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Inpatient Hypoglycemia: A Challenge That Must Be Addressed

  • Hospital Management of Diabetes (G Umpierrez, Section Editor)
  • Published:
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Abstract

Hypoglycemia in the inpatient setting is a common occurrence with potentially harmful outcomes. Large trials in both the inpatient and outpatient settings have found a correlation between hypoglycemia and morbidity and mortality. The incidence of hypoglycemia is difficult to assess, due to a lack of standardized definitions and different methods of data collection between hospital systems. Risk factors that predispose to hypoglycemia involve the changing clinical statuses of patients, nutrition issues, and hospital processes. Mechanisms contributing to morbidity due to hypoglycemia may include an increase in sympathoadrenal responses, as well as indirect changes affecting cytokine production, coagulation, fibrinolysis, and endothelial function. Prevention of hypoglycemia requires implementation of several strategies that include patient safety, quality control, multidisciplinary communication, and transitions of care. In this article, we discuss all of these issues and provide suggestions to help predict and prevent hypoglycemic episodes during an inpatient stay. We address the issues that occur upon admission, during the hospital stay, and around the time of discharge. We believe that decreasing the incidence of inpatient hypoglycemia will both decrease costs and improve patient outcomes.

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Acknowledgments

The contents of this article do not reflect the views of the VA and are the opinion of the authors.

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Leslie Eiland, Whitney Goldner, Andjela Drincic, and Cyrus Desouza declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Cyrus Desouza.

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This article is part of the Topical Collection on Hospital Management of Diabetes

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Eiland, L., Goldner, W., Drincic, A. et al. Inpatient Hypoglycemia: A Challenge That Must Be Addressed. Curr Diab Rep 14, 445 (2014). https://doi.org/10.1007/s11892-013-0445-1

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