Out-of-Hospital Management of Diabetic Emergencies in Germany: Structural and Process Quality

Area of Science:

• Emergency Medicine
• Diabetology
• Public Health

Background:

• Diabetic emergencies, particularly severe hypoglycemia, require prompt and effective out-of-hospital management.
• Assessing the quality of care for diabetic emergencies is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the structural and process quality of managing diabetic emergencies in Germany in 2020.
• To compare current management practices with data from a similar study in 2001.

Main Methods:

• A nationwide survey using standardized questionnaires was distributed to medical directors of emergency medical service districts (EMSDs).
• Data collected focused on structural and process quality indicators for out-of-hospital diabetic emergency care.
• Results were benchmarked against a 2001 study.

Main Results:

• Significant improvements were observed in blood glucose determination (71% vs. 24%) and paramedic treatment of severe hypoglycemia with intravenous dextrose (100% vs. 63%).
• Ambulance equipment with glucagon remained low (4% vs. 6%), though nasal glucagon's value was recognized.
• Out-of-hospital treatment without hospital admission increased (78% vs. 60%), but need for further training (53%) and interdisciplinary cooperation (14%) were noted.

Conclusions:

• The structural and process quality of managing diabetic emergencies in Germany has significantly improved since 2001.
• Addressing deficiencies in medical equipment and enhancing ongoing education for emergency teams are key to further quality enhancement.