Validation of a Hypoglycemia Risk Stratification Tool Using Data From Continuous Glucose Monitors

Abstract
The hypoglycemia risk stratification tool1,2 was developed to identify patients with diabetes at high risk of emergency department (ED) visits or hospitalizations due to hypoglycemia using electronic health records only. The 12-month rate of hypoglycemia-related ED visits or hospitalizations among patients at high risk was 6.7%, vs 0.3% for those at low or intermediate risk (C statistic = 0.83).1 This tool also performed well in 2 external validations among 1 350 938 patients with diabetes (C statistic = 0.79 and 0.81).1 Kaiser Permanente Northern California (KPNC) uses this tool to identify patients at high risk (those with ≥3 hypoglycemia-related ED visits or hospitalizations and insulin users with any history of hypoglycemia-related ED visits or hospitalizations). The tool is available as a free online calculator.3 To our knowledge, this tool has not been validated against biochemical hypoglycemia based on continuous glucose monitor (CGM) data.