848-P: Assessing Impact of Proactive Interventions in Patients with Near-Hypoglycemia

Background: Inpatient hypoglycemia (H) [<4 mmol/L] is associated with adverse clinical outcomes. In 2019, we implemented a program in three non-critical-care wards in a tertiary hospital, targeting inpatients near hypoglycemia (NH) [4-5 mmol/L].

Aim: To assess if proactive intervention in patients with NH was associated with reduced conversion to H and determine factors associated with conversion to H.

Method: Patients with NH in the last 24h were identified at the beginning of the next workday for review by a diabetes pharmacist followed by treatment change recommendations to prevent H. All patients with NH in the pre- and post- intervention period (T0, T1 respectively) were identified and conversion to H was assessed via difference in proportions. Multivariate analysis was used to assess factors associated with conversion to H.

Results: T0 had 924 NH events, where 15.2% converted to H, while T1 had 808 NH events, where 15.4% converted (p=0.908). Median conversion time was 11.07 and 14.95 hours for T0 and T1 respectively. Multivariate analyses showed that intervention was associated with fewer conversions, while ethnicity, polypharmacy and occurrence of NH between 8pm to 12am were associated with greater likelihood of conversion to H.

Conclusion: While NH conversion was reduced with current measures, other potential factors were identified. Future adoption of real-time measures may help to further reduce H occurrence.

View largeDownload slide

View largeDownload slide