Correction: Multidisciplinary strategies to treat severe hypoglycemia in hospitalized patients with diabetes mellitus reduce inpatient mortality rate: Experience from an academic community hospital

Kadayakkara, Deepak K.; Balasubramanian, Priyadarshini; Araque, Katherine A; Davis, Karri; Javed, Fawad; Niaki, Pontea; Majumdar, Sachin; Buller, Gregory K.

doi:10.1371/journal.pone.0222475

Cited by 4 publications

(14 citation statements)

References 1 publication

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“…Staff education in anticipating hypoglycemia by identifying individual risk factors and clear guidance to manage hypoglycemia once it occurs is an integral part of hypoglycemia prevention and management 5,8–13,19. The author also found staff anticipation of hypoglycemia based on the individual risk factors was very helpful in preventing and managing hypoglycemia.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the education of nurses was a critical component of the hypoglycemia prevention bundle. Lack of coordination in meal delivery and insulin administration accounts for most of hypoglycemia episodes in inpatient settings 5,10. Prolonged fasting or the inability to have sufficient nutritional intake is common in acute care settings.…”

Section: Available Knowledgementioning

confidence: 99%

“…Complications associated with hypoglycemia vary but can include seizure, loss of consciousness, altered T-wave morphology, increased coagulation, inflammation, atherothrombotic responses, endothelial dysfunction, and death 3,4. Hypoglycemia can increase mortality by 7% compared with nonhypoglycemic patients, and up to 35% of diabetic patients experience severe hypoglycemia during hospitalization 5. Hypoglycemia can directly and indirectly impact the patient, family, facility, and community both financially and psychologically 6.…”

mentioning

confidence: 99%

“…Management of hypoglycemic episodes requires an interdisciplinary approach, including nurses who can anticipate and manage episodes. When hypoglycemia is poorly managed, patient length of stay can increase by as many as 3 days, adding further risk for infection and financial burden for patients 5. A multipronged approach or bundle is recommended to decrease hospital-acquired hypoglycemia 2,5,8–11.…”

mentioning

confidence: 99%

“…5 A multipronged approach or bundle is recommended to decrease hospital-acquired hypoglycemia. 2,5,[8][9][10][11] Using SQUIRE guidelines, 12 this article describes the implementation of a bundled approach to care for patients at risk for hypoglycemia in a VA hospital.…”

mentioning

confidence: 99%

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Hypoglycemia Management Using a Bundled Care Approach

Mattathil

2022

Journal of Nursing Care Quality

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Background: Hypoglycemia is a leading cause of preventable hospitalization, and can increase morbidity, mortality, and length of hospital stay. Up to 35% of diabetic patients experience severe hypoglycemia during hospitalization; this concerns veterans, as 25% have been diagnosed with diabetes. Local Problem: A medical-surgical unit in a Veterans Affairs facility saw increased hypoglycemic episodes, with 26.8 episodes per 1000 patient days. Staff noted knowledge deficits with how to manage hypoglycemia episodes. Methods: A pre-/post-implementation quality improvement project was conducted over 8 weeks. Interventions: An implementation bundle was used to improve hypoglycemic episodes, including patient and staff education, coordination between meal delivery and insulin coverage, and developing a hypoglycemia protocol. Results: Hypoglycemia rates significantly decreased to 10.27 per 1000 patient days (P = .001), and occasions where insulin was given with food increased significantly to 76.2% (P < .001). Conclusions: A bundled approach was effective in decreasing hypoglycemia episodes and improved consistent management of hypoglycemia.

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Section: Discussionmentioning

confidence: 99%

Section: Available Knowledgementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Hypoglycemia Management Using a Bundled Care Approach

Mattathil

2022

Journal of Nursing Care Quality

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Evaluating the Impact of Inadequate Meal Consumption on Insulin-Related Hypoglycemia in Hospitalized Patients

et al. 2021

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Hypoglycemia in hospitalized patients: A sleeping monster

Kuragayala,

Nayak,

Khatib

2024

Muller Journal of Medical Sciences and Research

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Objective: This study describes the incidence and clinical profile of hypoglycemia (including mild, moderate, severe, and recurrent) and its correlation with the time of the day, duration of diabetes mellitus (DM), administration of insulin/oral hypoglycemic agents (OHAs) and diagnosis at admission in hospitalized adult patients. Materials and Methods: This retrospective, observational study analyzed the data of hospitalized patients with episode(s) of hypoglycemia. For each patient, clinical profiles such as age, gender, antidiabetic therapy, timing of hypoglycemic event, duration of diabetes, working diagnosis, place of hypoglycemia, dietary changes, and mode of corrective action were studied. Results: Of 100 patients with a mean ± standard deviation age of 62.72 ± 3.54 years, hypoglycemia was the most common among those aged 61–90 years. There were 134 hypoglycemic events and mild hypoglycemia was the most common (72.39% vs. moderate 21.64% and severe 5.97%). There were 59 (44%) events of recurrent hypoglycemia. Hypoglycemic events were maximum during 4:00 am–7:59 am (34%). Longer duration of DM (>15 years, 42%) and insulin therapy were the high-risk factors. There was a statistically significant association between hypoglycemia and duration of diabetes (P < 0.0133), insulin therapy (P < 0.0001), OHA (P < 0.0192), and a combination of insulin and OHA (P < 0.0059) within 24 h before the event but not with the incidence and dietary changes. Conclusion: Patients above 60 years were the most vulnerable population for hypoglycemia, especially during the early hours of the day. Patients who had diabetes for >15 years, on insulin therapy, and those with pulmonary and renal diseases were the most vulnerable to overall and recurrent hypoglycemic events, respectively.

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Correction: Multidisciplinary strategies to treat severe hypoglycemia in hospitalized patients with diabetes mellitus reduce inpatient mortality rate: Experience from an academic community hospital

Cited by 4 publications

References 1 publication

Hypoglycemia Management Using a Bundled Care Approach

Hypoglycemia Management Using a Bundled Care Approach

Evaluating the Impact of Inadequate Meal Consumption on Insulin-Related Hypoglycemia in Hospitalized Patients

Hypoglycemia in hospitalized patients: A sleeping monster

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