Excessive Rate of Hypoglycemia in Hospice Patients

A retrospective cohort study, conducted in the U.S. Veterans Affairs (VA) nursing home system between 2006 and 2015, provides evidence that hospice patients often experience hypoglycemia (blood glucose level, <70 mg/dL) and severe hypoglycemia (blood glucose level, <50 mg/dL). A total of 20,329 patients (age, ≥65) with type 2 diabetes were identified at admission to VA nursing homes for hospice care; 1687 of these patients (8%) were receiving insulin. Nearly all patients had died within 100 days.

Cumulative risks for hypoglycemia were 12% among all patients and 38% in those receiving insulin. Corresponding risks for severe hypoglycemia were 5% and 18%.