Endocrine Abstracts

JOINT3320

Introduction: Hypoglycemia, defined as blood glucose below 70 mg/dL, is a serious diabetes complication linked to higher mortality, cardiovascular risks, and prolonged hospital stays. Severe episodes are more frequent in type 1 diabetes but also occur in type 2. Effective management is key to improving outcomes. Prolonged hospital stays for hypoglycemia may arise from factors like age, underlying conditions, hormonal issues, diabetes type, and discharge protocols requiring support assessments. Timely care, medication adjustments, and monitoring can help minimize delays. This audit examines factors contributing to longer hospital stays for hypoglycemic patients and identifies barriers to efficient care and discharge. It aims to improve hypoglycemia management and reduce hospitalization times.

Objectives and Methodology: Objectives

• Analyze factors prolonging hospital stays in hypoglycemia.

• Assess management and discharge practices.

• Recommend strategies to reduce hospital stays.

Methodology: A retrospective review of 25 hypoglycemia patients (April–October 2024) was analyzed. Review included demographics, comorbidities, glucose levels, interventions, care delays, and discharge times. The goal was to identify patterns and improve management and discharge processes for hypoglycemic patients.

Results: The study involved 25 patients, with 64% male and 36% female. Most were aged 60–80 years, followed by 81–100 years and 20–60 years. Of the 25, 11 had type 1 diabetes and 14 had type 2. Nineteen patients were on insulin, and 16 used oral hypoglycemic agents, including 4 on sulfonylureas. At admission, 14 patients had blood glucose below 2.5 mmol/l, and 10 had levels above 2.6 mmol/l. Specialist referrals were made for 15 patients, with most reviewed within 24 hours of admission.

Discussion: Hospital stays ranged from 2 to 22 days, with half discharged within 7 days and the other half requiring longer stays. Prolonged hospitalizations in 3 out of 10 patients were due to factors like fluctuating blood glucose and rest 6 out of 10 were due to comorbidities (e.g., infections, kidney injury), and 1 out of 10 due to delay in discharge planning. Additional complications, such as pneumonia, acute kidney injury and pleural effusion, required extra interventions thus highlighting need for effective management of comorbidities and reduce hospital stay.

Conclusion: Hypoglycemia management involves resolution of factors that prolong hospital stays. Early interventions, efficient discharge plans, glucose monitoring, and regular audits are crucial to improving care and reducing hospitalizations.