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Reducing Morning Hypoglycemia Among Children Undergoing Treatment for Acute Lymphoblastic Leukemia

Ashraf Mohamed1, Christine Bolen2, Jennifer Morgan3

  • 1Department of Hematology/Oncology and Stem Cell Transplant, Cook Children's Medical Center, Fort Worth, TX.

JCO Oncology Practice
|March 17, 2021
PubMed

Insights

Hypoglycemia education significantly reduced low blood sugar in children undergoing acute lymphoblastic leukemia (ALL) therapy. This intervention improved patient safety and outcomes in pediatric oncology clinics.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Patient Safety

Background:

  • Hypoglycemia is a recognized complication in children undergoing acute lymphoblastic leukemia (ALL) therapy, potentially impacting treatment outcomes.
  • Prevalence of hypoglycemia in the studied clinics ranged from 4% to 6%.

Purpose of the Study:

  • To decrease morning hypoglycemia by 50% in children receiving ALL chemotherapy at two community pediatric oncology clinics within 9 months.
  • To address contributing factors such as prolonged fasting, caregiver knowledge gaps, and awareness of mercaptopurine guidelines.

Main Methods:

  • Utilized the Institute for Healthcare Improvement (IHI) Model for Improvement.
  • Developed and implemented a hypoglycemia prevention educational program for staff and caregivers.
  • Assessed knowledge retention through pre- and post-intervention assessments.

Main Results:

  • Achieved 88% caregiver participation in the educational program, with 78% scoring ≥75% on knowledge reassessment.
  • Reduced combined average hypoglycemic episodes by 46% across both clinics.
  • Observed a significant difference in improvement between clinics: 75% reduction in Clinic A versus 17% in Clinic B.

Conclusions:

  • Hypoglycemia education is effective in reducing hypoglycemic episodes in pediatric ALL patients.
  • Clinic-specific factors may influence the degree of improvement achieved with similar interventions.
Abstract

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