Ongoing support from a diabetes health professional is the most important intervention in people with problematic hypoglycaemia, an international expert has told delegates.

Speaking at the ADS clinical symposium yesterday morning Professor Simon Heller from the University of Sheffield in the UK reviewed the evidence before going on to suggest some practical approaches to reducing and treating hypoglycaemia.

According to Heller, who is Chair of the International Hypoglycaemia Study Group, the most important question to ask patients is what glucose level they get symptoms.

“The critical answer is 3. If it’s above this number they are cognitively functioning to recognise them. If it’s below then you have a patient with a potential problem,” he told delegates.

The next step is to find an experienced nurse or dietitian or educator who understands hypoglycaemia and can provide structured training.

If possible insulin analogues should also be used, he said.

Technology certainly has a part to play in managing hypoglycaemia, but in Heller’s view it should come after education and training.

“Structured training and flexible intensive therapy is the way you should go first,” he said.

“I’ve even been bold enough to suggest that it’s unethical to promote intensive insulin therapy unless you provide such training,” he added.

But probably the most important intervention that many of you can provide is support from skilled professionals who understand hypoglycaemia and diabetes self management, he concluded.