Patrick Burgess, MD: Hypoglycemia and Impact of Late Glucose Checks

A study analyzing more than 3 million blood glucose readings found that being 15 to 25 minutes late when checking can result in an almost 2-fold increase in risk of hypoglycemia — and being 55 to 65 minutes late translated to a 4-fold higher risk.

Investigators presented the findings of their study into the impact of late glucose checks on incidence hypoglycemia at the American Diabetes Association (ADA) 2019 Scientific Sessions in San Francisco, CA.

After analyzing 3.55 million blood glucose readings from the EndoTool database, investigators performed a retrospective, quantitative analyses of incidence of hypoglycemia relative to the lateness of blood glucose determination. Timing of all blood glucose readings 5 minutes late or less were used as baseline to measure the relative risk of later, low blood glucose readings in 10 minute increments.

Patrick Burgess, MD, PhD, founder and inventor of EndoTool, was one of the investigators involved in the study and he sat down with MD Magazine® to discuss the results of the study and their clinical impact.

MD Mag: What is the impact of late glucose checks on hypoglycemia incidence?

Burgess: Well, it started by working with EndoTool. We have a huge database, — over several million data points in close to 250 hospitals and in this database, it dawned on us that very few people have reported the quantitative effect of let sugar determinations in the course of IV insulin dosing. So, we had the data so we looked back and analyzed the data and determined the incidence of hypoglycemia, all 4 categories of hypoglycemia, as a function of how late the sugar was determined and also as a function of the frequency of the glucose testing at the time.

What we found is that there is roughly a 4-fold increase in low sugars if the nurses are late in determining the sugar. Now, this is important because if nurses understand the impact of being late then we are hopeful we can influence the behavior because what we find in the software is that the average time for determining sugar is actually 5 to 10 minutes late. So, while it's ideal to do it at the proper time there is consequences, negative consequences to patient care when the sugars are determined late and we put a number on it.