TY - JOUR
T1 - Hypoglycemia in the hospital
T2 - systems-based approach to recognition, treatment, and prevention
AU - Varlamov, Elena V.
AU - Kulaga, Mark E.
AU - Khosla, Akhil
AU - Prime, Danille L.
AU - Rennert, Nancy J.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Hypoglycemia causes immediate adverse reactions and is associated with unfavorable clinical outcomes and increased health care costs. It is also one of the barriers to optimization of inpatient glycemic control. Prioritizing quality improvement efforts to address hypoglycemia in hospitalized patients with diabetes is of critical importance. Acute illness, hospital routine, and gaps in quality care predispose patients to hypoglycemia. Many of these factors can be minimized when approached from a systems-based perspective. This requires creation of a multidisciplinary team to develop strategies to prevent hypoglycemic events by targeting many factors, such as systemic analysis of blood glucometrics, policies and protocols, coordination of nutrition and insulin administration, transitions of care, staff and patient education, and communication. This article reviews recommendations of the American Diabetes Association, the Endocrine Society, and the Society of Hospital Medicine, and highlights our institution's approach in each of these areas. Despite a multitude of challenges, we believe that it is feasible to improve the safety and quality of inpatient diabetes care and avoid hypoglycemia without requiring significant additional hospital resources. Physician leaders play a major role in guiding this process and encouraging participation of interdisciplinary members of the hospital team.
AB - Hypoglycemia causes immediate adverse reactions and is associated with unfavorable clinical outcomes and increased health care costs. It is also one of the barriers to optimization of inpatient glycemic control. Prioritizing quality improvement efforts to address hypoglycemia in hospitalized patients with diabetes is of critical importance. Acute illness, hospital routine, and gaps in quality care predispose patients to hypoglycemia. Many of these factors can be minimized when approached from a systems-based perspective. This requires creation of a multidisciplinary team to develop strategies to prevent hypoglycemic events by targeting many factors, such as systemic analysis of blood glucometrics, policies and protocols, coordination of nutrition and insulin administration, transitions of care, staff and patient education, and communication. This article reviews recommendations of the American Diabetes Association, the Endocrine Society, and the Society of Hospital Medicine, and highlights our institution's approach in each of these areas. Despite a multitude of challenges, we believe that it is feasible to improve the safety and quality of inpatient diabetes care and avoid hypoglycemia without requiring significant additional hospital resources. Physician leaders play a major role in guiding this process and encouraging participation of interdisciplinary members of the hospital team.
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U2 - 10.3810/hp.2014.10.1153
DO - 10.3810/hp.2014.10.1153
M3 - Article
C2 - 25502140
AN - SCOPUS:84922584431
SN - 2154-8331
VL - 42
SP - 163
EP - 172
JO - Hospital Practice
JF - Hospital Practice
IS - 4
ER -