Introduction

In a groundbreaking study published in the journal *Endocrine Practice*, researchers suggest that implementing quality improvement initiatives could significantly enhance the prescription rates of glucagon among patients with diabetes, particularly those experiencing hypoglycemia.

The Importance of Glucagon

Hypoglycemia poses a serious risk for individuals with diabetes, frequently leading to severe complications like organ failure, coma, and even death. The American Diabetes Association (ADA) emphasizes the importance of glucagon, a hormone that can swiftly reverse low blood sugar crises, as an essential treatment for patients deemed at high risk of hypoglycemic events. Despite this, current glucagon prescription rates remain alarmingly low; for instance, only 3% of patients in emergency settings and 30% in outpatient clinics are prescribed glucagon when needed.

Study Findings

Study findings from a collaborative effort led by Cleveland Clinic researchers reveal that engagement with healthcare providers through targeted educational efforts may be an effective strategy to increase glucagon prescriptions. The research team conducted a thorough review of patient histories while also implementing a quality improvement initiative which involved sending informative letters to providers. These letters detailed ADA’s care standards and provided guidance on prescribing glucagon, particularly for patients whose Continuous Glucose Monitors (CGMs) indicated that they spent 4% or more of their time in hypoglycemic ranges.

Patient Cohort

The study focused on a cohort of 1,543 adult diabetes patients being treated at a tertiary care health system in Ohio, with particular attention paid to those who utilized CGMs. Out of this group, 170 exhibited hypoglycemic symptoms—of which 66 had mild hypoglycemia, 88 had moderate, and 16 experienced severe cases. Interestingly, a majority of these patients had either a pre-existing prescription for glucagon or newly initiated prescriptions following the educational outreach.

Provider Engagement

Of the 70 healthcare providers who received the educational letters, a commendable 39% increased their glucagon prescribing practices. Notably, advanced practice providers showed a higher likelihood of prescribing glucagon compared to traditional physicians and clinical pharmacists. The study identified the top glucagon products prescribed as the Glucagon Emergency Kit, Gvoke Hypopen, and Baqsimi.

Future Research

Despite these promising results, the authors stress the need for further research to unpack the factors influencing glucagon prescribing patterns. Previous studies have indicated that education on glucagon usage has reached only 70% to 90% of patients, primarily those with Type 1 diabetes. Therefore, it is critical to extend educational efforts to patients with Type 2 diabetes and those experiencing hypoglycemia to improve prescription rates.

Conclusion

As healthcare providers contemplate strategies to enhance diabetes management, the current research underscores an important public health challenge: ensuring that life-saving medications like glucagon are readily available and prescribed when necessary. Future studies could help unveil deeper insights into prescription practices, ultimately paving the way for better patient outcomes.

Call to Action

Stay informed and advocate for improved healthcare practices—your health depends on it!