General Endocrinology

SUN-836 - Improving Hypoglycemia Preparedness through A Multidisciplinary, EHR-Integrated Program in A Predominantly Hispanic and African American Safety-Net Population

Sunday, June 14, 2026

9:00 AM - 4:00 PM CT

Location: ENDOExpo; Poster Floor

Abstract Poster Presenter(s)

Violetta Florova, MD

Resident
MOUNT SINAI HOSPITAL
Chicago, IL, United States

Co-Author(s)

ES

Emad U. Sajid, MD

Graduate medical doctor and an Internal Medicine match applicant.
DOW UNIVERSITY HOSPITAL
Oklahoma City, Oklahoma, United States
AM

Amulya Murthy, PharmD

Mount Sinai Hospital
Chicago, Illinois, United States
IB

Irene I. Brito, MD

Resident
MOUNT SINAI HOSPITAL
Chicago, Illinois, United States
NS

Nuzhat Shahid, MD

Mt. Sinai Hospital Chicago
Spring Hill, Florida, United States
SB

Shaniece Bond, Medical Student

Ross University School of Medicine
Jackson, Tennessee, United States
Chloe Arima, MD

Fellow
CHICAGO MEDICAL SCHOOL AT ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE
Hinsdale, Illinois, United States
Wajeeha Akhter, MD

Fellow
CHICAGO MEDICAL SCHOOL AT ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE
North Chicago, IL, United States
AH

Andriy Havrylyan, MD

MOUNT SINAI HOSPITAL
Chicago, Illinois, United States

Senior Author/Primary Investigator(s)

MS

Mahwash Fatima Siddiqui, MD

Division Head of Endocrinology & Clinical Associate Professor
MOUNT SINAI HOSPITAL
Chicago, Illinois, United States

Disclosure(s):

Violetta Florova, MD: No financial relationships to disclose

Chloe Arima, MD: No financial relationships to disclose

Wajeeha Akhter, MD: No financial relationships to disclose

Background:
Hispanic and African American patients living with diabetes experience a disproportionate burden of hypoglycemia related to insulin and sulfonylurea use, food insecurity, and limited access to diabetes education. Despite guideline recommendations for structured patient education and rescue glucagon prescribing for patients treated with insulin and/or sulfonylureas, implementation in clinical practice is inadequate. Safety-net health systems face structural barriers to delivering consistent hypoglycemia preparedness interventions. We evaluated the impact of a multidisciplinary, EHR-integrated hypoglycemia preparedness program in an underserved population.

Methods:
We conducted a retrospective pre-post study of high-risk patients with diabetes defined as those treated with insulin and/or sulfonylureas who were seen in an urban safety-net health system during a 3-month baseline period (n=400) and a 3-month post-implementation period (n=467). The intervention integrated endocrinologists, pharmacists, and certified diabetes care and education specialists into a standardized workflow that included: (1) guideline-based hypoglycemia education; (2) EHR-embedded quick order and documentation prompts; (3) rescue glucagon prescribing; and (4) formulary-aligned prior-authorization facilitation. Primary outcomes were documentation of hypoglycemia education and prescribing of rescue glucagon among high-risk patients.

Results:
The cohort was predominantly Hispanic and African American, with similar baseline characteristics between periods. Among high-risk patients, documented hypoglycemia education increased from 36.0% pre-intervention to 88.9% post-intervention (p < 0.001). Rescue glucagon prescribing increased substantially, from 11.5% to 51.8% (p < 0.001).

Conclusions:
In a safety-net population with a high proportion of Hispanic and African American patients, a multidisciplinary, EHR-embedded hypoglycemia preparedness program was associated with substantial improvements in the delivery of patient education and access to rescue glucagon. While causal inference is limited by the pre-post design, these findings support the use of equity-focused, scalable workflows to strengthen hypoglycemia preparedness in underserved settings. This model has potential to reduce disparities in hypoglycemia-related morbidity and warrants evaluation of downstream outcomes, such as impacts on severe hypoglycemia events and emergency department utilization.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*