Hypoglycemia Prevention Initiative

The Hypoglycemia Prevention Initiative is a multi-year joint effort of the Endocrine Society and Avalere Health to determine best practices in primary care to reduce the impact of hypoglycemia on older (65+) people with type 2 diabetes (T2D) who use insulin and/or sulfonylurea, have a recent A1c <7%, and are at increased risk of hypoglycemia. The initial effort of this initiative is the Hypoglycemia Prevention Study (HypoPrevent), an implementation research and quality improvement (QI) study designed to test an intervention in primary care settings to identify older people with T2D at risk of hypoglycemia and a clinical decision support tool designed to facilitate risk reduction.

This study assesses various methods to decrease the risk of hypoglycemia on an individual basis through shared decision making (SDM), individualized A1c goals and/or changes to their glucose-lowering medications regimen. The diabetes educator, who is also the practice coordinator for this study, plays a key role with annual assessments and education on glucose-lowering medications and their mechanism of action.


Objectives

1:  Increasing outpatient hypoglycemia surveillance & risk assessment by integrating a risk assessment into primary care clinical workflow
2:  Improving the management of older type 2 diabetes patients on insulin and sulfonylureas
3:  Developing outpatient hypoglycemia quality measures and integrating them into primary care practices to incentivize high-quality care

Why Focus on Hypoglycemia?

Top Three Preventable Adverse Drug ReactionIdentified as one of the top three preventable adverse drug reactions by the US Department of Health and Human Services

23 mild or moderate and 1 severe event per yearAverage incidence of hypoglycemia among people with T2D on insulin is 23 mild or moderate events and 1 severe episode per year

Expensive Emergency Department VisitsBetween January 2007 and December 2011, emergency department visits for therapy-associated hypoglycemia among Medicare beneficiaries resulted in more than $600 million in spending

Medicare aged individuals have 30 day readmissions rate over 18 percent Among Medicare-aged individuals, hospitalization for hypoglycemia is associated with a 30-day readmission rate of 18.1%

Significant affect on quality of life Mild or moderate hypoglycemia can significantly affect a person’s quality of life, social life, work productivity, and ability to drive safely

Primary care clinicians majority of T2D carePrimary care clinicians provide the majority of care for people with T2D
 

Patient Resources

The Hormone Health Network has patient information on hypoglycemia including:

  • What is hypoglycemia?
  • What is the link between diabetes and hypoglycemia?
  • What are the signs and symptoms of hypoglycemia?
  • How is hypoglycemia treated?
  • and more...

Steering Committee

  • Dr. Jeffrey Boord—Parkview Health Endocrinology
    Steering Committee Chair
  • Jesse Bushman—Senior Director, Health Policy, JDRF
  • Dr. Lawrence Dardick—UCLA Medical Center, Family Medicine
  • Dr. Kathleen Dungan—Ohio State University Wexner Medical Center, Endocrinologist
  • Dr. Deborah Koehn—Virginia Commonwealth University Medical Center, Internal Medicine
  • Dr. Ken Snow—Medical Director, Aetna
  • Dr. Amisha Wallia—Northwestern Memorial Hospital, Endocrinology
  • Hope Warshaw, RD, CDE, BC-ADM—Hope Warshaw Associates, LLC, Dietician and Diabetes Educator

Partners

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