6.1.0.0 HYPOGLYCEMIA
Recommendations
15.8 A hypoglycemia management protocol should be adopted and implemented by each hospital or hospital system. A plan for preventing and treating hypoglycemia should be established for each patient. Episodes of hypoglycemia in the hospital should be documented in the medical record and tracked. E
15.9 The treatment regimen should be reviewed and changed as necessary to prevent further hypoglycemia when a blood glucose value of <70 mg/dL (3.9 mmol/L) is documented. C
Patients with or without diabetes may experience hypoglycemia in the hospital setting. While hypoglycemia is associated with increased mortality (54), hypoglycemia may be a marker of underlying disease rather than the cause of increased mortality. However, until it is proven not to be causal, it is prudent to avoid hypoglycemia. Despite the preventable nature of many inpatient episodes of hypoglycemia, institutions are more likely to have nursing protocols for hypoglycemia treatment than for its prevention when both are needed. A hypoglycemia prevention and management protocol should be adopted and implemented by each hospital or hospital system. There should be a standardized hospital-wide, nurse-initiated hypoglycemia treatment protocol to immediately address blood glucose levels of <70 mg/dL (3.9 mmol/L), as well as individualized plans for preventing and treating hypoglycemia for each patient. An American Diabetes Association (ADA) consensus report suggested that a patient’s overall treatment regimen be reviewed when a blood glucose value of <70 mg/dL (3.9 mmol/L) is identified because such readings often predict imminent level 3 hypoglycemia (2).
Episodes of hypoglycemia in the hospital should be documented in the medical record and tracked (2).