Audit of Inpatient Monitoring and Management of Hypoglycemia in Diabetic Patients Compared to National Guidelines

Abstract

Background: Hypoglycemia is a common and potentially deadly complication of diabetic patients staying in the hospital, especially those who take insulin or insulin secretagogues. Poor monitoring and sluggish treatment may result in severe negative consequences. Compliance with national guidelines is thus necessary to provide patient safety and enhance clinical outcomes. Aims: The objective of the study was to assess the practices in management and monitoring of hypoglycemia in diabetic patients at Hayatabad Medical Complex and compare the results with the initial audit cycle that was performed at Lady Reading Hospital. Methods: The second-cycle clinical audit was done between January and December 2025. One hundred and sixty-five patients were identified who had recorded hypoglycemic episodes (blood glucose <70mg/dl). A structured proforma that was in line with national hypoglycemia management guidelines was used to collect data. Measures of variables were timing of treatment initiation, frequency of monitoring, reassessment practices, documentation quality, preventive strategies and escalation of care. Analysis of data was done using SPSS version 25. Results: There were a recorded 248 hypoglycemic events. There was an increased initiation of treatment in 15 minutes of 57.3% versus 33.5% in the initial cycle. Reassessment of blood glucose 30 minutes later was reached in 86.3 percent. Documentation has risen to 79.8 and preventive measures (48.8) and escalation of care (38.7) were not optimal. Conclusion: The second audit cycle showed a substantial progress in the management of inpatient hypoglycemia, especially in the timely intervention and monitoring. Nonetheless, the lack of preventive measures and care intensification continues to suggest the necessity of further training, reinforcement of systems, and periodic re-audits to maintain national guidelines continuity.