New recommendations for long-term care — including assisted living — on hypoglycemia treatment protocols are reducing the chances of lengthy hospital stays for residents.
The American Society of Consultant Pharmacists recently released a new hypoglycemia management protocol for assisted living and other long-term care facilities that builds on recent guidance updates from the American Diabetes Association and the Endocrine Society on who should have glucagon, when it should be administered and which glucagon option should be used.
Diabetes is highly prevalent in older adults, with one-fourth of people aged more than 65 having a diagnosis of the disease, and half of older adults having a diagnosis of prediabetes, according to the ADA. Hypoglycemia is the No. 1 side effect for individuals taking insulin. Glucagon helps to prevent blood sugar from dropping to dangerous levels.
Earlier this year, the Endocrine Society and the ADA released recommendations that anyone taking insulin and sulfonylurea and at risk of having a hypoglycemic event should have emergency rescue glucagon available.
The associations also recommended that those individuals should have access to new ready-to-use glucagon that does not require mixing. The new liquid-stable form of glucagon can be stored at room temperature and resembles an Epipen, removing the need to mix a solution, load it into a vial and deliver it via syringe.
That formulation opens the door to assisted living providers to deliver the treatment. Due to state regulations, assisted living staff traditionally did not administer glucagon because it was considered medication delivery, which is outside the scope of practice in most assisted living communities.
The introduction of the ready-to-use glucagon option now opens up access to assisted living residents, who previously relied on emergency medical services for hospital transport and treatment. A 2021 study noted that long-term care residents who had hypoglycemia spent an average of 8 days in the hospital at a cost of $19,800.
The ASCP was the first professional organization to develop hypoglycemia management protocols specifically for assisted living and other long-term care providers in light of this new option.
