The Problem of Hypoglycemia in Diabetes Care: An Integrative Overview of the Latest Behavioral, Pharmacological, and Technological Solutions

Friday, July 9, 2021
Friday, November 5, 2021 (second offering)

This program has been designed as a one-day, interactive, case-based workshop devoted to helping HCPs recognize the widespread problems associated with hypoglycemia to improve their ability to identify problematic hypoglycemia (and the associated consequences, such as profound hypoglycemic fear), and to more confidently address such problems through the judicious use of currently available medications, diabetes technology tools, and innovative behavioral strategies.

By the conclusion of the program, participants will have a more comprehensive understanding of the problem of hypoglycemia in T1D and T2D populations, including the potentially profound medical and psychological costs that often accrue. They will become adept at recognizing and understanding the common problematic presentations, will be able to assess and decipher the medical and behavioral aspects of complex case presentations and select the most critical issues that need to be addressed, will gain confidence in modifying medication regimens and using and prescribing the most appropriate diabetes technology tools, will be able to communicate more effectively and collaboratively with their patients in addressing hypoglycemic problems, and will have acquired the skills and comfort to engage with their patients in providing the needed education and promoting appropriate changes in self-care.

Learning Objectives

Following this activity, participants should be able to:

• Describe the key types of hypoglycemia, their prevalence in the T1D and T2D populations, and the critical impacts of hypoglycemia on biomedical outcomes and quality of life.
• Identify patients who are most at-risk for problematic hypoglycemia.
• Identify the key components of the hypoglycemic fear syndrome.
• Discuss the major strategies for addressing impaired hypoglycemic awareness.
• Describe how available medication options and new diabetes technology can address problematic hypoglycemia.
• Perform a comprehensive assessment of the major contributors to problematic hypoglycemia and/or hypoglycemic fear.
• Describe how to engage family and friends to best tackle hypoglycemic problems.
• Demonstrate the use of diabetes-focused action planning strategies to engage with patients to address critical hypoglycemic problems. 

Agenda

9:00 AM – 3:35 PM Pacific Daylight Time (PDT)

9:00 – 9:55 AM	Why Worry about Hypoglycemia? Hypoglycemia types and definitions Prevalence in T1D and T2D Potential costs and impacts (hospitalization/ER visits, biomedical outcomes, chronic hyperglycemia, quality of life)
9:55 – 10:00 AM	Break
10:00 – 11:00 AM	Common Presentations and Underlying Issues Frequent hypoglycemic episodes Hypoglycemic unawareness Hypoglycemic fear syndrome Hyperglycemic fear syndrome Harmful responses from family and friends
11:00 – 11:05 AM	Break
11:05 AM – 12:05 PM	Developing Skills for Identifying the Critical Issues Assessment of hypoglycemic and hyperglycemic fear Case presentations
12:05 – 12:35 PM	Lunch Break
12:35 – 1:35 PM	Helping PWDs to Be Safe Educating PWDs about preventing and addressing hypoglycemia Making good use of available medication options Making good use of new diabetes technology
1:35 – 1:40 PM	Break
1:40 – 2:35 PM	Helping PWDs to Be Safe AND Feel Safe Addressing frequent hypoglycemic episodes Addressing hypoglycemic unawareness Addressing the hypoglycemic fear syndrome Addressing the hyperglycemic fear syndrome Optimizing the involvement of family and friends
2:35 – 2:40 PM	Mini-Break
2:40 – 3:35 PM	Putting It All Together: Assessing and Addressing Complex Cases

Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of California San Diego School of Medicine and the Behavioral Diabetes Institute. The University of California San Diego School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

AMA: The University of California San Diego School of Medicine designates this live activity for a maximum of 5.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses: For the purposes of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 credits™ issued by organizations accredited by the ACCME. For the purpose of re-licensure, the California Board of Registered Nursing accepts AMA PRA Category 1 credits™

Physician Assistants: The AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 credits™ from organizations accredited for ACCME or a recognized state medical society.

Psychologists: The California Board of Psychology recognizes and accepts AMA PRA Category 1 Credit(s)™ for license renewal. Psychologists outside of California should check with their state and local boards to ensure that ACCME accredited activities are acceptable for renewal.

Certified Diabetes Care and Education Specialists: To satisfy the requirement for renewal of certification by continuing education for the Certification Board for Diabetes Care and Education (CBDCE) continuing education activities must be diabetes related and approved for a provider on the CBDCE list of approved providers (cbdce.org). CBDCE does not approve continuing education. The University of California San Diego is accredited by the ACCME, which is on the CBDCE list of approved providers.

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Resources

Reference for both assessment tools for fear of hypoglycemia for children and for parents:

 **Gonder-Frederick, L., Nyer, M., Shepard, J. A., Vajda, K., & Clarke, W. (2011). Assessing fear of hypoglycemia in children with Type 1 diabetes and their parents. Diabetes management (London, England), 1(6), 627–639. https://doi.org/10.2217/DMT.11.60

**BE SAFE & FEEL SAFE (PDF)