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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