1072-P: Incidence of Inpatient Hypoglycemia by Specialty Area—A Case for Targeted Inpatient CGM

Abstract

Inpatient hypoglycemia is traumatic for people with diabetes and increases length of stay, hospital costs and subsequent mortality (at least in the elderly). We report inpatient hypoglycemia by specialty ward in an 800-bed, acute hospital serving a largely deprived population (350,000) with diabetes prevalence 8%. Over 1 year, 21,089 inpatients with diabetes had 176,603 point of care (POC) tests (median 8.4, ward range 1.1-29.2, POC tests/person/stay); and 9.2 (ward range 2.1-24.7)% of subjects experienced hypoglycemia (CBG <72 mg/dl). Patients who experienced hypoglycemia had 2.6 (range 1.2-5.8) episodes of hypoglycemia either from early persistence (failure of protocol-driven hypoglycemia treatment) or late recurrence. There was a strong correlation between POC testing frequency and detection of hypoglycemia (Chi-square, Yates’ correction = 8.4374, p=0.004). Compared with the whole hospital (index 1.0), specialty wards hypo index ranged 10-fold from 0.2 to 5.1. A recent RCT demonstrated CGM superiority over POC testing in preventing recurrent inpatient hypoglycemia. Consistent with this RCT, our data suggest that increased POC testing is associated with increased hypoglycemia detection and our approach might guide initial targeting of CGM to highest risk specialty wards for hospitals unable to deploy CGM simultaneously in every inpatient specialty ward area. Disclosure G.A.Lewis: None. J.Cardwell: None. S.Bujawansa: Stock/Shareholder; Merck & Co., Inc., GlaxoSmithKline plc. K.J.Hardy: Other Relationship; Sanofi, Speaker's Bureau; Napp Pharmaceuticals Limited.