Preventing Severe Hypoglycemia in Type 2 Diabetes: Randomized Trial of Proactive Care With or Without Psychoeducation

Background

Severe hypoglycemia, or dangerously low blood sugar, is one of the most feared complications of diabetes treatment. It can cause confusion, loss of consciousness, seizures, injury, and in some cases require emergency treatment. The risk is especially important in people with type 2 diabetes who use insulin or sulfonylureas, two treatment classes that can lower glucose too much if dosing, meals, activity, or awareness of symptoms are not well matched.

In type 1 diabetes, psychoeducational programs have been shown to help reduce severe hypoglycemia by improving recognition of warning signs, self-management skills, and decision-making around insulin use, exercise, and eating. However, whether similar approaches add benefit for adults with type 2 diabetes has been less clear. This trial was designed to test whether adding structured psychoeducation to proactive nurse-led care would reduce severe hypoglycemia more than proactive care alone.