# Prediction and Prevention of Hypoglycemia in Veterans with Diabetes

> **NIH VA I01** · EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL · 2020 · —

## Abstract

Control of hyperglycemia to prevent or delay the onset of vascular complications is a fundamental goal
of diabetes care. Intensive treatment is limited, however, by risk of hypoglycemia, a common and potentially
hazardous metabolic complication of glucose-lowering treatment. Traditionally, this risk was considered
unavoidable during treatment but new models of care focus on improving the safety of treatment while
optimizing glycemic control. To monitor for safety and foster better care, work is needed to develop
standardized methods and strategies for performance evaluation.
 The proposed research employs multiple methodologies to address the issue of hypoglycemia and
improved safety of diabetes treatment. For identification of the condition in the Veteran patient population with
diabetes, we propose to analyze national VA and non-VA structured data and claims, measure patient-reported
experience through patient surveys collected from stratified random samples of patients, and develop accurate
and efficient natural language processing (NLP) tools to search documentation in the medical records for
evidence of hypoglycemia. This will include development of a valid case-finding algorithm. These measures
will be combined and compared to obtain a unique and comprehensive evaluation of the condition in the
patient population and to provide practical information on the accuracy and completeness of various methods.
Patients with identified hypoglycemia will be followed forward to evaluate the risks of subsequent adverse
outcomes associated with the condition, including repeat hypoglycemia, preventable hospitalizations, and
death. We will combine all available and relevant information and model hypoglycemia to identify predictors in
the sample of patients who completed the survey and in the whole VA diabetes population, limiting candidate
predictors to factors available from structured medical data or from NLP extractions. We will identify those
factors obtained from surveys or NLP extraction that add substantially to the predictive models. These models
will inform the process of developing parsimonious predictive algorithms for the whole population and in
relevant subgroups. Risk algorithms will include branching to classify patients by contextual factors that are
useful in guiding clinical management. The best practical algorithms will be implemented in an integrated
system for near real-time hypoglycemia case finding and assignment of diabetes patients by predicted
hypoglycemia risks.
 This work will generate methods and tools for monitoring population health and safety among Veterans
with diabetes and for improving care to reduce risks. The near real-time hypoglycemia case-finding and risk
assignment system will be available for use by operations and research as it is implemented. This work could
form the basis for new measures of care quality, providing technologies for risk adjustment, facility and
provider profiling, and practice evaluations. It co...

## Key facts

- **NIH application ID:** 9503930
- **Project number:** 1I01HX002355-01A2
- **Recipient organization:** EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL
- **Principal Investigator:** DONALD R MILLER
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9503930

## Citation

> US National Institutes of Health, RePORTER application 9503930, Prediction and Prevention of Hypoglycemia in Veterans with Diabetes (1I01HX002355-01A2). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9503930. Licensed CC0.

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