6.4.0.0 Pre­ven­tion

Com­mon pre­ventable sources of ia­tro­genic hy­po­glycemia are im­prop­er pre­scrib­ing of hy­po­glycemic med­i­ca­tions, inap­pro­pri­ate man­age­ment of the first episode of hy­po­glycemia, and nu­tri­tion–in­sulin mis­match, often re­lat­ed to an un­ex­pect­ed in­ter­rup­tion of nu­tri­tion. Stud­ies of “bun­dled” pre­ventative ther­a­pies in­clud­ing proac­tive surveil­lance of glycemic out­liers and an in­ter­dis­ci­plinary data-‍driv­en ap­proach to glycemic man­age­ment showed that hy­po­glycemic episodes in the hos­pi­tal could be pre­vented. Com­pared with base­line, two such stud­ies found that hy­po­glycemic events fell by 56% to 80% (57,58). The Joint Com­mis­sion rec­om­mends that all hy­po­glycemic episodes be eval­u­ated for a root cause and the episodes be ag­gre­gat­ed and re­viewed to ad­dress sys­temic is­sues.