr Rosemary Leonard, the campaign follows announcements from the DVLA, relating to changes in medical standards that people who hold a UK driving licence for personal or commercial vehicles must meet. This includes the number of hypoglycaemic attacks, or hypos, that a person with diabetes is ‘allowed’ per year. From last year, a change in legislation meant that all Group 1 drivers (those who hold an ordinary driving licence for cars and motorcycles), with diabetes treated with either oral antidiabetic agents or insulin must not have had more than one hypoglycaemic event in the past 12 months to maintain their driving licence.
From 15th November 2011, new legislation will mean that drivers with type 1 or type 2 diabetes taking insulin might, for the first time, be allowed to apply for a Group 2 licence (for heavy goods vehicles or passenger service vehicles), if they fulfil similar strict criteria for monitoring and controlling their blood glucose.
There are 2.61 million people with type 2 diabetes in the UK. Hypoglycaemia is a common concern for people with the condition, with one study finding 38% of 342 patients studied reporting symptoms that caused interruption of activities in one year and 7% feeling the need for assistance, including medical attention. However, research commissioned by MSD among 500 UK healthcare professionals to inform the campaign highlights the difficulty that healthcare professionals face in discussing the importance of hypoglycaemia with people with type 2 diabetes. While 87% of GPs surveyed said they proactively ask their patients about hypoglycaemia or the likelihood of an event, 64% of HCPs responded that people’s lack of awareness and misconceptions about the condition and its symptoms were a barrier to meaningful discussion. 84% of HCPs said that they consider lack of awareness of hypoglycaemia to be a risk factor for an event.
Speaking on behalf of the campaign group, Dr Sarah Jarvis comments, “The educational campaign wants to encourage people with type 2 diabetes to feel comfortable discussing hypos with their doctors, without fear. There is a lot that can be done to prevent hypoglycaemia including advice on how to recognise the symptoms and what to do if they think they are suffering hypoglycaemia. In the campaign research, 60% of HCPs reported that they felt that people were reluctant to discuss hypos for fear that this may result in the loss of driving licence.”
According to police notifications to the DVLA, there are around five fatal crashes a year involving hypoglycaemia and 45 serious events a month. Meanwhile, nearly 60% of A&E physicians surveyed reported treating a type 2 diabetes patient who has been driving at the point of experience a hypoglycaemic event. Debbie Hicks, Diabetes Specialist Nurse and co-Chair of TREND, comments: “With the expected change in DVLA guidance, as healthcare professionals, we have a real opportunity to talk to our patients about hypoglycaemia and help to reassure them that it is a manageable treatment side effect. Our survey highlighted that nearly a fifth of GPs do not discuss appropriate precautions before driving a vehicle with a person with type 2 diabetes, yet 92% of those surveyed believe they are more likely to do so as a result of the new DVLA legislation.”
People often know about the issues with 'hyperglycaemia', high blood sugar, but low blood sugar can cause issues too. If left unmanaged, hypoglycaemia can lead to people having to give up driving due to its side effects, including blurred vision and in some severe cases, loss of consciousness.
Hypoglycaemia is a side effect associated with some antidiabetic medicines, for example glinides, sulphonylureas and insulin, but people's risk of developing the condition can be reduced if certain steps are taken to avoid it. Ways to tackle hypoglycaemia risk include encouraging regular eating and eating more carbohydrate before and after physical activity, as well as always carrying a form of glucose to treat hypoglycaemia quickly. Hypoglycaemia can also be managed by identifying patients at risk of hypo and reviewing the treatment options for a person with type 2 diabetes in accordance with the NICE guideline. The NICE Quality Standard recognises the importance of achieving good blood sugar control, whilst considering the individual patient's needs, such as diet, exercise and reducing the risk of hypoglycaemia. GPs and specialist nurses are now tasked with proactively investigating and managing people at risk of hypoglycaemia events.
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