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Three Part Question

For [diabetic patients who call 999 for hypoglycaemia symptoms] does [a pre-hospital referral to specialist diabetes services] improve [long term management of the patient’s diabetes resulting in fewer ambulance calls or ED attendance]

Clinical Scenario

A 64 year old male with Type 1 diabetes is experiencing symptoms of hypoglycaemia and his wife calls 999. An ambulance crew attend the patient who is drowsy and non-cooperative with blood sugar 1.8mmol/l. Following treatment with intramuscular glucagon and oral carbohydrate, he fully recovers and you follow guidelines that suggest the patient can be left at home with a referral to their GP, but you worry that without diabetes specialist input the patient will not have timely follow up resulting subsequent hypoglycaemic events with ambulance call out.

Search Strategy

The Cochrane Library: MeSH descriptor: [Emergency Medical Services] AND hypoglyc*
Embase 1996-2016 using the Pubmed interface:
(((diabetes OR diabetes mellitus OR diabetic)) AND (ambulance OR paramedic OR pre-hospital OR prehospital OR EMS OR emergency medical services)) AND hypoglyc*