Assessment of Hypoglycemia Management in Acute Care Hospitals

Background Hypoglycemia is a common and potentially preventable complication among hospitalized patients, particularly those receiving insulin or other glucose-lowering therapies. Delayed recognition and inconsistent management can increase adverse outcomes. Although protocols exist, variability in treatment selection and timing may influence the likelihood of returning to normoglycemia. Understanding these patterns is critical to optimizing patient safety in acute care settings. Methods This retrospective review evaluated hypoglycemia management in adult inpatients across acute care hospitals within a large health system. Patients were included if they were aged 18 years or older, were hospitalized within the health system, and experienced a hypoglycemic event, defined as a blood glucose level less than 40 mg/dL within 24 hours of receiving a glucose-lowering medication. Episodes were identified using electronic health record (EHR) glucose measurements. Patients were excluded if repeat glucose exceeded 80 mg/dL within 5 minutes of the initial low glucose reading. Data collected included patient demographics, precipitating factors, intervention timeliness, treatments administered (eg, oral glucose, IV dextrose, glucagon), and clinical outcomes. Analyses assessed associations between initial treatment selection, time to treatment, and median time to return to normoglycemia (glucose > 70 mg/dL within 2 hours of initial treatment). Results There were 6614 events that met the original inclusion criteria. In total, 2037 events fell into the category of no treatment received. Among all treated events, 4089 (92.6%) showed return to normoglycemia within the allotted time, with a median time to treatment of 7 minutes, and a median time to return to normoglycemia of 24 minutes. Conclusion This study supports that multiple first line therapies are effective to treat hypoglycemia when used in a timely manner and enforces that prompt intervention is paramount in hypoglycemia management.