In a new paper, researchers have introduced the first-ever quality measures to help healthcare providers assess how well they identify and care for older adults at greater risk of hypoglycemia—low blood sugar that can be a dangerous complication of diabetes treatment.
The measures focus on outpatient treatment for adults who are 65 and older and have type 2 diabetes.
The research was done by a panel of diabetes experts from the Endocrine Society and Avalere Health.
An estimated 33% of adults aged 65 or older have diabetes, and this age group faces an increased risk of developing hypoglycemia. Hypoglycemia can lead to seizures, coma, and even death.
The U.S. Department of Health and Human Services identified hypoglycemia as one of the top three preventable and measurable adverse drug events.
In the study, the quality measures outline key risk factors that raise an individual’s chances of developing hypoglycemia and emphasize the importance of people who meet these criteria receiving education to help prevent future diseases.
Key risk factors include:
Experiencing a hypoglycemic event where blood glucose levels dropped below 54 mg/dL and required immediate attention within the past year
Experiencing altered mental or physical status requiring assistance during a severe hypoglycemic event in the past year
Among individuals who manage their blood sugar with insulin or medicines like sulfonylureas that increase the risk of hypoglycemia:
A documented A1c of less than 7 percent in the past six months, or
At least one other relevant chronic medical problem.
The expert panel also recommends healthcare providers capture information about hypoglycemic episodes where individuals experienced altered mental or physical status requiring assistance within the past year.
This information can help clinicians better determine if an individual is experiencing growing unawareness of hypoglycemia over time and identify what kinds of interventions stand the best chance of helping the patient avoid future episodes.
Once medical centers and practices begin using the quality measures, the Society and Avalere hope to use information and data from users to refine the quality measures in the future.
The lead author of the study is James L. Rosenzweig, MD, of Hebrew SeniorLife.
The study is published in the Journal of Clinical Endocrinology & Metabolism.
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