Temporal occurrences and recurrence patterns of hypoglycemia during hospitalization
Abstract
Objective To describe the temporal distribution of hypoglycemia and its rate of recurrence during hospitalization to aid in the development of strategies to prevent hypoglycemia in hospitalized patients. Methods Retrospective review of hypoglycemia (blood glucose Results A total of 274 index occurrences of hypoglycemia were analyzed. The mean age of the patients was 53.8 years, with roughly equal gender distributions. Twenty-eight percent of the events occurred in the absence of antihyperglycemic therapy. The incidence of hypoglycemia peaked between midnight and 6 AM. There were 36 instances of recurrent hypoglycemia associated with antihyperglycemic therapy, with 78% (n = 28) cases involving basal insulin. Patients on basal insulin who developed hypoglycemia did not have their dose changed prior to the time of the next administration in 75% of the cases. Conclusion Hypoglycemia in hospitalized patients may occur with greater frequency overnight. Although cumbersome, routine nocturnal glycemic testing should be considered. Education regarding insulin management in the hospital and improved communication between night and day staff may aid in decreasing subsequent hypoglycemic events.
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In another study of hypoglycemic episodes (defined as <50 mg/dL), 78% of individuals were taking basal insulin, with the incidence of hypoglycemia peaking between midnight and 6:00 A.M.
“In another study of hypoglycemic episodes (defined as <50 mg/dL [<2.8 mmol/L]), 78% of individuals were taking basal insulin, with the incidence of hypoglycemia peaking between midnight and 6:00 A.M. (111).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [111]
Despite recognition of hypoglycemia, 75% of individuals did not have their dose of basal insulin changed before the next basal insulin administration.
“Despite recognition of hypoglycemia, 75% of individuals did not have their dose of basal insulin changed before the next basal insulin administration (111).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [111]
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- Authors
- Ulmer, B. J., Kara, A., & Mariash, C. N.
- Affiliations
- Indiana University Health (US)
- Corresponding author
- Ulmer, Brian J.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 21
- Issue
- 5
- Pages
- 501-507
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W2072467804
- Cited by
- 28
- References
- 31
- Citations by year
- 2025: 4 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 5 · 2015: 1
- FWCI
- 2.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Methodist Health Foundation
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- hypoglycemia, hospitalized patients, temporal distribution, nocturnal hypoglycemia, recurrent hypoglycemia, basal insulin, insulin dose adjustment, antihyperglycemic therapy, insulin management, hospital staff communication
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Glucose, Female, Hospitalization, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Recurrence, Retrospective Studies, Time Factors
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