Minimizing Hypoglycemia in Diabetes
Dr KK Aggarwal
President CMAAO and HCFI
December 11 in the Journal of Clinical Endocrinology and Metabolism: The US Department of Health and Human Services has identified hypoglycemia as one of the top three preventable and measurable adverse drug events.
Hypoglycemia is defined in
- Level 1: Glucose < 70 mg/dL and ≥ 54 mg/dL
- Level 2: Glucose < 54 mg/dL that needs immediate action.
- Level 3: A severe event characterized by altered mental and/or physical status requiring assistance.
Remember the three measures
Measure 1: Identify high risk patients
· First, if the patient has experienced a previous Level 2 or Level 3 hypoglycemic event within the past year. If not, then:
· Second, if the patient has a prescription for insulin and/or insulin secretagogues and has an A1c < 7% documented within the past 6 months. If not, then:
· Third, if the patient has a prescription for insulin and/or insulin secretagogues and at least one relevant comorbidity.
Measure 2: Educate patients ( 65+) and care givers at greater risk for hypoglycemia
Measure 3: Patient report hypoglycemic events
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