Provider response to insulin‐induced hypoglycemia in hospitalized patients

Abstract

Provider response in making treatment changes after an episode of hypoglycemia is suboptimal. Standardized protocols to make changes in diabetes treatment after an episode of hypoglycemia need to be tested.

Impact of a Hypoglycemia Reduction Bundle and a Systems Approach to Inpatient Glycemic Management

“…Others have reported similar findings. [17][18][19] place, and the hypoglycemia reduction bundle and other interventions were not yet formulated. A multidisciplinary improvement team introduced a series of interventions during a two year transitional period (CY 2011-2012, TP2) and continued to observe the impact across a more mature postintervention phase (CY 2013, TP3).…”

Iatrogenic Inpatient Hypoglycemia: Risk Factors, Treatment, and Prevention

“…11, 13,14 Hypoglycemic excursions on medical/surgical wards by methods other than ignoring glycemic control may be preventable as the rule, rather than the exception. 15 More than 40% of patients experiencing one iatrogenic episode go on to suffer from at least one additional distinct hypoglycemic event, and these recurrent events also appear to be largely preventable.…”

“…11, [13][14][15] Most of these studies have relied on a case series methodology, however. This makes it difficult to gauge the relative importance of these risk factors, because these same conditions are also common in patients who do not suffer hypoglycemia.…”

The case for supporting inpatient glycemic control programs now: The evidence and beyond

“…One recent study examined 52 patients who received intravenous 50% dextrose solution for an episode of hypoglycemia. 83 Changes to insulin regimens were subsequently made in only 21 patients (40%), and diabetes specialists agreed with the changes for 11 of these patients. The other 31 patients (60%) received no changes in treatment, and diabetes specialists agreed with that decision for only 10 of these patients.…”