Endocrine Abstracts

Aim: To know the compliance on management of inpatient hypoglycaemia among diabetic inpatients admitted for non-critical illness at Bronglais General Hospital based on JBDS guidelines

Method: A retrospective collection of data of diabetes patients from EMR and patient files over the period of 6 months from September 2022 to March 2023, who were admitted for various conditions and developed hypoglycemia during their stay in hospital.

Results: The median age of patients was around 81 years; with equal male: female ratio. The median length of stay in hospital was around 23 days. Out of 30 patients, 28 were type 2 and 2 were Type 1 Diabetes Mellitus Insulin in combination with oral diabetic agents was prescribed in 46 % of type 2 Diabetes patients and 28 % of patients were on Glicazide. Majority of hypoglycemic episodes fall under mild (77 %) with 13 % and 10 % in moderate and severe categories, respectively. Nine patients were treated with oral glucose preparations based on guidelines and rest of patients’ management plan were not recorded. Repeat blood glucose after 15 mins of initial hypoglycemic episode were done in all of them. None of them died from any hypoglycemic event.

Conclusion: There is wide range of missing data from the files regarding management of hypoglycemic episodes. Overall compliance with respect to management of JBDS guidelines is about 30 %. All patients were correctly categorized based on the level of severity of hypoglycemia. About 70 % have missing documentation which led us to implement a proper documentation tool for inpatient hypoglycemia which should be easily accessible and also clearly stating the treatment given. Also, staff education on the latest guidelines is important as well as proper tritration of insulin based on blood glucose level for the doctors. We plan to Re-audit within 6 months after implementation of the above action plan.