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