Current practice of hypoglycemia management in the ED

Area of Science:

• Emergency Medicine
• Endocrinology
• Clinical Research

Background:

• Hypoglycemia, defined by blood glucose (BG) levels ≤50 mg/dL, requires prompt and effective management in emergency settings.
• Characterizing management patterns and identifying factors contributing to persistent or recurring hypoglycemia is crucial for optimizing patient care.

Purpose of the Study:

• To analyze the management strategies for hypoglycemia in adult emergency department (ED) patients.
• To identify patient characteristics and treatment factors associated with refractory and recurrent hypoglycemia.

Main Methods:

• A retrospective review was conducted on 244 adult ED patients with hypoglycemia (BG ≤50 mg/dL) from January 2011 to July 2015.
• Data included BG measurements, treatment timing, and patient outcomes, analyzed using descriptive statistics and comparative tests.

Main Results:

• 12% of patients with BG ≤50 mg/dL did not receive any treatment or food.
• Treatment was initiated faster with point-of-care testing (11 minutes) compared to serum sample results (25 minutes).
• Refractory or recurrent hypoglycemia occurred in 30.3% of patients, with infection being the only significant associated characteristic.

Conclusions:

• A notable percentage of ED patients with hypoglycemia do not receive timely treatment.
• Infection is linked to refractory or recurrent hypoglycemia, and lack of dextrose-containing IV fluids is associated with recurrence.
• Point-of-care testing expedites hypoglycemia treatment initiation in the ED.