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Register for hypo education booklet to drive down 999 calls

Ambulance services are being invited to register their interest in a booklet designed to reduce diabetes-related emergency call outs ahead of its launch.

Hypoglycaemia, or hypo, is the medical term used when someone’s blood sugar (glucose) levels drop too low. It is estimated there are up to 100,000 emergency call-outs annually for hypoglycaemia in the UK, costing £13.6 million per year to the NHS, with each admission to hospital costing about £1,000. Around 1 in 10 people have another severe hypo within a fortnight of calling an ambulance.

To mark Diabetes Week, ARC East Midlands is taking early orders for the ‘Hypos Can Strike Twice’ booklet, which evidence shows can lead to significant reduction in repeat ambulance attendance for hypoglycaemia. The resource has also been shown to provide a significant improvement in the information, advice and treatment given for hypoglycaemia delivered by ambulance staff. 

Based on research

Research carried out by ARC East Midlands, in collaboration with the East Midlands Ambulance Service NHS Trust, found that the ‘Hypos Can Strike Twice’ booklet together with the advice provided by ambulance staff significantly reduced the chances of a subsequent ambulance attendance for further hypo attacks. 

Professor Niro Siriwardena, who has led the study, said: “Although hypoglycaemia can be serious if left untreated, it is possible to treat the condition and prevent a future episode, if action is taken early. Prevention, instead of reaction is always favourable, so we wanted to see what impact the Hypos Can Strike Twice booklet has on people when it comes to dialling 999 for hypoglycaemia.

“The new process of care was found to work, was easy to use, acceptable to patients and prevented recurrent hypos. By reducing potentially unnecessary calls to the ambulance service, it may also decrease hospital attendances, thereby reducing pressures and costs for ambulance services and hospitals.”

More about the booklet

‘Hypos Can Strike Twice’ involves ambulance staff providing treatment and advice to people who have had a hypo to access follow-up care by the GP or specialist diabetes team as detailed in national ambulance guidelines. This is supported by the provision of an information booklet which the patient can read when they are fully recovered from the effects of the hypo.   

  • When an ambulance attends, the ambulance team fill in the treatment section of the booklet after caring for the patient. It provides a summary of their physical condition both when the ambulance service arrives and when it departs, and a section where the ambulance staff record details of the relevant treatment provided.
  • The patient is given the booklet to read when they are fully recovered from their hypo. In addition to explaining to the patient what has happened to them, the booklet also provides advice about what to eat following a hypo and reminds them to avoid strenuous activities, alcohol and be cautious about driving during the first few hours of recovery. It also encourages them to undertake regular self-monitoring of their blood-glucose levels. 
  • FAQs are provided to explain in lay terms, what hypos are, the symptoms, causes, how to try to prevent them and what to do if they happen again.

Comments about the booklet

“The “Hypos Can Strike Twice” patient information leaflet has assisted the EMAS clinician to give up to date, detailed and effective safety netting advice which can be left with the patient. It has encouraged collaborative working with referral to the specialist services when required, to ensure the patient gets the advice they need to manage their condition”. [East Midlands Ambulance Service]

“It would certainly have been useful to somebody who had been recently diagnosed or was having problems getting adjusted to the condition and any changes in lifestyle they had to make” [A patient] 

Order your copy now

This free booklet will soon be available for all ambulance services to use and provide to their staff and patients. To register your interest in receiving the booklet, please email:

Published on: 14 Jun 2021