Hypoglycaemia-prevention plan for school — OSCE

OSCE communication and shared decision-making station: explaining to the parents and a school teacher of a seven-year-old with type 1 diabetes what hypoglycaemia is and why it recurs, the rule of 15 and the school hypoglycaemia plan, when and how to give glucagon, the role of continuous glucose monitoring and hybrid closed-loop in prevention, and the importance of two-to-three-week hypoglycaemia avoidance to restore the warning — while addressing fear, guilt, and the wish to keep glucose high.

osce communication and shared decision-making4 min readVerification in progress

Prompt

You meet the parents and the classroom teacher of a seven-year-old boy with type 1 diabetes diagnosed a year ago, on a hybrid closed-loop pump system with a continuous glucose monitor. He has had two severe hypoglycaemic events in the last term, both at school during sport, and his parents are now so frightened that they have been running his glucose high overnight and skipping his pre-sport carbohydrate. The teacher is anxious about recognising a low and about giving glucagon. Counsel the family and teacher, agree a school hypoglycaemia plan, and address the fear without abandoning safe glycaemic targets.

Task

Counsel the parents and the teacher. You have eight minutes. Demonstrate an organised, empathic, and accurate explanation that addresses four questions a fellowship communication station rewards: why the hypoglycaemia happened and what it means, the practical school plan including the rule of 15 and glucagon, the role of his technology and what to do when it warns, and how to lower the fear without trading away his long-term health. The plan follows the ISPAD 2022 framework. [1]

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References4Show ledger

[1]Abraham MB, Karges B, Dovc K, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Assessment and management of hypoglycemia in children and adolescents with diabetes Pediatr Diabetes, 2022.PMID 36537534
[2]McCrimmon RJ, Sherwin RS. Hypoglycemia in type 1 diabetes Diabetes, 2010.PMID 20876723
[4]Nathan DM, Genuth S, Lachin J, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus N Engl J Med, 1993.PMID 8366922
[11]Pontiroli AE, Tagliabue E. Intranasal versus injectable glucagon for hypoglycemia in type 1 diabetes: systematic review and meta-analysis Acta Diabetol, 2020.PMID 32025860