QUALITY INDICATORS FOR DIABETIC HYPOGLYCEMIA
Diabetes is a disease that develops as a result of the body's inability to make appropriate use of food consumed, which in turn is the result of an insufficiency of insulin (Hanestad, 1992, pp. 229 240). Type I diabetes is defined as insulin dependent diabetes, while Type II diabetes is defined as non insulin dependent diabetes (Spollett, 1993, pp. 27 28).
The individualistic character of diabetes "demands a careful, sensitive balance between lifestyle and treatment" (Macheca, 1993, p. 26). Normal physiological control and good health are considered as essential in altering the progression of the disease (Anderson, Fitzgerald, Gorenflo, and Oh, 1993, pp. 41 40). Thus, the development in diabetic patients of effective self care behavior is required, if the progression of the disease is to be controlled outside of an hospital environment (Tu and Barchard, 1993, p. 113). As soon as diabetes is detected, it is important to begin at once a program to control the disease (Pollock, 1993, pp. 86 92). A properly treated person with diabetes can be both free of symptoms and feel well (Thom, 1993, pp. 97 112).
Both acute and chronic complications may beset the diabetic patient (Macheca, 1993, p. 26). Of the acute complications, the most prevalent in insulin treated patients is hypoglycemia. More than 90 percent of Type I diabetics experience episodes of symptomatic hypoglycemia, and some Type II diabetics also experience symptomatic hypoglycemia. Unrecognized and untreated, hypoglycemic can result in seizures, unconsciousness, brain damage, and death (Macheca, 1993, p. 26).
In describing quality indicators for diabetic hypoglycemia in this paper, an assumption is made that the diabetic patient of interest is characterized by hypoglycemia unawareness, a condition wherein the first manifestation of hypoglycemia "may be the neuroglycopenic symptoms" (Davis, 1990, pp. 11 13). The f...