title: Hypoglycaemic brittle diabetes successfully managed by social worker intervention.
abstract: The case is presented of a 39-year-old Type 1 diabetic patient of 22 years duration with recurrent hypoglycaemic comas. He was of unusual personality and had bizarre ideas on self-regulation of his diabetes, resulting in wide variations of insulin dosage. In one 12-month period he had 88 separate admissions to an emergency department with severe hypoglycaemic coma requiring intravenous glucose administration. The cycle of admissions was eventually broken by the intervention of a social worker, who provided structured non-medical support. The patient's diabetic misconceptions remained, but he appeared to gain sufficient insight to prevent recurrent hypoglycaemia.
authors.affiliation: Department of Medicine, Arrowe Park Hospital, Wirral, Merseyside, UK.
authors.forename: G
authors.initials: G
authors.lastname: Gill
authors.forename: M
authors.initials: M
authors.lastname: Robinson
authors.forename: J
authors.initials: J
authors.lastname: Marrow
mesh_terms: D000328:Adult; D003128:Coma / Q000209:etiology; D003376:Counseling; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000534:rehabilitation*; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D010353:Patient Education as Topic; D012947:Social Work
chemical_list: D007328:Insulin