Supportive Toolkit

Hypoglycemia Assessment

These resources will assist the provider in assessing episodes of hypoglycemia, risk factors associated with hypoglycemia, and a patient’s confidence in addressing hypoglycemia.

  • Hypoglycemia and Diabetes: A Report of a Workgroup
    Endocrine Society and American Diabetes Association
    The consensus report reviews evidence about the impact of hypoglycemia on patients with diabetes and provides guideline about how this information should be incorporated into clinical practice.
    • Patient Questionnaire
      Review of the questionnaire will help you learn how often the patient is experiencing symptomatic and asymptomatic hypoglycemia and ensure the patient is aware of how to appropriately treat hypoglycemia.
  • Patient Safety Infographic
    Department of Veteran Affairs
    Infographic that reviews risk factors for hypoglycemia, the importance of individualized A1c goals, socioeconomic considerations in caring for patients with diabetes, topics for improved patient support, and additional resources to offer to patients.
  • Hypoglycemia Confidence Scale
    Behavioral Diabetes Institute 
    A 9-item self-report scale that examines the degree to which people with Type 2 Diabetes feel able, secure, and comfortable regarding their ability to stay safe from hypoglycemic-related problems.

Care Plan

These resources will help inform clinical decision-making and the creation of a patient care plan. These items will identify potential A1c goals and whether medication modifications that may be needed.

Clinical Decision-Making

Antihyperglycemic Medications

  • Antihyperglycemic Deprescribing Algorithm || U.S. Version
    Deprescribing.org
    Flow chart that facilitates clinical decision-making around deprescribing antihyperglycemic medications. Lists drugs that affect glycemic control and ways to engage patients.
  • Antihyperglycemic Deprescribing Algorithm Whiteboard video
    Deprescribing.org
    Provides an overview of how to use a deprescribing algorithm to help decide when and how to safely reduce or stop certain antihyperglycemics, especially in at-risk patients.
  • Oral Diabetes Medications Summary Chart
    Joslin Diabetes Center
    Chart that reviews of available non-insulin diabetes medications, their mechanisms of action, side effects, dosage, frequency, and dosing range. 
  • Resource of Oral Diabetes Medications
    Diabetes Teaching Center at the University of California, San Francisco
    A table to look up different medications that can be used to treat T2D, with expanded information about each drug including dosing information and side effect profile including hypoglycemia.

Shared Decision-Making 

  • The SHARE Approach
    AHRQ
    Set of slides used to guide a workshop on AHRQ’s five-step SHARE Approach for shared decision-making, which includes exploring and comparing the benefits, harms, and risks of each healthcare option through meaningful dialogue around patient priorities.

Patient Education

These resources are intended to help educate patients about their risk for hypoglycemia and ways to treat episodes. They are organized by topic and scored for literacy level. The SMOG Index is used - which computes readability based on the number of syllables per word. The number indicates the reading level of each resource. The higher the score, the higher the reading level. For more information, review the scoring instructions.

Diabetes Action Plans

  • AmeriHealth Diabetes Action Plan
    AmeriHealth | SMOG Index: 6
    Two-page document with which a patient and their clinician can develop a schedule for testing blood sugar at home. The action plan supports a patient in recognizing their specific symptoms and acting on hypo/hyperglycemia, ultimately improving disease control.
  • Health Alliance Plan of Michigan Diabetes Action Plan
    Health Alliance Plan of Michigan | SMOG Index: 10.7
    Two-page document that provides key signs and symptoms of hyper/hypoglycemia as well as actions to correct them, outlines the patient’s medication, diet, exercise, labs, and foot care.

Hypoglycemia Awareness and Management

  • Type 2 Diabetes & A1C Fact Sheet  (Spanish)
    Hormone Health Network | SMOG Index: 9
    The fact sheet describes what Type 2 Diabetes is and what a patient’s A1C should be.
  • Changing Life with Diabetes: Hyper/Hypo Handout
    Novo Nordisk | SMOG Index: 3.6
    Two-page handout with visual depictions of symptoms of hyper and hypoglycemia, treatment and when to call the provider.
  • Low Blood Sugar (also available in Spanish) 
    Learning About Diabetes, Inc. | SMOG Index: 3
    One-page handout that visually depicts warning signs of hypoglycemia and steps for the patient to take if it occurs.
  • Low Blood Glucose (Hypoglycemia)
    National Institute of Diabetes and Digestive and Kidney Diseases | SMOG Index: 6.6
    NIDDK website that defines hypoglycemia, reviews symptoms and causes, discusses prevention and treatment guidelines, and outlines when to contact a provider or emergency care.
  • Managing and Preventing Hypoglycemia
    Academy of Nutrition and Dietetics | SMOG Index: 3.1
    Two-page nutrition resource for those living with diabetes that outlines symptoms of severe and mild hypoglycemia, the rule of 15 to treat hypoglycemia, and methods for prevention.
  • Understanding Blood Sugar (also available in Spanish) 
    Learning About Diabetes, Inc. | SMOG Index: 3
    Longer, but easy-to-read document with pictures that outlines management of blood sugar testing, high/low blood sugar, how to treat both conditions, and when to call the provider.

Medications

  • Diabetes & Insulin Fact Sheet (Spanish)
    Patient Engagement | SMOG Index: 8
    The fact sheet provides the patient with information on different types of insulin with questions to ask their physician.
  • Mealtime Insulin Fact Sheet
    Patient Engagement | SMOG Index: 8
    Different types of insulin is detailed, including their duration and approaches for combining background and mealtime insulin.
  • Mealtime Insulin Infographic
    Patient Engagement | SMOG Index: 6
    The infographic discusses how to take mealtime insulin and pros and cons for adding rapid-acting or premixed insulins.
  • Diabetes & Low Blood Sugar Fact Sheet (Spanish)
    Patient Engagement | SMOG Index: 9
    An overview of how to identify and treat hypoglycemia is described, along with tips on how to avoid it.
  • Is an Antihyperglycemic still needed? || U.S. Version
    Deprescribing.org | SMOG Index: 9.2
    Two-page handout that describes antihyperglycemics, the reasons a patient may change or stop these medications, how to safely reduce an antihyperglycemic and monitor for side effects, as well as a personalized antihyperglycemic dose reduction strategy.
  • Reducing Medications Safely to Meet Life's Changes
    Deprescribing.org | SMOG Index: 15.8
    One-page handout that discusses the concept of deprescribing, why a patient may consider it, and how to safely go about stopping or changing a diabetes medication.

Reference Journal Articles

This section includes peer-reviewed articles that helped inform HypoPrevent and its study instruments, such as the Hypoglycemia Reduction Clinical Decision Support Tool.

Hypoglycemia Management

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