Hypoglycaemic Brittle Diabetes Successfully Managed by Social Worker Intervention

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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.