Endocrine Abstracts

Background: Inpatient hypoglycemia, defined as a blood glucose level below 4 mmol/l, poses a substantial risk to diabetic patients, increasing morbidity and extending hospital stays. This study combines data from two audit cycles at a district general hospital to identify factors contributing to hypoglycemia, particularly during high-risk nighttime hours.

Aim: This study aims to evaluate the timing, frequency, and management of hypoglycemic episodes in hospitalized diabetic patients, assessing associations with risk factors like renal impairment, HbA1c levels, and adherence to management protocols.

Method: A total of 122 hypoglycemic events were analyzed across two audit cycles. Data included patient demographics, diabetes type, timing of episodes, AKI presence, HbA1c levels, and protocol adherence. Statistical analyses were conducted using chi-square tests for categorical variables and t-tests for continuous ones.

Findings: Results indicate that 60% of hypoglycemic events occurred between 8 PM and 8 AM, a statistically significant association (χ² = 9.34, P < 0.05). AKI was also significantly correlated with hypoglycemia incidence (χ² = 7.28, P < 0.01), underscoring renal impairment as a major risk factor. Higher HbA1c levels showed a marginal, though statistically insignificant, increase in recurrent hypoglycemia risk (t = 1.96, P = 0.06). Protocol adherence was suboptimal, with 68% of cases achieving timely blood glucose rechecks and little improvement between cycles (χ² = 0.89, P = 0.35).

Conclusion: This study highlights the need for targeted training on hypoglycemia management, particularly during nighttime hours and in patients with concurrent AKI. Next steps include implementing protocol improvements to reinforce adherence, increasing staff training on hypoglycemia risks, and establishing proactive monitoring for high-risk patients, particularly during off-peak hours. Routine audits and feedback loops are recommended to support continuous improvement in inpatient glycemic management, with the ultimate goal of reducing hypoglycemic events and enhancing patient safety.