SHM Converge Scientific Abstract ePoster Gallery-Evaluating the 15/15 Rule in the Hospital for Management of Hypoglycemia

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This retrospective hospital study compared the standard “15/15 rule” for oral carbohydrate treatment of hypoglycemia with personalized IV D50 dosing guided by the Glucommander insulin management system.<br /><br />Hospitals commonly treat hypoglycemia with 15 grams of oral carbohydrates for awake patients, IV D50 for patients who cannot eat but have IV access, or glucagon if no IV access is available. The authors noted that many protocols use a fixed 15-gram oral dose and a fixed 12.5-gram D50 dose, regardless of how low the glucose level is. They examined whether a dose tailored to the severity of hypoglycemia would work better.<br /><br />Using retrospective data from January 1, 2017 to June 1, 2021, they reviewed 57,629 hypoglycemia events with blood glucose readings of 70 mg/dL or lower. Of these, 29,935 were treated with 15 grams of oral carbohydrates and 27,694 with personalized IV D50 dosing. For repeat glucose checks within 45 minutes, 67.5% of oral carbohydrate treatments resulted in a subsequent glucose of at least 70 mg/dL, with a median follow-up glucose of 79 mg/dL. In the IV D50 group, 89.4% reached at least 70 mg/dL, with a median follow-up glucose of 100 mg/dL.<br /><br />In more severe hypoglycemia cases (40 mg/dL), 577 patients received oral carbohydrates and only 34.5% achieved a subsequent glucose of at least 70 mg/dL. In contrast, 311 patients treated with personalized IV D50 had an 82.1% success rate.<br /><br />The authors concluded that personalized IV D50 dosing was substantially more effective than a fixed oral 15-gram approach, especially in severe hypoglycemia. They suggested that IV D50 dosing should be matched to the glucose level, ideally using a computerized algorithm, and that 15 grams of oral carbohydrates may be insufficient for some patients.

Asset Subtitle

Jordan Messler

Meta Tag

Author List Emily Ohanuka, Jordan Messler, Robby Booth

Category Research

Concept Hypoglycemia

Concept Oral Carbohydrate

Concept Intravenous D50

Concept Severe Hypoglycemia

Concept Glucagon

Distinguished Non-Finalist

Presenter Organization Glytec

Presenting Author Jordan Messler

Track Technology in Hospital Medicine

Keywords

hypoglycemia

oral carbohydrates

15/15 rule

IV D50

Glucommander

blood glucose

retrospective study

diabetes management

glucose correction

personalized dosing

Hypoglycemia

Oral Carbohydrate

Intravenous D50

Severe Hypoglycemia

Glucagon