The US Department of Health and Human Services has identified hypoglycemia as one of the top three preventable and measurable adverse drug events in a recent article published in the December 11 issue of the Journal of Clinical Endocrinology and Metabolism. 

Hypoglycemia is defined in

• Level 1: Glucose < 70 mg/dL and ≥ 54 mg/dL
• Level 2: Glucose < 54 mg/dL; 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 assess if the patient has experienced a previous Level 2 or Level 3 hypoglycemic event within the past year. If not, then proceed to;
• 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 proceed to;
• 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 who are at greater risk for hypoglycemia

Measure 3: Encourage patients to report hypoglycemic events

Dr KK Aggarwal

Padma Shri Awardee

President Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA