Underutilization of Glucagon in the Prehospital Setting
Authors: Peter A. Kahn, Nicole E. Wagner, Robert A. Gabbay
Journal: Annals of Internal Medicine (2017)

Letters17 April 2018Underutilization of Glucagon in the Prehospital SettingPeter A. Kahn, MD, MPH, ThM, Nicole E. Wagner, BA, and Robert A. Gabbay, MD, PhDPeter A. Kahn, MD, MPH, ThMYale School of Medicine, New Haven, Connecticut (P.A.K.)Search for more papers by this author, Nicole E. Wagner, BAJoslin Diabetes Center, Boston, Massachusetts (N.E.W.)Search for more papers by this author, and Robert A. Gabbay, MD, PhDJoslin Diabetes Center and Harvard Medical School, Boston, Massachusetts (R.A.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2222 Annals Author Insight Video - Robert A. Gabbay, MD, PhD In this video, Robert A. Gabbay, MD, PhD, offers additional insight into the article, "Underutilization of Glucagon in the Prehospital Setting." SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Patients receiving insulin or certain oral hypoglycemic agents are at increased risk for hypoglycemia, which results in more than 100 000 emergency department visits incurring approximately $120 million in costs annually (1). Although not all of these visits can be prevented, glucagon use could reduce the number and severity of hypoglycemic episodes requiring emergency medical attention and hospitalization. Data from the National EMS Information System's public-release research data sets (2) between 2013 and 2015 and from Medicare Part D (3) claims from 2014 suggest that glucagon is underutilized in the prehospital setting and underprescribed in the outpatient setting. Despite its ...References1. Mitchell BD, He X, Sturdy IM, Cagle AP, Settles JA. Glucagon prescription patterns in patients with either type 1 or 2 diabetes with newly prescribed insulin. Endocr Pract. 2016;22:123-35. [PMID: 26484405] doi:10.4158/EP15831.OR CrossrefMedlineGoogle Scholar2. National EMS Information System. 2017. Accessed at https://nemsis.org on 8 December 2017. Google Scholar3. Centers for Medicare & Medicaid Services. Part D prescriber data for CY 2014. Updated 25 May 2017. Accessed at www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/PartD2014.html on 15 April 2017. Google Scholar4. Centers for Medicare & Medicaid Services. 2014 CMS Statistics. CMS publication no. 03510. Baltimore: Centers for Medicare & Medicaid Services; August 2014. Accessed at www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Statistics-Reference-Booklet/Downloads/CMS_Stats_2014_final.pdf on 10 July 2017. Google Scholar5. Chapman SA. EMS Workforce for the 21st Century. A National Assessment. Washington, DC: National Highway Traffic Safety Administration; 2008. Google Scholar Author, Article, and Disclosure InformationAffiliations: Yale School of Medicine, New Haven, Connecticut (P.A.K.)Joslin Diabetes Center, Boston, Massachusetts (N.E.W.)Joslin Diabetes Center and Harvard Medical School, Boston, Massachusetts (R.A.G.)Note: The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.Financial Support: None.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2222.This article was published at Annals.org on 26 December 2017. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Robert A. Gabbay, MD, PhD In this video, Robert A. Gabbay, MD, PhD, offers additional insight into the article, "Underutilization of Glucagon in the Prehospital Setting." FiguresReferencesRelatedDetailsSee AlsoUnderutilization of Glucagon in the Prehospital Setting Michael E. Mullins , William H. Dribben , and Bridget Svancarek Underutilization of Glucagon in the Prehospital Setting Kimberly Pruett , Chelsea C. White IV , and Darren Braude Underutilization of Glucagon in the Prehospital Setting Robert A. Gabbay , Peter A. Kahn , and Nicole E. Wagner Metrics Cited byEpidemiology and outcomes from severe hypoglycemia in Kuwait: a prospective cohort studyImpact of pharmacist intervention on glucagon prescribing patterns in an outpatient internal medicine teaching clinicHuman factors studies of a prefilled syringe with stable liquid glucagon in a simulated severe hypoglycemia rescue situationUnderutilization of Glucagon in the Prehospital SettingKimberly Pruett, MD, Chelsea C. White IV, MD, NRP, and Darren Braude, MD, EMT-PUnderutilization of Glucagon in the Prehospital SettingMichael E. Mullins, MD, William H. Dribben, MD, and Bridget Svancarek, MD 17 April 2018Volume 168, Issue 8Page: 603-604KeywordsEmergency departmentEmergency medical servicesEmergency medicineGlucagonGlucoseHypoglycemiaHypoglycemicsInformation technologyMedicareOutpatients ePublished: 26 December 2017 Issue Published: 17 April 2018 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...