Christopher J. Child, United States of America
Eli Lilly and Company LRLPresenter of 2 Presentations
NASAL VERSUS INJECTED GLUCAGON: USER EXPERIENCE RESULTS OF A SIMULATED SEVERE HYPOGLYCEMIA STUDY
Abstract
Background and Aims
Use of injectable glucagon (IG) challenges caregivers of a person with diabetes (PWD) during stressful severe hypoglycemia (SH) rescue. Success rates, administration time, and user preference for nasal glucagon (NG) vs IG devices were evaluated after treating SH simulations.
Methods
Adult PWDs were trained to use NG or IG, and then trained their caregivers (1 hour later) in its use; 1 week later, caregivers attempted administration to a manikin exhibiting SH in a simulated real life setting. Untrained adults were shown the device pre-simulation. After 1 week, procedures were repeated with the alternative device. Proportions of success with each device (complete dose+critical steps) and administration times were studied. Device comparative questionnaires were completed after viewing videos of simulations after the second simulation.
Results
Of PWD trained users, 90% and 16% were successful with NG and IG, respectively (McNemar p<0.0001). Similarly, 91% of untrained users were successful with NG, 0% with IG (p<0.0001). Median time to NG success was 30 sec (trained and untrained users); 5 trained users successful with IG took 73 sec. NG was rated preferred by those successful with NG or IG, and PWDs indicated feeling safer with NG even with IG success (Table).
Conclusions
PWD-trained and untrained users were more successful and faster in administering NG than IG. None of the few preferring IG were successful with IG, while the few successful IG-users preferred NG or stated no preference. Training was not critical for NG success and ease of preparation/use likely contribute to overall preference.
NASAL VERSUS INJECTED GLUCAGON ADMINISTRATION: EVALUATING OVERALL WORKLOAD IN A SIMULATED SEVERE HYPOGLYCEMIA RESCUE
Abstract
Background and Aims
Injectable glucagon (IG) is challenging to use for caregivers of a person with diabetes (PWD) during severe hypoglycaemia (SH) rescue. We assessed overall workload for the administration of nasal glucagon (NG) and IG using National Aeronautics and Space Administration – Task Load Index (NASA-TLX) questionnaires, during a randomized, crossover, SH simulation study.
Methods
Adult PWDs (N=33) were trained to use NG or IG and then trained their caregiver (1 hour later) in its use; 1 week later caregivers attempted administration to a manikin exhibiting SH in a simulated real life setting. Untrained adults (N=33; no PWD association) were shown the device pre-simulation. After 1 week the process was repeated with the other device. After each simulation, users completed the NASA-TLX questionnaire assessing overall workload on 6 subscales, each rated on a scale of 0 to 20 (higher scores indicating greater workload). Participants also evaluated the weighting of each subscale to the overall workload of the task through pairwise comparisons of the 6 subscales (15 pairs in total; weights ranging from 0=not relevant to 5=most important).
Results
Users reported a mean overall workload score of 37.8 following NG simulation, compared with 48.4 following IG simulation (p=0.0020; weighted average). A similar trend was observed for a mean regular average (p=0.0025). Users reported lesser mental demand (p=0.0048, weighted score difference) and effort (p=0.0240) for the administration of NG, compared with IG (Table).
Conclusions
Users perceived a lesser workload administering NG, compared with IG, during simulated SH rescue.
