Hypoglycaemia is a common complication of diabetes treatment with either insulin or sulphonylureas and is particularly common with intensified insulin regimens.1 Episodes are often distressing and carry the risk of serious neurological and cardiovascular sequelae.1 Hypoglycaemia is especially hazardous in patients with longstanding type 1 diabetes who have lost the early warning symptoms of falling blood glucose levels.1 Nocturnal episodes are also potentially dangerous and have been implicated when diabetic patients have been found unexpectedly dead in bed.2 Hypoglycaemia is one of the complications of diabetes most feared by patients, on a par with blindness and renal failure.3
Intensive research has been devoted to the development of hypoglycaemia alarms, exploiting principles that range from detecting changes in the electroencephalogram or skin conductance (due to sweating) to measurements of subcutaneous tissue glucose concentrations by glucose sensors.4,5 As yet, however, none has proved sufficiently reliable or unobtrusive to be useful in clinical practice.
We describe here a novel alarm system that can detect hypoglycaemia before the patient notices any symptoms and that operates robustly in a uniquely, patient friendly fashion. The reports were volunteered spontaneously and independently by the patients.
- The reliable detection of hypoglycaemia has long been a major preoccupation for diabetic patients and researchers alike
- Many previous approaches have been barking up the wrong tree
- We believe that we have identified a more promising tree