Evaluation of Hypoglycemia and Potential Risk Factors in a Veterans Affairs Community Living Center.

Abstract

Objectives: To describe hypoglycemic events in a Veterans Affairs (VA) community living center (CLC) population and to determine predictive risk factors associated with hypoglycemia.

Design: Retrospective, exploratory, observational chart review.

Setting: Tertiary-care VA Healthcare System CLC.

Patients: Residents residing in a VA CLC with at least one active order for insulin between June 1, 2009, and June 30, 2013, were evaluated over a 90-day study period.

Main outcome measures: The primary outcome was the number of days to the first hypoglycemic event as described by the survival curve analysis. The secondary outcomes included the overall incidence of hypoglycemia, the association of potential risk factors on the proportion of hypoglycemic events, and the association of potential risk factors on the development of an additional hypoglycemic event.

Results: There was a 49% incidence of a hypoglycemic event in the 90-day study period with a 24% incidence within the first 7 days of resident admission, representing approximately half of all events that occurred. The only statistically significant risk factor for having a hypoglycemic event was the number of units of insulin/kg/day (hazard ratio = 1.008, 95% confidence interval 1.001, 1.015; P = 0.0317) that a resident was prescribed.

Conclusions: Residents are at increased risk for hypoglycemia within the first seven days of admission to a CLC. It is imperative that providers closely monitor and reevaluate antidiabetic regimens at this time of transition.