Hypoglycemia Management in Primary Care

Abstract

Diabetes is one of the largest global health emergencies in the 21st Century. Over 30 million individuals have been diagnosed with diabetes, and uncontrolled diabetes can lead to poor patient outcomes. One of the greatest threats to achieving tight glycemic control is hypoglycemia. Hypoglycemia is a common, and potentially preventable complication. This quasi-experimental, single-cohort quality improvement study aimed to improve clinical management of hypoglycemia over three months through time in range monitoring. Time in range monitoring is recommended by the American Diabetes Association to evaluate glycemic control. Study participants were recruited through convenience sampling with the goal of recruting10-15 adults, age 18-70 diagnosed with diabetes from an outpatient endocrinology clinic in Kansas City. Primary outcome measures included improvement in hypoglycemia monitoring, medication adherence, glycosylated hemoglobin, and low-density lipoprotein. Secondary measures were hyperglycemia, weight, and blood pressure. The standard glucose target range for time in range is 70-180 mg/dl. Patients who spend greater than 80% of time in range have fewer complications, fostering improvement in quality of life. The pre-posttest results found a reduction in weight and blood pressure. The time in range goal of 80% showed a 50% improvement. The Summary of Diabetes Self-Care activities served as a valid and reliable tool for assessing diabetes self-care behavior. The study outcomes support the use of time in range monitoring as an effective tool for evaluating hypo- and hyperglycemia management in the outpatient clinic setting