Hypoglycemia in the Hospitalized Patient: Interventions and Opportunities

Abstract

Hypoglycemia occurs frequently in hospitalized patients and can lead to cardiac arrhythmia/ischemia, seizures, or death. The Louisiana Hospital Improvement Innovation Network (HIIN) requires hospitals to report incidents of hypoglycemia as a quality measure. The purpose of this study is to evaluate the incidence of hypoglycemic events and identify precipitating factors at our institution. This is an IRB-approved single-center, retrospective chart review conducted from January to December of 2022 at an academic medical center. All admitted patients who received an antihyperglycemic agent and experienced a hypoglycemic event, defined as blood glucose <50 mg/dL (2.8 mmol/L), within 24 hours were included. The primary outcome assessed the incidence of hypoglycemic events. A total of 2455 patients received insulin during their admission, of which 91 (3.7%) had a hypoglycemic event that met inclusion criteria. Patients were predominately male (58%) with a median age of 53 years old. A diagnosis of Type I or Type II Diabetes Mellitus was reported in 73% of patients. Basal or basal-bolus insulin was ordered in 70.3% of patients. Our institution’s yearly incidence of 3.7% is above the HIIN standard of 3%. Optimization of guidelines and order sets are proposed to help lower the incidence of hypoglycemic events.